Medicaid Unwinding Linked to Disruption of Chronic Medication Therapy in Youth

Pausing Medicaid eligibility determinations during COVID-19 pandemic linked to increased risk for having no prescriptions and cash-pay prescriptions

By Elana Gotkine HealthDay Reporter

FRIDAY, May 16, 2025 (HealthDay News) — In young patients, especially young adults, Medicaid unwinding associated with the COVID-19 pandemic disrupted chronic medication therapy, according to a study published online May 2 in Pediatrics.

Noting that Medicaid eligibility determinations paused during the COVID-19 pandemic and resumed in April 2023, Kao-Ping Chua, M.D., Ph.D., from the University of Michigan Medical School in Ann Arbor, and colleagues conducted a difference-in-differences analysis to examine whether this “Medicaid unwinding” disrupted chronic medication therapy in children (0 to 18 years) and young adults (19 to 25 years). Participants were using five chronic medication classes during quarter 1 of 2017 to 2023: attention-deficit/hyperactivity disorder medications, antidepressants, antiepileptics, antipsychotics, and inhaled steroids; sample sizes varied from 226,311 to 4,683,451 person-years.

The researchers found that residence in a state with high Medicaid enrollment loss was associated with a greater reduction in the number of days with active prescriptions for one class and with a greater increase in the risk for having one or more cash-pay prescriptions for three classes among children. Residence in such a state was associated with a greater reduction in the number of days with active prescriptions for two classes and with an elevated risk for having no prescriptions and one or more cash-pay prescriptions for all classes among young adults.

“As policymakers debate whether to enact drastic cuts to Medicaid funding, they should consider the possibility that doing so could similarly disrupt chronic disease therapy for children and young adults, placing them at higher risk for disease exacerbations and absenteeism from school and work,” Chua said in a statement.


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