Getting a Medicaid termination notice is frightening. In 2026, redeterminations are happening more frequently and with stricter income and documentation requirements than in recent years. The One Big Beautiful Bill Act (OBBBA), signed July 4, 2025, added new work requirements and verification rules that are pushing more people through redetermination reviews. If you lost coverage, you are not alone -- and you have more options than you might think.
This guide walks through the 6 steps to take immediately after losing Medicaid at redetermination: how to appeal, how to enroll in marketplace coverage within the 90-day SEP window, and how the 2026 subsidy cliff affects your costs. Note that the enhanced premium tax credits from ARPA and the IRA expired January 1, 2026, so marketplace costs are higher in 2026 than in recent years for people above 400% FPL. If your income is under 400% FPL ($62,600 single, $128,600 family of 4), you still qualify for standard ACA premium tax credits.
6 Steps to Get Coverage
Common Mistakes That Cost People Thousands
The most costly mistakes people make after losing Medicaid at redetermination:
- Waiting to act because you filed an appeal. Appeals can take weeks or months. Apply for marketplace coverage through healthcare.gov at the same time as your appeal -- if the appeal succeeds, you can cancel the marketplace plan.
- Missing the 90-day SEP window. Unlike the standard 60-day SEP for other coverage losses, loss of Medicaid gives you 90 days. But many people don't realize the clock starts on the termination date -- not the date you receive the notice.
- Not checking whether income still qualifies for Medicaid. If your termination was based on a data-matching error or outdated income information, re-applying with current income documentation may restore your Medicaid immediately.
- Enrolling in a short-term health plan to save money. Short-term plans are not ACA-compliant, can deny coverage for pre-existing conditions, and count as a coverage gap. An ACA Silver plan with subsidies is almost always a better choice for people between 138% and 400% FPL.
- Assuming children lose coverage when adults do. Children may qualify for CHIP at incomes up to 200% to 300% FPL depending on your state -- even when the adult in the household loses Medicaid. Apply for CHIP through your state agency or healthcare.gov immediately.
Frequently Asked Questions
How long do I have to enroll in an ACA plan after losing Medicaid?
You have 90 days from the date your Medicaid coverage ended to enroll in an ACA marketplace plan. This is longer than the standard 60-day SEP that applies to other coverage losses. Log in to healthcare.gov, select 'lost qualifying health coverage,' choose Medicaid/CHIP as the type, and enter your termination date. Your 90-day clock starts from that termination date.
Can I appeal a Medicaid termination from a 2026 redetermination?
Yes. Every state must provide a fair hearing process. Submit your appeal request before the deadline stated in your termination notice (typically 30 to 90 days from the notice date, depending on your state). If you appeal before coverage ends, you may be entitled to continuation of benefits during the appeal. If your coverage was terminated because the state did not receive documents you already submitted, that is a procedural error and reinstatement may be immediate.
What if my income is just over the Medicaid limit?
Enroll in an ACA marketplace Silver plan through healthcare.gov. If your income is between 138% FPL ($22,025 single) and 400% FPL ($62,600 single) in 2026, you qualify for premium tax credits. For incomes between 138% and 250% FPL (about $39,900 single), Silver plans also include cost-sharing reductions that dramatically lower your deductible and out-of-pocket maximum. Run a quote on healthcare.gov -- many people in this range pay under $100 per month.
What changed with Medicaid redeterminations in 2026?
The One Big Beautiful Bill Act (OBBBA), signed July 4, 2025, introduced two major changes: (1) Starting December 31, 2026, states must redetermine Medicaid expansion adults (ages 19 to 64 without disabilities) every six months instead of annually. (2) New work requirement rules are being phased in, with Nebraska already enforcing them as of May 2026 and most states required to comply by January 1, 2027. Stricter income-verification rules are also in effect, leading to more terminations on administrative grounds.
Do work requirements apply to me in 2026?
It depends on your state. Nebraska implemented work requirements on May 1, 2026. Montana and Iowa plan to implement by end of 2026. All states must comply by January 1, 2027. Exempt groups typically include those with disabilities, caregivers, pregnant women, people over 64, and full-time students. Check your state Medicaid agency website for current rules. If your termination cites work requirements and you believe you are exempt, file an appeal immediately.
What if I miss the 90-day window to enroll in a marketplace plan?
If you miss the 90-day SEP after losing Medicaid, you typically have to wait until the next Open Enrollment Period -- November 1 to January 15 for 2027 coverage. One exception: if another qualifying life event occurs (job change, marriage, birth, move to a new state), you get a new SEP. You can also re-apply for Medicaid year-round through your state agency if your income drops back below 138% FPL.
Will my children lose Medicaid coverage if I do?
Not necessarily. Children's eligibility for Medicaid and CHIP is evaluated separately. Even if your income makes you ineligible, your children may qualify for Medicaid or CHIP at incomes up to 200% to 300% FPL depending on your state. Apply for CHIP through healthcare.gov or your state agency -- enrollment is year-round and there is no deadline.
Does the 2026 subsidy cliff affect me if I am switching from Medicaid to the marketplace?
Yes, if your income is above 400% FPL ($62,600 single, $128,600 family of 4 in 2026). The enhanced premium tax credits from the American Rescue Plan Act expired January 1, 2026, so people above 400% FPL receive no ACA subsidy. If your income is between 138% and 400% FPL, standard premium tax credits still apply and marketplace coverage remains affordable.
