Policy changes are impacting children and families enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The Academy is advocating to ensure children do not inappropriately lose coverage or experience disruptions in care. Use the information on this page to navigate this process, communicate changes to families, and help with advocacy.

Share this video from the AAP that explains how families can obtain coverage for their children.

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A policy that kept individuals continuously enrolled in Medicaid during the COVID-19 public health emergency (PHE) ended on March 31, 2023.

During the period of April 1, 2023 through July 31, 2024, states must check whether every person currently enrolled in Medicaid is still eligible, then either renew or terminate that person’s coverage. Those families who are no longer eligible for Medicaid may lose their coverage and/or be moved to other forms of coverage, like CHIP or the marketplace. This process of redetermining the eligibility of all 90 million Americans enrolled in Medicaid is being called the “unwinding.”

Forty-two million children – more than half of all kids in the US -- are covered by Medicaid and CHIP. Ensuring children do not inappropriately lose their health care coverage is critical to supporting their health and wellbeing. To help make this possible, states, pediatricians, and families must proactive steps – and AAP is here to offer support.


Practice Resources

The AAP has a suite of resources to help members, patients, and families understand and navigate the Medicaid Unwinding. Below you will find practice resources to help AAP members communicate on the Medicaid Unwinding with patients and families, advocacy resources to help AAP chapters prevent children from losing affordable health care coverage, and practice guidance to help pediatric practices through the Unwinding period.

Medicaid Unwinding: What Pediatric Practices Need to Know

Information for pediatric practices on the Medicaid Unwinding.

Pediatric Practice Template Letter to Families

A template letter practices can customize with state-specific information and send to families on the Unwinding.

AAP Unwinding Overview

A slide deck providing background and an updated overview of the Unwinding.

Unwinding Practice Guidance

View practice guidance to help maximize patient coverage & prevent revenue loss during the Medicaid Unwinding.

State Unwinding Flyers

To post in offices and distribute to families.

Coverage Loss Flyers

To distribute to patients who have lost Medicaid coverage.

Op-Ed Guide: Medicaid Unwinding and Regaining Coverage

Consider writing an op-ed to educate families in your community about finding health coverage. This guide includes best practices for writing an opinion piece, sample messages to include in your article, and tips for pitching your piece to local news outlets.

Advocacy Resources

Advocacy Action Guide
Guide for advocates providing background information on the Unwinding, the changes implemented by the 2023 budget omnibus bill, and opportunities for state level advocacy and patient advocacy.
50 State Update Your Contact Info Resource
Info, where available, for each state on how Medicaid enrollees can update their address with their state Medicaid agency.
Importance of Coverage One-Pager
Flyer that explains the importance of keeping children and teens continuously covered; share it with policymakers when discussing access to care with them.


AAP State Advocacy Webinar – The Unwinding: Important New Changes as State Prepare for April 1, 2023 [January 2023]
(AAP login required) -- Webinar presented by AAP State Advocacy and the Georgetown Center for Children and Families on the current status of the Unwinding, including new requirements from the 2023 budget omnibus bill

If you have questions on the Unwinding, need technical assistance, or would like to report a specific Unwinding-related issue to the AAP, please contact us.

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American Academy of Pediatrics