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What is the Medicaid Unwinding?


At the start of the COVID-19 pandemic, Congress enacted the Families First Coronavirus Response Act (FFCRA). This ensured that people would have access to continuous health coverage through Medicaid and CHIP, even if their eligibility changed. 

This resulted in 19.8 million people - a 27.9% increase - enrolling in Medicaid since February 2020.

Congress put an end to the continuous enrollment provision, and this will take effect on March 31, 2023. Those currently on Medicaid will automatically be put through a state-run process to redetermine their eligibility to remain on Medicaid.

Who is affected?

According to the Centers for Medicaid Services (CMS) it is estimated that approximately 7-9 million people will lose Medicaid coverage during the unwinding period. States have 12 months to complete their redetermination for all enrollees starting by April 1st.

If someone is determined to be ineligible for re-enrollment with Medicaid, they have the following options for finding coverage: Marketplace coverage, Employer coverage, or the Family Glitch.

Marketplace Coverage: Millions of those denied reacceptance for Medicaid coverage will qualify for an APTC to obtain affordable coverage through the marketplace. 

Those who are ineligible to return to Medicaid are eligible for a Special Enrollment Period (SEP)  to enroll in marketplace coverage. 

The marketplace has created a unique SEP for those losing Medicaid that runs from March 31st, 2023 all the way to July 31st, 2024.

Once consumers attest they are losing Medicaid coverage and select a plan, their marketplace coverage will begin on the first day of the following month.

Employer Coverage: If someone is offered affordable insurance through their workplace, they themselves are not eligible for an APTC.

Family Glitch: Before recent changes, a family’s eligibility for subsidized health plans was determined by the affordability of the employee’s health plan cost—regardless of the cost of a family plan.

Regulations for this were changed for the 2023 Open Enrollment Period to allow more access to federally-subsidized healthcare for families with high-premium employer plans. 

The new regulations allow an employee’s family to be enrolled in a subsidized marketplace plan when the employer-sponsored family plan costs more than 9.12% of the gross household income.

Visit for a no-cost affordability calculator and training on how to utilize the family glitch.

How to Maximize The Opportunity

If you’re an agent who already works with ACA, this is the time to increase your marketing! 

  • Make sure you’re utilizing ‘Help On-Demand’ through the marketplace
  • Cultivate referral partnerships 
  • Send out informational material to your clients and prospects about the changes taking place
  • Order leads from vendors with proven results

If you’re an agent who isn’t writing much ACA business or feel you could use more help to maximize the opportunity, now is the time to connect! Not sure where to start? Compass can help. Some benefits of partnering with Compass:

  • Street level commissions
  • Proprietary software to quote, automate presentations, calculate APTC, cross-sell products, and automate client follow up
  • Lead Navigator exclusive lead platform
  • Weekly training specifically on ACA and compliance
  • New agent training to get you started quickly
  • Marketing team to help you achieve your goals and outline your prospecting gameplan 
  • Along with much more

If you’re a P&C agent not doing health, you’re missing out on a lot of business! Compass has a P&C program with three different pathways to help you incorporate health into your business.

  1. Referral partnership - have a trusted referral partner to send your clients to. You’ll have access to a custom landing page to submit information securely, receive weekly updates on your clients, and generate passive income for each referral sent over. All while having peace of mind that your reputation is being protected.
  2. Get contracted to start selling health - Compass has helped numerous P&C agencies incorporate health into their business. They’ve seen increased client retention and additional revenue streams. Some now are even doing more health than they are P&C.
  3. We can place a Compass agent in your office- this is a great way to ensure that your clients have all their insurance needs taken care of in-house. You’ll receive overrides on all health policies written.

Whatever your situation, Compass can help you maximize this opportunity!  Visit for more information

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