A provision in a 2020 coronavirus relief package prohibited states from kicking anyone off of Medicaid, regardless of eligibility.

That limitation was set to expire at the end of the public health emergency, but lawmakers changed the deadline to April 1 as part of the 2023 government funding bill. 

The Biden administration is giving states a year to go through the once-routine process of sorting through Medicaid rolls, though some are moving much faster. 

According to government data, five states — Arizona, Arkansas, Idaho, New Hampshire and South Dakota — are beginning this month. 
Arkansas will speed through the redetermination process in only six months, citing cost concerns and the goal of Gov. Sarah Huckabee Sanders (R) to push people to “escape the trap of government dependency.” 

The Biden administration estimates as many as 15 million people could be at risk of losing Medicaid during the process, though many of those people will be able to transition to employer-sponsored coverage or get insurance through a subsidized Affordable Care Act plan. 

But whether people know about other options will often depend on how much their state is publicizing them. 

And in some cases, even people who are still eligible for Medicaid will get removed— health officials estimate nearly 7 million people will lose coverage because of administrative barriers like lost or incomplete paperwork.

States have historically struggled to track down Medicaid beneficiaries. People change addresses frequently, some die, some don’t have phones. Experts have said states need to make sure they have correct databases to ensure as few people as possible fall through the cracks. 

“It’s a shame,” said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation. “During the pandemic we took down some of our longstanding barriers to getting people covered and keeping them covered and we got to an all time low in the uninsured rate. And now we’re re-erecting those barriers.”