States of Unwinding: May 12, 2023

States continue to focus their efforts on outreach and communications, with several states adopting a collaborative approach to disseminating information about unwinding. Michigan’s governor has directed all state agencies to support the distribution of information to state residents about unwinding. Other states are co-branding communications materials across Medicaid and the Marketplace. Some states are working with other stakeholders, such as managed care plans and community-based organizations, to reach out to enrollees. Other strategies states are implementing to reduce barriers to coverage include Minnesota canceling unpaid premiums for its Basic Health Program and New Jersey announcing it will host a special enrollment period. As a reminder, SHVS has created a one-stop resource page to support states as they plan for and implement unwinding.  

Educating Consumers About Junk Plans

Delaware is warning consumers about non-standard plans. The Delaware Department of Insurance created a Medicaid unwinding list of frequently asked questions (FAQs). The FAQs warn consumers about misleading discount plans, health sharing plans, and supplemental plans which do not qualify as Affordable Care Act healthcare plans and therefore do not have the same protections or coverage, and encourage enrollees to visit ChooseHealthDE.com to locate a Navigator for enrollment assistance. The FAQs also address unwinding related questions.

Coordinating Unwinding Communications and Outreach

Michigan’s governor is directing all state agencies to collaborate to spread the word about unwinding. Governor Gretchen Whitmer issued an executive directive instructing all state of Michigan departments to work together to help Michiganders keep Medicaid coverage or find affordable health insurance as Medicaid renewals begin. The executive directive instructs all state departments to assist the Department of Health and Human Services and the Department of Insurance and Financial Services including working together to distribute information to Michiganders regarding the redetermination process and how to renew eligibility, and sharing necessary data to conduct outreach, subject to all applicable protections.

Michigan has created multiple websites with information about unwinding. The state of Michigan created two websites to provide information to enrollees about redeterminations and alternative health insurance options during the unwinding. The Michigan Department of Health and Human Services’ website includes the state’s renewal timeline and a walkthrough video, an eligibility and renewal FAQ, and an informational brochure. The Department of Insurance and Financial Services’ website includes information about enrolling in Marketplace, employer-sponsored, and Medicare coverage, as well as  FAQs. The state has also increased workforce capacity to the MI Bridges Help Desk and customer service lines to help Michiganders navigate the unwinding.

California is aligning communications efforts across Medicaid and its State-Based Marketplace. The California Department of Health Care Services and Covered California are also aligning their efforts. For example, Covered California shared information about Medi-Cal renewals in a recent Twitter post. The post features copy and a graphic shared with the Marketplace from the Medicaid agency, and reinforces official branding and messages. Coordination between Medicaid agencies and Marketplaces is an effective tool for aligning on messaging, and ensuring consumers have the correct information from the correct sources.

Maryland is co-branding communication materials. The Maryland Department of Health and Maryland Health Connection, the state’s official health insurance Marketplace, are collaborating to co-brand many of their communications materials. One example is the Department of Health’s communications webpage for providers on the unwinding and renewal process. All consumers will be directed to the Maryland Health Connection portal and customer service, since enrollment and eligibility for Medicaid and the Marketplace is managed through Health Connection. 

Pennsylvania launched a collaborative campaign to raise awareness about renewals. The Pennsylvania Department of Human Services and Pennie, the state’s official health insurance Marketplace, announced a collaborative multichannel, long-term outreach strategy to raise awareness of the critical need for Pennsylvanians to complete their Medicaid and CHIP renewals on time when it is their turn to maintain healthcare coverage. Advertisements span English and Spanish-language television and radio, video and music streaming platforms, social media channels, public transit systems, and billboard placements around the Commonwealth.

Outreach Partnerships With Other Stakeholders

New Jersey Medicaid is working with its MCOs. New Jersey’s five managed care organizations (MCOs) will send postcards at the beginning of each month to the members who will receive their renewals that month. The MCOs will also follow up by phone, email, and text message when possible to ensure New Jerseyans have access to healthcare coverage even if they are no longer eligible for Medicaid.

Pennsylvania hosted an event on unwinding at a federally qualified health center. The Pennsylvania Department of Human Services and Pennie are working with community organizations to help Pennsylvanians amid the unwinding. The state hosted an event with the Berks Community Health Center, a federally qualified health center in the state committed to improving the health of the community through the delivery and coordination of affordable, comprehensive, culturally sensitive patient- and family-centered healthcare.

Rhode Island is providing mini-grants to community-based organizations to support outreach. The Executive Office of Health and Human Services awarded more than $85,000 in mini-grants to 21 community-based organizations to support Medicaid renewals. Mini-grant awardees will use these funds to enhance their outreach, technology, training, and language and cultural competency development related to Medicaid renewals. Many awardees said they plan to use their funds to purchase iPads so they can help Medicaid members complete the renewal process or upload requested documents. Other awardees said they will use the funds to print informational materials in multiple languages or for staff to complete training to become Certified Application Counselors. Applications for mini-grants will continue to be accepted on a rolling basis between now and May 19.

