On January 30, 2023, the Biden Administration announced the end of the COVID-19 public health emergency (PHE) effective May 11th. Though this may seem like the final step towards a post-pandemic world, it is dreadful news for 7 to 15 million people in the U.S. who could lose their health insurance as early as now.

The public health emergency declaration created many benefits especially for those who had no or limited health coverage.

The most important advantage is the federal law called the continuous enrollment requirement that mandated states to stop all Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) eligibility redeterminations. This protected millions from losing their much-needed health coverage during the pandemic. The continuous enrollment requirement expired on March 31, 2023, which will restart Medicaid redeterminations and eligibility checks.Up to 15 million people in the U.S. will lose their health coverage because of this. To make matters worse, almost 6 million people who are actually still eligible for coverage will be dropped due to administrative issues, namely the churning process.

Churning, which is when disenrolled people get re-enrolled, is a costly and time consuming process for administrations and individuals. The end of the PHE will lead to the worst churning phase in U.S. history. Unfortunately, not everyone who is disenrolled will try to re-enrolled again since many people might not even know they have lost their coverage until it is too late.

Marginalized communities will be affected more than others

Just like any health issue today, the consequences of the end of the PHE will disproportionately affect vulnerable communities, such as:

• Children and young adults who benefited from the PHE’s flexible eligibility criteria.
• People who do not have a permanent mailing address.
• Individuals and families who moved during the pandemic.
• Those who did not update their contact information recently.
• People living with disabilities or specific medical needs.
• Individuals with limited English proficiency
• Black, Indigenous, or People of Color.

The vital role of Health Centers & Outreach Workers
After several conversations with health centers and enrollment specialists, health centers are already facing increased pressure as they work hard to alert their vulnerable populations particularly children and post-partum women. Health centers all around the nation will face the brunt of the burden, as they directly work with affected people. In fact, almost half of patients who go to health centers rely on public assistance programs such as Medicaid.

The good news is, there are ways to minimize the issue, and it all lies within the hands of health center staff.

To be better prepared, health centers are encouraged to:

• Increase outreach and enrollment staffing and efforts.
• Begin unwinding the PHE-related policies and procedures.
• Train outreach workers how to address the coming pressure.

Outreach workers are the key

Outreach workers are a health centers’ first point of contact with impacted communities. They are the best at understanding their community’s strengths, weaknesses, interests and concerns. When properly prepared and equipped, they can optimize the connection between community members and enrollment specialists.

To reduce the number of people losing their health coverage, outreach workers should:

• Warn their community about coming changes.
• Encourage people to update their contact information, look out for renewal notices, and renew coverage on time.
• Check with individuals who are uninsured to see if they (or a family member) are eligible for Medicaid, CHIP, or State Marketplace.
• Remind folks about available services like filling out applications and solving issues such as missed deadlines, denials, or lost renewal notices.

May 11th is fast approaching, and many states have already started their redeterminations. Health centers must act swiftly in order to help millions of people all over the nation maintain their health coverage during this difficult time.

By Nadeen Mikhael, Associate Project Manager – Intern, for HOP’s series of monthly staff blogs.