Insurance Coverage Among Working-Age U.S. Adults After the End of the Medicaid Continuous Enrollment Provision

Background:The continuous enrollment provision, a pandemic-era policy that prevented states from disenrolling persons from Medicaid, helped reduce the uninsured rate among working-age adults to a record low of 9.6% in 2022 (1).This provision expired on 31 March 2023, allowing states to disenroll Medicaid beneficiaries who no longer met eligibility criteria or did not complete the required paperwork.Although this "unwinding" directly affected Medicaid beneficiaries, it may have influenced broader insurance coverage patterns among working-age adults.Those who lost Medicaid coverage may have remained uninsured, reenrolled later, or transitioned to other plans (for example, Marketplace or employer sponsored).Administrative barriers from unwinding-related processes may have affected those newly seeking Medicaid coverage.In addition, policies aimed at mitigating unwinding-related insurance loss-such as enhanced Marketplace subsidies and extended enrollment-could have had spillover effects on non-Medicaid populations.