July 25, 2022

Resources for Impacts to Medicare and CHIP

Now that the public health emergency surrounding COVID-19 has expired, states will require eligibility renewals for most receiving Medicaid and Children’s Health Insurance Program (CHIP) for the first time since March 2020.

Given that significant time may have elapsed since families were last required to renew, the Assistant Secretary for Children and Families issued a Dear Colleague letter in May explaining what the eligibility renewal means for Medicaid and CHIP enrollment and how to help families in danger of losing health care coverage. This situation impacts both families and child care providers and requires each group to take specific and targeted steps in order to prevent the loss of benefits.


In order to assist families during the effects of the COVID-19 pandemic, the U.S. Department of Health and Human Services (HHS) issued a Public Health Emergency declaration (PHE), which offered flexibility and additional resources for families struggling during the pandemic. Since the PHE has expired this month, the flexibilities and waivers surrounding it have also dissipated, the most pressing of which requires the need to renew Medicaid and CHIP benefits.

Impacts to Benefits

At the beginning of the pandemic, HHS took steps to prevent ineligible recipients of Medicare and CHIP from losing benefits. This sharply increased enrollment from 16 million beneficiaries to over 70 million. Now that these steps have expired with the PHE, families required to renew their benefits. Since renewals have not taken place since 2020, the most proactive step that families can take to prevent their loss of benefits are:

  • Updating their contact information with state Medicaid program or CHIP
  • Checking their mail for a renewal form while completing and submitting the form in a timely manner.

Assistance with these key messages is available in a Medicaid and CHIP Continuous Enrollment Unwinding — Toolkit in English (PDF) and a toolkit in Spanish (PDF).

Additionally, there are key steps that child care providers can take to share this information with their families:

  • Train all front-line staff and ensure they are knowledgeable on steps families can take to renew their health care coverage.
  • Share key information on Medicaid and CHIP renewal as part of their application intake or renewal process for other programs.
    • States may use information from other programs like Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) to verify eligibility and facilitate renewals, though some actions will require a state plan amendment.
    • CMS encourages states to set a renewal schedule that spreads renewal volume over a full 12-month period and aligns renewal dates for individuals within households and with recertification timing for the SNAP and other human services programs.
  • Promote Medicaid and CHIP renewal on their websites, social media channels, and in physical offices. Medicaid Unwinding Toolkit graphics are available in English and Spanish.
  • Ensure that families know if they are no longer eligible for Medicaid and CHIP, they may be eligible for the Health Insurance Marketplace.  Direct them to or help them visit Visit disclaimer page, or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to get details about Marketplace coverage.
Caregiver playing with an infant in a child care