An unprecedented number of people has enrolled in Medicaid since the COVID-19 pandemic began, due to the continuous coverage requirement of the Families First Coronavirus Response Act, which has prevented state Medicaid agencies from disenrolling people during the public health emergency (PHE) unless they specifically request it. An increasingly urgent question is what will happen to health coverage after the PHE expires and states resume normal eligibility determinations. Using the latest available administrative data on Medicaid enrollment, recent household survey data on health coverage, and the Urban Institute’s Health Insurance Policy Simulation Model, we estimate health coverage at the expiration of the PHE (when Medicaid enrollment will be at its peak) and after the major coverage transitions that will follow.

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, about 3.2 million children are estimated to transition from Medicaid to separate Children’s Health Insurance Programs, 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.