JOHN YANG: During the pandemic, enrollment in Medicaid, the public insurance program for those with low incomes, surged more than 28%, and the uninsured rate reached an all-time low.

That's largely because Congress temporarily blocked states from kicking people off Medicaid even if they were no longer eligible.

That ends starting at the end of this month, and as many as 15 million of the 84 million current enrollees could eventually lose coverage.

Rachana Pradhan is a Correspondent for Kaiser Health News.

Rachana, this is what's called continuous coverage in other words, not kicking people off, not checking their eligibility.

That all ends under the law on March 31.

Is this all going to happen at once on April 1, or people just going to be who are no longer eligible, just going to find out they're not covered?

RACHANA PRADHAN, Correspondent, Kaiser Health News: No, I think it's pretty unlikely that someone immediately on April 1 would get a letter saying, you don't qualify, you're going to lose your benefits.

States have about a year actually to complete this whole process, and part of that is because the Biden administration and Congress, frankly, are trying to make sure that we have enough time.

They have enough time to go through everyone, to make sure that people aren't kicked off unnecessarily when they may still qualify.

But the other thing, too, is because we have unprecedented numbers of people on Medicaid right now, it's going to take a lot of time.

So they have about a year, and every state's timeline might be a little different.

Some are going to move faster than others.

JOHN YANG: Are there some states who are already checking?

RACHANA PRADHAN: There are states that have begun to notify people that their benefits could end soon.

They've begun sending letters to people letting them know that technically, starting in April, if they get a renewal notice and they don't furnish information that's needed for the state to confirm that they still qualify, they are at risk of losing their benefits.

So that will be starting soon, but it could be months from now before someone actually receives that kind of notification.

JOHN YANG: And in the meantime, they'd be covered?

RACHANA PRADHAN: Right.

In the meantime, they're still covered.

JOHN YANG: So, Rachana, are we essentially going back to where were before the pandemic, where there is a Medicaid gap?

People who earn too much to qualify for Medicaid, but too little to qualify for the subsidies under the Affordable Care Act?

RACHANA PRADHAN: So, yes, the states where Medicaid was not expanded, the eligibility was not broadened under the Affordable Care Act.

Those states are, of course, disproportionately.

They're in the south and the Midwest.

They are going to have very restrictive eligibility levels once again for especially adults without children because, of course, Medicaid, it covers so many people that how you qualify based on your income varies depending on whether you are a senior in a nursing home, whether you are a pregnant person who's currently receiving Medicaid, whether you're a child.

So, I think the risk really people who are trying to ensure that coverage is maintained for those who are eligible, certain people are at higher risk for losing their benefits, especially adults about children, and parents and their children.

Those are people who are, I think, especially vulnerable.

JOHN YANG: Why?

Why those groups, particularly?

RACHANA PRADHAN: Children in particular, a lot of the time, their health insurance status will depend on those of their parents.

And so, if the parents are uninsured, they're not necessarily going to get their children insured.

But also certain groups who are on Medicaid, they're more likely to experience instability in their income and their housing and their jobs.

And so those people tend to kind of -- they don't always stay consistently on the program.

So, I think those people are the ones who maybe they qualify for Medicaid at certain points in the year, but then at other points they don't.

And so, for a state, they need to be able to reach those people to really ensure that their income is within the limits that Medicaid prescribes.

JOHN YANG: And as you say, in a normal year, they're constantly checking to see people's income levels, to see where they're living, to make sure they're still eligible.

This sounds like a huge administrative task to go through the entire roles.

Talk about the fear that people who are qualified are going to get dropped.

RACHANA PRADHAN: Well, it's been a long-standing problem even before the pandemic, it was a long-standing issue to get a hold of people who are on Medicaid, right?

This population, they're low income.

They tend to be more transient.

They have unstable housing, unstable jobs.

All of that, of course, was compounded during the pandemic.

But as a result, if you're trying to confirm that someone still qualifies, you have to be able to reach them.

And you're not necessarily going to be able to, especially when people have had so much instability in their lives over the last three years.

A lot of Medicaid verification work is still done through paperwork.

It's hard paper.

It's letters that are sent through the mail.

It's not the most tech savvy area in terms of trying to get a hold of people.

And it's very common that mail won't be sent back to the state or it gets sent to the wrong address to begin with.

And I think that is the risk in all of this because as we know, this is the largest renewal -- Medicaid renewal effort really in the program's history.

It's never been this big.

JOHN YANG: And politically, it's very tough to take away a benefit or something that take away something that people are getting from the government.

Do you think, is this going to renew the debate or the push to expand Medicaid nationwide, even in the eleven states that didn't do it under the Affordable Care Act?

I think it will depend on the extent to which people lose their benefits.

I think it's safe to say there are people who are receiving coverage right now who should not still be on that program because of their income or because they've moved out of state, for example.

But that being said, if you start seeing tremendous numbers of people losing their benefits, especially when they might still qualify, then I think you could see a push again or that used as a reason to expand eligibility levels more broadly in the states that tend to be more restrictive.

JOHN YANG: Rachana Pradhan of the Kaiser Health News, thank you very much.

RACHANA PRADHAN: Thank you for having me.