The Impact of the COVID-19 Public Health Emergency Expiration on All Types of Health Coverage

In this report, we update our earlier projections of Medicaid enrollment after the expiration of the COVID-19 public health emergency (original report; follow-up report). We also go further to show what would happen to people disenrolling from Medicaid and whether they take up other types of coverage.

We estimate that if the PHE expires in April 2023, 18.0 million people will lose Medicaid coverage in the following 14 months. Of those 18.0 million people,

• About 3.2 million children are estimated to transition from Medicaid to separate Children’s Health Insurance Programs, so total Medicaid and Children’s Health Insurance Program enrollment will decline by 14.8 million people;
• About 3.8 million people will become uninsured;
• About 9.5 million people will either newly enroll in employer-sponsored insurance after losing Medicaid or transition to employer-sponsored insurance as their only source of coverage after being enrolled in both employer-sponsored insurance and Medicaid sometime during the PHE;
• And more than 1 million people will enroll in the nongroup market, most of whom will be eligible for premium tax credits in the Marketplace.

Further extensions of the PHE are possible. If it is extended for an additional 90 days, we estimate that the number of people losing Medicaid will rise to nearly 19 million.

The original report was published by the Urban Institute in September 2021. Following further extensions of the PHE, we published a follow-up report with updated projections in March 2022. In December 2022, we published this third installment. Our findings have been cited by the New York Times, the Washington Post, the LA Times, CNN, NBC News, CBS News, the Associated Press, USA Today, POLITICO, Bloomberg Businessweek, NPR, HuffPost, Forbes, and Axios, among many other media outlets.