Medicaid Unwinding Is Still Affecting Millions — Here's What to Do Next

If you lost Medicaid coverage in the past year or are unsure whether your household is still enrolled, you are not alone. The Medicaid unwinding process — the nationwide redetermination effort that began in April 2023 after the end of pandemic-era continuous enrollment protections — has resulted in tens of millions of coverage terminations across the country, according to tracking data from KFF (Kaiser Family Foundation). A significant share of those terminations were procedural, meaning people were dropped not because they were ineligible, but because paperwork was not completed or contact information was outdated. Understanding what happened, what programs may still be available to you, and where to apply is the most important step you can take right now.

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What Was the Medicaid Unwinding?

During the COVID-19 public health emergency, the federal government required states to maintain continuous Medicaid enrollment — meaning states could not disenroll anyone, even if their income or circumstances changed. This protection ended in March 2023, and states were given up to 14 months to work through a backlog of eligibility redeterminations.

The result was a massive, state-by-state review process. KFF's Medicaid Enrollment and Unwinding Tracker has documented that:

  • Disenrollment rates varied widely by state, with some states terminating coverage at far higher rates than others.
  • A large proportion of terminations were procedural — meaning the state could not reach the enrollee, not that the person was found ineligible.
  • Children and working-age adults were among the most affected groups.

If you received a notice that your Medicaid coverage was ending, or if you discovered your coverage lapsed when you tried to use it, the first step is to find out why — and whether you can re-enroll.

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Who May Still Be Eligible for Medicaid

Income Thresholds Under ACA Expansion

In the 40 states (plus Washington, D.C.) that have adopted Medicaid expansion under the Affordable Care Act, adults may be eligible if household income is at or below 138% of the Federal Poverty Level (FPL). This threshold applies regardless of whether you have children in the household.

In the remaining non-expansion states, eligibility for adults without dependent children is often extremely limited or unavailable. In those states, adults may need to look at ACA Marketplace options instead (see below).

Children and CHIP

The Children's Health Insurance Program (CHIP) covers children in families with incomes too high for Medicaid but generally up to 200%–300% of FPL, depending on the state. Some states have set CHIP thresholds even higher. If your child lost Medicaid coverage during unwinding, they may still be eligible for CHIP — and in many states, CHIP enrollment is open year-round.

Pregnant Individuals

Many states have extended Medicaid eligibility for pregnancy-related coverage up to 200% of FPL or higher, and postpartum coverage has been extended to 12 months in most states under recent federal policy changes.

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How to Check Your Eligibility and Re-Enroll

Step 1: Contact Your State Medicaid Agency Directly

Every state has a Medicaid agency that handles enrollment. If you received a termination notice, that notice should include a reason code and instructions for appealing or reapplying. You generally have 90 days to request a fair hearing after a termination notice.

Step 2: Gather Required Documents

When reapplying, you will typically need: - Proof of identity (government-issued ID or birth certificate) - Proof of state residency (utility bill, lease agreement) - Proof of income (recent pay stubs, tax returns, or a self-attestation form if income is irregular) - Social Security numbers for all household members applying - Immigration documentation, if applicable

Step 3: Apply Through HealthCare.gov or Your State Marketplace

If you apply through HealthCare.gov or your state's marketplace, the system will automatically screen you for Medicaid and CHIP eligibility before routing you to a Marketplace plan. This is often the fastest way to determine which program may be available to you.

Step 4: Work With a Navigator or Enrollment Assister

Free, certified enrollment assisters — called Navigators — are available in every state. They can help you complete applications, gather documents, and appeal wrongful terminations at no cost to you. Find one at localhelp.healthcare.gov.

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If You No Longer Qualify for Medicaid: Other Programs That May Be Available

ACA Marketplace Plans With Premium Tax Credits

If your income is above 138% of FPL (or you live in a non-expansion state and fall in the coverage gap), you may be eligible for subsidized coverage through the ACA Marketplace. Households with incomes between 100% and 400% of FPL — and in some cases above that threshold — may qualify for premium tax credits that significantly reduce monthly costs.

Open Enrollment for ACA Marketplace plans typically runs from November 1 through January 15 in most states. However, losing Medicaid coverage qualifies as a Special Enrollment Period (SEP), giving you 60 days from the date of coverage loss to enroll in a Marketplace plan.

Federally Qualified Health Centers (FQHCs)

If you are uninsured and cannot afford any coverage, Federally Qualified Health Centers (FQHCs) — also called community health centers — provide primary care, dental, mental health, and prescription services on a sliding-fee scale based on income. There are over 1,400 FQHC organizations operating more than 14,000 service delivery sites nationwide. You do not need insurance to be seen. Find the nearest location at findahealthcenter.hrsa.gov.

Prescription Assistance Programs

If you lost coverage and cannot afford medications, the Extra Help program (also called the Low Income Subsidy) through Medicare Part D may help eligible individuals with prescription costs. Additionally, most major pharmaceutical manufacturers operate Patient Assistance Programs (PAPs) that provide free or reduced-cost medications to uninsured or underinsured patients. The NeedyMeds database at needymeds.org is a free resource for locating these programs.

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A Note on State-by-State Variation

Medicaid eligibility rules, income thresholds, covered services, and re-enrollment procedures differ significantly from state to state. What applies in California may not apply in Texas. The KFF Medicaid Unwinding Tracker is one of the most reliable public resources for understanding how your specific state has handled redeterminations and what the current enrollment landscape looks like.

Program eligibility and availability vary by state. Not affiliated with any government agency.

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People Also Ask

Can I reapply for Medicaid after being disenrolled during unwinding? Yes. In most states, Medicaid enrollment is open year-round. If you were disenrolled, you can reapply at any time through your state Medicaid agency or HealthCare.gov. If you believe you were wrongly terminated, you have the right to request a fair hearing, typically within 90 days of your termination notice.

What income level makes someone eligible for Medicaid? In the 40 Medicaid expansion states plus D.C., adults may be eligible at or below 138% of the Federal Poverty Level. Non-expansion states have much more restrictive rules, often limiting adult eligibility to parents with very low incomes. Children may qualify through CHIP at higher income thresholds, often 200%–300% of FPL or more.

What is a Special Enrollment Period for ACA coverage? A Special Enrollment Period (SEP) allows you to enroll in an ACA Marketplace health plan outside of the standard Open Enrollment window. Losing Medicaid or CHIP coverage qualifies as a life event that triggers a 60-day SEP. You must enroll within 60 days of losing coverage to use this window.

Are there free clinics for people who lost Medicaid and can't afford insurance? Federally Qualified Health Centers (FQHCs) provide care on a sliding-fee scale regardless of insurance status. Services often include primary care, dental, behavioral health, and prescriptions. There are over 14,000 FQHC service sites nationwide. Use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to locate one near you.

What documents do I need to reapply for Medicaid? Typically: a government-issued photo ID, proof of state residency (such as a utility bill or lease), proof of income (pay stubs, tax returns, or self-attestation), Social Security numbers for all applying household members, and immigration documents if applicable. Requirements vary by state, so check with your state Medicaid agency for the exact list.

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Last reviewed: April 2026