Feds Extend Marketplace Special Enrollment Amid Medicaid Unwinding
By Emma Freer

Texas patients who have been disenrolled from Medicaid in the wake of the COVID-19 public health emergency now have more time to find alternative coverage on the federal marketplace. The extension could mitigate a coverage cliff about which the Texas Medical Association has long raised concerns.   

The Centers for Medicare & Medicaid Services (CMS) recently extended the temporary special enrollment period for federal marketplace health plans from July 31 to Nov. 30. The policy change is part of a broader effort to smooth the unwinding of continuous Medicaid coverage.  

“This extension will be crucial to ensuring people remain covered, including in states that have given people additional time to renew their coverage, as CMS has recommended, to help eligible people stay enrolled,” the federal agency wrote in a March 28 press release

Federal pandemic relief legislation allowed for continuous Medicaid enrollment, but the perk ended along with the COVID-19 public health emergency in May 2023. Around that time, Texas, like other states, began the unwinding by reverifying the eligibility of all Medicaid enrollees – nearly 6 million people.  

As of March, Texas Medicaid had disenrolled nearly 2.1 million people, more than any other state, according to the Kaiser Family Foundation. (Enter Texas for state data.) The majority – about 67% or 1.4 million – lost coverage for procedural reasons, such as technical barriers and address changes, and many may remain eligible for coverage.  

Texas physicians worry about the high number of disenrollees – 64% of whom are children – and the risks of coverage gaps for patients and the physicians who care for them. 

“When children lose their Medicaid, if they have conditions that require ongoing medication treatment or therapies or specialty care, then there’s a burden on the [clinician] to revise the treatment plans,” Austin pediatrician Louis Appel, MD, told Texas Medicine in late 2023. 

To augment efforts like the CMS extension, TMA continues to work closely with the Texas Health and Human Services Commission to consider interventions that might reduce the share of disenrollments that occur because of red tape.  

More recently, CMS issued new guidance for states about the unwinding that reinforces federal renewal requirements and for Medicaid managed care plans regarding renewals, among other resources. 

For more information about the end of the public health emergency, including the unwinding, check out TMA’s Ask the Expert: End of the Public Health Emergency CME.  


Last Updated On

April 19, 2024

Originally Published On

April 19, 2024

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Emma Freer

Associate Editor

(512) 370-1383

Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

More stories by Emma Freer