In this report, we update our earlier projections of Medicaid enrollment after the expiration of the COVID-19 public health emergency (original report; follow-up report). We also go further to show what would happen to people disenrolling from Medicaid and whether they take up other types of coverage. 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 18.

This report examines the cost and coverage effects of lowering the age of Medicare eligibility from 65 to 60. We show that there would be improvements in health insurance coverage for most people ages 60-64, though these coverage gains would differ by enrollees’ income and current coverage. There would be a modest drop in the number of uninsured, and the remaining uninsured would now have access to Part A coverage for hospital expenses.

The American Rescue Plan Act of 2021 increased premium tax credits (PTCs) for Marketplace coverage and extended eligibility for those credits to people with incomes above 400 percent of the federal poverty level (FPL). Consequently, Marketplace enrollment reached a record high during the 2022 open enrollment period. However, these enhancements are set to expire after 2022. Without extension, Marketplace enrollment will most likely fall and the number of people uninsured will increase.