Millions of people who enrolled in Medicaid during the COVID-19 pandemic could start to lose their coverage on April 1. The measure in a mammoth spending bill passed by Congress will sunset a requirement of the COVID-19 public health emergency that prohibited states from booting people off Medicaid. The Biden administration has been under mounting pressure to declare the public health emergency over, with 25 Republican governors asking the president to end it in a letter on Monday, which cited growing concerns about bloated Medicaid enrollment.