Changes in Medication Use During Medicaid Continuous Enrollment and Unwinding

How did the use of prescription medications change during periods of Medicaid continuous enrollment during the COVID-19 pandemic and the subsequent unwinding of coverage once the continuous enrollment provision ended in April 2023?In this cross-sectional study including all Medicaid enrollees from 2018 through the first quarter of 2024, state Medicaid enrollment increased by 2.42% per quarter during continuous enrollment and decreased by 4.92% per quarter during unwinding; concurrently, the number of prescriptions increased by 1.85% per quarter and then decreased by 3.94% per quarter.Expansion and unwinding of Medicaid coverage had measurable impacts on patient access to prescription medications, and these changes were affected by state policies.

Corresponding Author: Benjamin N. Rome, MD, MPH, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, 1620 Tremont St, Ste 3030, Boston, MA 02120 (brome@bwh.harvard.edu).

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