As part of the pandemic relief effort, states paused removing people from Medicaid during the public health crisis because they are no longer qualified. Coupled with the influx of enrollees due to the unprecedented rapid loss of employment during the pandemic, Medicaid enrollment has swelled to its highest level ever. The public health emergency is scheduled to end on April 16, and states will have 12 months to review the eligibility information of nearly 78 million Medicaid enrollees. It is expected that many who no longer qualify for Medicaid will turn to ACA exchanges for health insurance.