Several major payer groups and Medicaid advocates are pressing Congress for a 120-day heads up when the COVID-19 public health emergency ends, arguing they need as much time as possible to make Medicaid enrollees aware they could lose coverage.

A collection of payer and Medicaid state advocacy groups wrote to congressional leadership on Thursday asking for the greater lead time. The letter comes as providers and other stakeholders are preparing for an end to key flexibilities granted back in January 2020.

States and payers are facing the daunting task of redetermining the eligibility of Medicaid enrollees. The PHE prevented states from dropping any enrollees off Medicaid rolls for the duration of the emergency. States will have a year after the PHE ends to fully redetermine eligibility.

But states, plans and providers need sufficient lead time to process millions of eligibility redeterminations, the groups said.

If enough time isn’t provided, then “millions of individuals who otherwise remain eligible for Medicaid become uninsured,” according to the letter.

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Insurance lobbying group AHIP signed on to the letter as well as Medicaid Health Plans of American and National Association of Medicaid Directors.

Other advocacy groups such as the National Association of Community Health Centers and Association for Community Affiliated Plans signed on.

State Medicaid officials and payers have been bracing for months on how to handle the coming wave of redeterminations. Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said back in September 2021 that the center is working to help ensure that people who drop off Medicaid can get coverage on the Affordable Care Act’s insurance exchanges.

How the redeterminations are handled could also affect coverage for millions of people. A study from the Urban Institute last year estimated that 15 million people could lose Medicaid insurance coverage after the end of the PHE. The think tank said states should be working hard to reach out to affected beneficiaries about other coverage options.

The current PHE ends in April and can be extended for another 90 days.

Former acting Department of Health and Human Services Secretary Eric Hargan had promised stakeholders a 60-day notice of when the PHE would end.

Some hospital groups have wanted the PHE to be extended again as facilities are still struggling financially due to the latest surge of COVID-19. House Republicans, on the other hand, pressed HHS Secretary Xavier Becerra to end the period and to give a glide path for an easy transition.