Medicaid, the nation’s largest health insurance program, currently provides essential coverage to over 83 million Americans, offering free or low-cost healthcare to those who need it most. However, the program faces significant challenges as pandemic-era continuous coverage protections have recently ended—a process often referred to as “the great unwinding.” This shift has led to approximately 23 million people, including 3 million children, either losing or at risk of losing their Medicaid coverage. Alarmingly, 69% of those disenrolled did not lose coverage due to ineligibility but rather because of paperwork and procedural issues.
Medicaid plays a crucial role in advancing health equity, serving as a vital safety net for low-income individuals, children, pregnant women, the elderly, and people with disabilities. Expanding Medicaid to close the coverage gap is one of the most effective strategies for states to increase insurance coverage rates and promote health equity—particularly in the wake of the unwinding. Yet, ten states, primarily in the South, continue to refuse Medicaid expansion under the Affordable Care Act (ACA), exacerbating health disparities in some of the nation’s most vulnerable regions.
A recent Ethnic Media Services (EMS) briefing brought together experts to address the urgency of strengthening Medicaid and expanding coverage to ensure equitable access to healthcare for all. The panel included Katherine Hempstead, Senior Policy Adviser at the Robert Wood Johnson Foundation; Stan Dorn, Director of the Health Policy Project at UnidosUS; Martha Sanchez, Health Policy and Advocacy Director at Young Invincibles; and Joan Alker, Executive Director and Co-Founder of the Center for Children and Families at Georgetown University.
The panelists underscored that Medicaid is more than just a government program; it is a lifeline for millions of Americans. They called for immediate action to address the coverage gap, particularly in states that have yet to expand Medicaid. These states suffer from some of the worst health inequities in the country, leaving millions—especially communities of color—without access to affordable healthcare.
Moreover, the experts highlighted the need for federal and state policymakers to streamline Medicaid’s administrative processes to prevent unnecessary disenrollments. They emphasized that eligible individuals should not lose coverage due to bureaucratic hurdles. Expanding Medicaid, they argued, is not just a policy decision but a moral imperative to ensure every American has access to the healthcare they need.
As the nation grapples with the aftermath of the pandemic and the ongoing “great unwinding,” the future of Medicaid remains a critical issue. Decisions made now will have long-lasting impacts on the health and well-being of millions of Americans, particularly those in underserved communities. The call to action is clear: States must act to close the coverage gap and strengthen Medicaid to ensure equitable healthcare for all.
Martha Sanchez, Director of Healthcare Policy and Advocacy at Young Invincibles, delivered a compelling presentation on the essential role her organization—affectionately known as “Y”—plays in advocating for healthcare, education, and workforce opportunities for young adults aged 18 to 34. Founded in 2009 during the drafting of the Affordable Care Act (ACA), Young Invincibles has been at the forefront of ensuring that young adults have access to affordable and quality healthcare.
Sanchez emphasized the critical importance of healthcare access for young people, especially as they transition out of Medicaid due to aging out or changes in their life circumstances, such as attending college or moving out of state. Despite the perception of youth invincibility, Sanchez pointed out that many young adults suffer from chronic conditions, and mental health issues have surged, particularly since the COVID-19 pandemic. She noted that young adults remain the highest uninsured population, with many falling into the Medicaid coverage gap.
To address these challenges, Young Invincibles is committed to increasing health literacy among young people, helping them navigate their options, retain Medicaid if eligible, and understand the importance of renewing coverage. Sanchez also advocated for policy improvements, such as Medicaid expansion and better communication of benefits to young adults, particularly regarding mental health resources.
Through their work, Young Invincibles aims to ensure that young adults, including those from low-income and immigrant backgrounds, have the tools and knowledge needed to access the healthcare they require. Sanchez’s advocacy underscores the importance of maintaining and expanding healthcare coverage for young adults—not just for their well-being but for the future of the U.S. workforce and economy.
Stan Dorn, who leads the health policy team at UnidosUS, focused on the significant impact of Medicaid “unwinding” on communities of color. Although exact numbers on race and ethnicity are not fully available, initial estimates indicate that communities of color have disproportionately suffered from the reduction in Medicaid coverage. Latino and African American populations, in particular, have seen millions lose coverage, primarily due to administrative issues rather than eligibility concerns.
Dorn highlighted that most terminations were due to paperwork and administrative hurdles, with less than a third of those affected actually being ineligible for Medicaid. He stressed the need to eliminate these administrative burdens by streamlining processes and improving support for families navigating the system. He also pointed out stark differences in Medicaid coverage loss between states, suggesting that federal standards and incentives are needed to encourage states to maintain higher levels of Medicaid coverage, especially for children. Dorn concluded by advocating for continuous coverage policies and better federal oversight to ensure states meet their obligations to provide equitable healthcare access.
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