Since the start of the pandemic, Medicaid, the federal and state program to provide health insurance to low income Americans, has been far more generous than in the past. Enrollment is higher than ever, at 77.8 million.

This isn’t because of some nationwide change of heart in state governments; it’s because states were paid to stop cutting people from their Medicaid rolls. Under the Families First Coronavirus Response Act, the first coronavirus relief bill passed in March 2020, states received a 6.2 percent boost in federal Medicaid funding in exchange for halting disenrollments.

The usual process of conducting “redeterminations,” in which states redetermine whether a beneficiary’s income levels or other factors still qualify them for Medicaid, has been paused for almost two years. States can still conduct these checks, but they can’t cut off anyone’s Medicaid until the end of the public health emergency (PHE) the federal government declared at the beginning of the COVID-19 pandemic.