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For almost three years, hospitals and health insurers have been riding the waves of the Covid-19 pandemic. Even though they can better predict what lies ahead in 2023, there remain several big unknowns. STAT’s business reporters will be paying attention to three trends in particular: the end of the public health emergency, how hospital price hikes will affect people’s paychecks, and Medicare Advantage’s explosive growth.

What will happen to the pandemic Medicaid enrollees?

The pandemic’s “public health emergency” has been a boon for state Medicaid rolls and the health insurance companies that manage those programs. Congress gave states more money to enroll lower-income people as they lost their jobs, and in return, states could not kick people off the program until that emergency designation lapsed. As a result, Medicaid enrollment soared more than 30% from December 2019 to August 2022, reaching 83.5 million people.

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But Congress’ budget deal last week will let states start kicking people out of the program in April. And although states and insurers have been preparing for that change over the past year, it will be difficult, if not impossible, to make sure the millions of Medicaid enrollees who will get booted from the program find other sources of health insurance. Hospitals, community health centers, and schools have the power to help uninsured patients and see if they still are eligible for Medicaid or another form of insurance — and are preparing staff to enroll those who qualify.

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