Feb, 23, 2024

States of Unwinding: February 23, 2024

A year into unwinding, roughly half of all individuals enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) at the start of unwinding have been redetermined. Some states, including Maine and Oregon, are extending their timelines for unwinding. To outreach to enrollees yet to be redetermined, states are partnering with stakeholders: Georgia is working with community-based organizations (CBOs) to reach postpartum individuals and Rhode Island released a third round of mini-grants for CBOs. States continue to refine their communication and outreach strategies, with Colorado’s Marketplace making outbound calls to individuals no longer eligible for Medicaid and Hawaii launching a phone and text campaign. 

As states look to learn from unwinding through evaluation, California  published the findings from the first month of surveying individuals disenrolled from Medicaid. While fewer states are reporting data, states continue to make information about unwinding public, with Georgia publishing unwinding data for December and Oregon announcing it has completed redeterminations for 84% of cases. As a reminder, SHVS has created a one-stop resource page to support states as they plan for and implement unwinding.  

Extending the Timeline for Unwinding

Maine is pushing out its timeline for completing redeterminations. The Department of Health and Human Services (DHHS) hosted a briefing on February 13 to provide an update on unwinding. During the meeting, DHHS shared an updated timeline for conducting redeterminations: the state now plans to have completed all unwinding renewal determinations by October, 2024. As a result, the state has shifted the end of the unwinding special enrollment period on CoverMe.Gov, the state’s official health insurance Marketplace, to December 31, 2024 to align with the state’s updated unwinding timeline.

Oregon received approval to extend its timeline for unwinding. The Oregon Health Authority (OHA) received approval from the federal government to extend the state’s timeline for processing its remaining 107,000 renewals. Some of the enrollees who are yet to be renewed were affected by systems changes requiring OHA to implement ex parte review at the individual level. The updated timeline calls for redeterminations to be completed by February 2025. As of May 2024, the state will have completed updates to Oregon’s automated renewal process which will allow the state to use the updated process for the remaining renewals.

Outreach Partnerships With Other Stakeholders

Colorado thanked community partners for helping to reduce procedural terminations. On January 24, the Colorado Department of Health Care Policy and Financing (HCPF) hosted a meeting for community partners on unwinding. During the meeting, HCPF highlighted the role of partner organizations in reducing the number of individuals procedurally terminated as a result of “whereabout unknown” from 26% to 5%. The state also credited improvements to the eligibility system and their consolidated return mail center.

Georgia is providing mini-grants to community based organizations to reach postpartum people and children. The Department of Human Services, in partnership with HOPE for Georgia Moms at Northeast Georgia Health System, has announced $60,000 in community mini-grants available to fund community-based Medicaid redetermination awareness and educational activities. These grants will leverage local partner expertise to inform and educate communities that have been marginalized, with a specific focus on pregnant and postpartum women and children. Up to five organizations could be awarded grants to place ads in local papers, staff local outreach, or host an event through May 2024—the end of the Medicaid redetermination process.

Rhode Island announced a third round of mini-grants for community based organizations. The McKee administration opened applications for a third round of mini-grants for CBOs to support outreach related to Medicaid renewals. Community organizations can apply for mini grants in four categories: technology, training, outreach, and language and cultural competency. Organizations can be awarded up to $4,950 for each of the mini-grant categories, for a total of up to $19,800.

Medicaid and Marketplace Communication and Outreach Efforts

Colorado’s Marketplace is making outbound calls to individuals no longer eligible for Medicaid. During a presentation to community partners on January 24, Connect for Health Colorado, the state’s official health insurance Marketplace, highlighted the strategies it is using to outreach to individuals no longer eligible for Medicaid. Connect for Health is conducting direct outreach through letters, emails and outbound calls and has also hosted over 60 unwinding events across the state. The Marketplace is continuing to explore other data-driven strategies.  

Connecticut’s Marketplace is hosting in-person enrollment fairs. Access Health CT, the state’s official health insurance Marketplace, announced it will host two free, in-person enrollment fairs in February and March to assist individuals who have lost Medicaid coverage.

Hawaii launched a phone and text campaign to remind members to update contact information. As part of its multi-pronged communications effort, the Department of Human Services Med-QUEST Division launched an automated telephonic campaign to remind members about the importance of updating their contact information. The telephonic campaign will employ both automated phone calls and SMS text messages. 

Virginia published an updated infographic on the renewal process. In an email to their mailing list, the Department of Medical Assistance Services (DMAS) shared an updated infographic in both English and Spanish that explains the role of DMAS in the process and the steps members must take to renew. 

Washington released a new flier. The Washington Health Care Authority developed a new Apple Health outreach flier to help reach enrollees and encourage them to update their contact information and renew their coverage. 

Evaluating Unwinding

California is surveying individuals who lost coverage for procedural reasons. The Department of Health Care Services published findings from the first month of their survey of individuals who lost coverage for procedural reasons. The purpose of the survey is to develop a better understanding of renewal barriers and reasons for procedural disenrollment to inform real-time changes to help people keep coverage and to encourage people to “cure” their renewal so they can restart coverage. The survey will run through April 2024. 

Implementation of Individual Ex Parte

Maine will implement individual ex parte as of July 2024. During a briefing session on unwinding, DHHS highlighted that it will begin individual ex parte reviews as of July 2024 for individuals due for renewal in August. The state will also resume terminations for administrative reasons in July. 

Making Information About Unwinding Public

Georgia published unwinding data for December. The Georgia Department of Community Health published its December Medicaid redetermination data, reporting that in November, Georgia initiated eligibility checks for 139,906 Georgians with Medicaid or CHIP. At the close of the month, 64,662 (46%) of these Georgians were renewed for Medicaid or CHIP coverage, while 56,305 (40%) were found ineligible.

Oregon announced that nearly 84% of the state’s 1.5 million renewals are complete. OHA highlighted that at this point in the renewal process, more than five out of six Oregonians are keeping their Oregon Health Plan (OHP) or other Medicaid benefits. As of January 27, 2024, 1,221,363 people have completed the renewal process. Of these, 1,029,057 people (84.9%) were renewed and kept their benefits, 167,082 people (13.7%) were found ineligible, and 14,924 people (1.2%) had a reduction in their benefits.

Tennessee published unwinding data for the month of November. The Division of TennCare published an unwinding report for the month of November in which 150,000 TennCare members were due for renewal. The report details that 8,661 individuals who were determined ineligible after returning their renewal paperwork were referred to the federal Marketplace for coverage.