Medicaid uncertainty looms in South Dakota and North Carolina.

Millions of Americans are about to lose Medicaid coverage as pandemic protections expire. South Dakota and North Carolina are removing participants from Medicaid while also planning to add people to the program through Medicaid expansion. States could have delayed reviewing enrollees who are likely to requalify under expansion to avoid a gap in health care coverage. People who wind up uninsured during the gap period might avoid seeking treatment or face expensive bills. South Dakota and North Carolina residents can apply for private insurance, which could be subsidized under the Affordable Care Act, and then reapply for Medicaid once applications for expansion coverage begin.