March 13, 2023

Millions of households face a hunger cliff now that the Supplemental Nutrition Assistance Program’s Emergency Allotments have ended. Many of these same households may also be at risk of losing health insurance coverage as the Medicaid continuous coverage provision ends on March 31, exacerbating hardships for household health, food security, and economic security.

The single most important action that anti-hunger stakeholders can take now is to make sure that households have provided updated contact information to the state agency administering Medicaid.


What Anti-Hunger Advocates Need to Know 


As part of the Families First Coronavirus Response Act in March 2020, Congress included a requirement that states provide continuous enrollment for most Medicaid enrollees, in exchange for enhanced federal funding. This provision not only proved effective in curtailing Medicaid churning — where people move off of and on coverage in a short period of time due to changes in circumstance — but also in providing continuous health care coverage to tens of millions of people during the COVID-19 health and economic crisis.

Medicaid/CHIP enrollment grew from 71.1 million in February 2020 to 91.3 million in October 2022, an increase of 20.2 million (28.5 percent), in large part due to the continuous coverage requirement in Medicaid.

Under the Families First Act, the end of the continuous coverage provision was tied to the end of the federal COVID-19 Public Health Emergency (PHE). Congress, however, passed legislation to end continuous coverage prematurely, setting off an unwinding period. During the unwinding of the continuous coverage, states will begin the challenging process of initiating and completing redeterminations for millions of Medicaid enrollees within a 14-month period (though states are allowed to take less time to complete this process).

Impact on Households

The unwinding of continuous coverage means that 6.8 million people, including 3.8 million children, could lose coverage despite being eligible for Medicaid, due to procedural disenrollments, where individuals lose coverage for administrative reasons rather than being determined ineligible. For instance:

  • People may not receive their redetermination forms because they moved during the PHE and did not update their contact information.
  • Other people may face language barriers or have a disability that poses unique challenges to submitting forms and may lose coverage as a result.
  • Others will lose access because they are no longer income-eligible for the program and will have challenges accessing alternative health care.

Without adequate health insurance, people may forgo or postpone medical treatment or rack up medical debt, placing a strain on household financial stability and leaving less money available for food. Losing Medicaid could also have a spillover effect, making it more challenging for families to access nutrition programs, since participating in Medicaid confers income eligibility for other nutrition programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children, and in a growing number of states, free school meals.

Take Action Today

As states begin the process of Medicaid redeterminations, it is incumbent that anti-hunger organizations support efforts to ensure that households who are still eligible for Medicaid maintain their coverage.

In Food Research & Action Center’s (FRAC) webinar, Opportunities to Help Mitigate the Hunger Cliff Through Health Care and Economic Security Programs, Allie Gardner from the Georgetown University Center for Children and Families shared the three key unwinding messages from Centers for Medicare & Medicaid Services that anti-hunger stakeholders can share to prepare individuals for the upcoming changes.

Spread the word to Medicaid households in your community that they should:

  • Update contact information: Update your contact information. This includes mailing address, phone number, and email.
  • Check your mail: Your state Medicaid office will mail you a letter and let you know if you need to complete a renewal form.
  • Return the renewal: If you receive a renewal, fill out the form and return it right away to avoid a gap in your Medicaid or CHIP coverage.

Anti-hunger advocates can locate state-specific outreach materials for clients on the Medicaid unwinding by connecting with their state agency that administers Medicaid, and community-based health care and health access organization. Advocates may also find their state’s unwinding communication materials on Georgetown University Center for Children and Families 50-State Unwinding Tracker.

For more on the Medicaid unwinding and actions to take: