California is experiencing a major shift in the healthcare industry since COVID-19 ended. More than 850,000 Californians now lack public health coverage.
This decline is primarily attributed to the nationwide Medicaid “unwinding” process – also referred to as disenrollment – which began in 2023. KFF is a health policy non-profit that focuses on research. According to their data, the enrollment of California’s Medicaid and Children’s Health Insurance Programs (CHIPs) decreased between October 2024 and approximately 14,3 million.
Why enrollment change is important
California has a disenrollment of 6%, which is lower than the other large states such as Florida and Texas. But it still poses a major concern for its nearly 1 million residents who will be denied healthcare. KFF’s research indicates that California’s overall disenrollment rate – those who were disenrolled and unable to renew – stands at 19%, below the national average of 31%. But further analysis revealed that most disenrollments were not caused by ineligibility. Instead, they stemmed from confusion about the unwinding of policies, inadequate state communication and bureaucratic obstacles in renewing them.
Learn about the expiration of continuous enrollment
Families First Coronavirus Response Act enacted at the beginning of 2020 included a provision for “continuous registration”. This provision prevents states from canceling Medicaid or CHIP coverage of individuals during the COVID-19 emergency. This provision prevented states from terminating Medicaid and CHIP coverage for individuals throughout the COVID-19 public health emergency.
KFF’s surveys, conducted following the discontinuation of the continuous enrollment period, revealed that there was widespread confusion as to the consequences. Many people did not know that they needed to renew their insurance coverage. They also experienced administrative errors and delays.
The differences in the disenrollment rate across states can be attributed to several factors. Some states like Pennsylvania expedited the disenrollment process by marking enrollees “likely eligible” in order to speed up the process. California on the contrary implemented automatic renewal initiatives.Ex parteTo mitigate any procedural hurdles and to ensure that eligible people are covered.
California, therefore, has lost approximately 850,000 people who were enrolled in the public insurance program since March 20, 2023. This figure, however, is still lower than what was initially projected. Additionally, Medicaid and CHIP are still 1.8 million (16%) above pre-pandemic enrollment levels of February 2020.
Expert perspectives on Medicaid Unwinding
Ben Anderson, Families USA Deputy Senior Health Policy DirectorIn September, KFF Health News reported that a consumer advocate group focusing on healthcare had said: “We’ve seen coverage expand in Oregon and California.” Since the pandemic, your state-mandated health insurance has been disrupted, even if it was preventable.
Medicaid Enrollment in the Future
KFF reports that the Medicaid dewinding is nearly complete. Some states may be still determining eligibility, but the large enrollment shifts seem to have stabilized. Experts and advocates in health care policy will monitor and analyze the impact of long-term changes on access to healthcare for Californians and Americans, and especially vulnerable groups. In order to ensure continued affordable healthcare, it is important to understand the complexity of Medicaid eligibility and redetermination procedures, as well as potential barriers.