Eligibility checks for Medicaid were paused during the pandemic. Many people are still losing coverage in the bureaucratic jumble that has ensued since they resumed.

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Ordinarily, people enrolled in Medicaid — government-provided health insurance for people with low incomes or disabilities — go through eligibility checks every year to determine whether they can renew coverage. But in March 2020, the federal government froze the checks as part of its public health emergency. So people were continuously enrolled in Medicaid, and no one was dropped for three years.

That stopped when President Joe Biden ended the emergency in the spring. Many months later, Medicaid enrollees across the country are still getting letters like Olenski’s as part of the “unwinding” process, which is scheduled to continue through May. After that, the pre-pandemic status quo resumes.

As of Dec. 20, at least 13 million people had been disenrolled from Medicaid in 2023, according to an analysis by KFF, a nonprofit group focused on health policy. Net enrollment in the program (given that some people were newly enrolled or have re-enrolled) has dropped by around 7.8 million, according to an analysis by the Georgetown University Center for Children and Families.