Congress’ public health emergency order to keep people automatically enrolled in Medicaid expired on April 1. Nationwide, states have to figure out who is still eligible for coverage. But health advocates warn that the “unwinding” process could disproportionately impact millions of children of color.  

For the most part, pre-COVID you’d apply for Medicaid coverage based on your income and those who were ineligible usually had the Affordable Care Act (ACA) to fall back on, especially children, people of color and people with disabilities. During the pandemic the order stated that no one could be kicked off while the emergency was ongoing. 

Last December, Congress passed the Consolidated Appropriations Act, which significantly changed enrollment requirements for several healthcare programs. Now that the emergency is over, the unwind is required to be completed within 14 months and will likely be completed by May 2024. 

About 91.8 million people were enrolled in the healthcare program last year, and as of December 2022, New York’s total Medicaid/Children’s Health Insurance Program (CHIP) enrollment was 7,346,992. 

Over half of all CHIP recipients in the U.S. are Black, Latino, or live in rural areas. About 7 million children are expected to lose coverage, said the Protect Our Care organization.

“Clearly what it’s shown is how critical Medicaid is for so many people,” said Protect Our Care Chair Leslie Dach about the pandemic. “People purposely try to mischaracterize the people who rely on Medicaid.”

The org (Protect Our Care) predicts that states may disenroll people from Medicaid because of income changes, language barriers, lack of support and communication from the state, confusing renewal notices, and procedural errors. Children of color are more likely to experience churn or gaps in coverage than their white counterparts, due to parents of color being more likely to work low-wage jobs that are less likely to offer coverage, said the org.

Dach said that the safety net that is the ACA really depends on whether the Republican majority in Congress succeeds in taking trillions out of the Obama-era healthcare program.

“It’s in a more secure place because it’s become part of the fabric of America,” said Dach, “but there are still Republican members of the House in particular who have made it their sworn stated objective to repeal the Affordable Care Act or take away a lot of its parts.”

He said that states absolutely have to do persistent outreach to communities to make sure people are covered. So far states that haven’t expanded coverage include Texas, Florida, Alabama, South Carolina, Mississippi, Georgia, Wyoming, Wisconsin, Kansas, and Tennessee. 

“NY State of Health has over 100 assistor agencies serving New York County, prioritizing New Yorkers who are uninsured, communities of color, and hard-to-reach populations. These include Navigator agencies, health plans, hospitals, health care providers, federally qualified health centers (FQHCs) and other community-based organizations,” said the New York State (NYS) Medicaid office. 

NYS offered Medicaid, Child Health Plus, and the essential plan as the Public Health Emergency (PHE) order. The state said it was not “required to pause renewals” for Child Health Plus or the essential plan, but elected to do so during the PHE to ease the burden on customers during the COVID-19 pandemic. They are resuming the eligibility determining process in phases working community partners in local districts to inform people that they need to reapply.

The state said that several navigator agencies have sites in Harlem, such as the Harlem YMCA, where people can get help with the application and renewal process.

“The end of the public health emergency does not mean a downshift in public health,” said NYS Medicaid Director Amir Bassiri in a statement. “It is our top priority to reinstate eligibility reviews in a way that retains coverage for as many enrollees as possible and limits coverage gaps, particularly for vulnerable populations dependent on services. It is the right of every New Yorker to have access to insurance, and we remain committed to keeping this right intact.” Additionally, the state has requested waiver options for individuals with disabilities and the elderly 65 and up, and proposed an expansion of its basic health plan through a 1332 Waiver.

NYS will send out renewal notices this Spring 2023 on a rolling basis and renewal deadlines will be based on the enrollees’ enrollment end dates. Those dates range from June 30, 2023, through May 31, 2024. 

For more info on NYS Medicaid coverage, check out NY State of Health and the Department of Health website. Or call 1-855-355-5777.   

Ariama C. Long is a Report for America corps member and writes about politics for the Amsterdam News. Your donation to match our RFA grant helps keep her writing stories like this one; please consider making a tax-deductible gift of any amount today by visiting

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