About 65% of Medicaid enrollees are unsure if states are allowed to now disenroll people from Medicaid if they aren’t eligible anymore or didn’t renew coverage, and 7% incorrectly believe  that states can’t do this, a new analysis showed.

During the Covid-19 pandemic and under the continuous enrollment provision, states were barred from disenrolling people on Medicaid. However, this provision ended March 31, meaning the normal renewal process for Medicaid has resumed and states will disenroll those who are no longer eligible or don’t renew coverage (many states are completing this process over the course of a year). As many as 18 million people could lose Medicaid coverage during this period.

The new analysis, published Wednesday by the Kaiser Family Foundation, was based on the organizations’ Survey of Health Insurance Consumers. The survey was conducted prior to the end of the continuous enrollment provision between February 21 and March 14.

It found that about half of Medicaid enrollees said that they have not gone through the renewal process for Medicaid before.

“Prior to the pandemic, Medicaid enrollees had their Medicaid coverage redetermined at least annually, and many lost coverage at renewal even though they remained eligible because they faced administrative barriers to completing the process,” KFF said. “Some Medicaid enrollees may not be aware that their Medicaid coverage was renewed because the state was able to complete the process using available data sources, and therefore did not require the enrollee to take any action to maintain coverage.”

A third of Medicaid enrollees haven’t updated their contact information for their state Medicaid agency in the last year, which is required to renew coverage. In addition, a third of enrollees have had a change in income or another change that would make them ineligible, or don’t know if they’ve had a change.

The survey also found that four in 10 enrollees only covered by Medicaid said that if they were told they’re no longer eligible, they wouldn’t know where to look for coverage or would become uninsured.

About half of the respondents said they would prefer to receive information about renewing coverage through ways other than mail, such as email, online portal or text message. Younger generations were more likely to say this. In addition, 85% of enrollees said it would be “very useful” or “somewhat useful” to have a navigator help them through the process.

“Connecting people on Medicaid with Navigators and other organizations who can assist them with the renewal process can help increase the number of people who complete their renewals and retain coverage if they remain eligible or know where to look for and enroll in other coverage if they are determined to no longer be eligible,” KFF said.

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