Medicaid Communication and Outreach Efforts

Alaska has created a consumer friendly tool for enrollees to update contact information. The Alaska Department of Health is utilizing a cost-effective and consumer friendly tool to collect updated information from their members. Their Medicaid Information Update Form has clear and concise copy, and uses SurveyMonkey, which many agencies can access and use, and it does not require any kind of account login from the consumer.

Colorado is making information available in English and Spanish. The Colorado Department of Health Care Policy & Financing, which administers the state’s Medicaid program, has added an informational webpage for members on their website. Members can find general information about the renewal process and answers to frequently asked questions. This page is published in English and Spanish. Illinois has created a webpage dedicated to unwinding with materials in multiple languages. The Illinois Department of Healthcare and Family Services created a “Medicaid Renewals Information Center.” The webpage includes the state’s Ready to Renew messaging toolkit available in multiple languages, FAQs for Medicaid enrollees, healthcare providers, advocates, community-based organizations, members of Illinois General Assembly and the media, and an electronic form for Medicaid enrollees to report a change of address.

D.C. is publishing sample notice letters. The Department of Health Care Finance has made available sample notices along with information that will be sent to Medicaid enrollees during the unwinding. This includes passive renewal approval notices for which the state can renew an enrollee’s coverage based on reliable and current information available to the state, the renewal forms for enrollees in which the state is unable to complete a passive renewal, and termination notice examples.

Kentucky is providing directions on how to access information in members’ online accounts. The Kentucky Cabinet for Health and Family Services created a resource for Medicaid enrollees which demonstrates how to access the enrollee’s renewal date during the unwinding.

New Jersey has created a one-stop webpage related to unwinding. The webpage “Stay Covered NJ” includes resources related to the unwinding such as renewal information for Medicaid enrollees, template messages for employers, providers, school administrators, faith-based organizations, advocacy and community-based organizations, a toolkit available in multiple languages, and FAQs. 

New York is using the SHVS unwinding video on their website. The New York State Department of Health created a webpage on unwinding which features SHVS’ Continuous Coverage Unwinding: Enrollee Outreach Video, customized for New York. Each state can customize the end card of the videos with specific branding elements, such as agency logos, call center phone numbers, and web addresses. If you are interested in a customized video, please contact Laura Buddenbaum at lbuddenbaum@princeton.edu.

Vermont has an unwinding page that features resources on how the renewal process works. The Department of Vermont Health Access created a webpage, “Medicaid Renewals Restart.” The webpage includes FAQs on Medicaid renewal basics and how the renewal process works, and a guide of the different types of renewal notices that the state will send such as the notice of renewal, notice of decision and the notice of Medicaid closure. The state also has information for partners and providers and a communications toolkit which consists of sample drop-in articles, handouts, posters and flyers, social media posts, a town hall presentation, and basic information about health insurance.

Virginia is tailoring outreach materials to individuals with disabilities. A recent Twitter post intended for Medicaid enrollees who are visually impaired featured a graphic with clean and clear layout and copy, and includes an image with audience representation. Virginia is also sharing information about the renewal process. The Virginia Department of Medical Assistance Services released a renewal calendar to help Medicaid enrollees understand when their renewal process will begin. The notice also includes several resources on the renewal process, including a flowchart and a step-by-step list describing the renewal process.

Washington is reminding enrollees to update their contact information. The Washington State Health Care Authority, Washington Health Benefit Exchange, and the Department of Social and Health Services have begun mailing letters in May to Washington Apple Health (Medicaid) clients reminding them to update their contact information and renew coverage to see if they still qualify.

Marketplace Communication and Outreach Efforts

Illinois is answering questions about the state’s special enrollment period. Get Covered Illinois, the state’s official health insurance Marketplace, created a list of FAQs to inform individuals of the special enrollment period (SEP) for enrollees losing Medicaid coverage during the unwinding. The FAQs address questions related to eligibility for the SEP, how consumers can access the SEP through HealthCare.gov, what documentation is needed to verify eligibility, and what an individual should do if they are unsure if their Medicaid or All Kids coverage was terminated. Maine also published FAQs on Marketplace coverage. CoverME.gov, the state’s official health insurance Marketplace, created a list of FAQs for individuals who recently lost Medicaid during the unwinding. The FAQs answer questions related to the special enrollment period to enroll, eligibility, and the timeline for transitioning Marketplace coverage.

New Jersey has created consumer guides for individuals being transferred from Medicaid. Get Covered New Jersey, the state’s official health insurance Marketplace, created a list of FAQs on the loss of NJ FamilyCare (Medicaid/CHIP) during the unwinding. The FAQs inform enrollees of a 120 day special enrollment period to enroll in coverage through GetCoveredNJ after Medicaid or CHIP coverage ends. Consumers who are determined ineligible for Medicaid based on income will automatically be transferred to GetCoveredNJ and will receive a welcome notice by mail or email with a unique access code that allows them to access their account, complete a pre-filled application to determine eligibility for financial assistance, and shop for coverage. The state has created a consumer guide for individuals enrolling in coverage if their account was transferred to the Marketplace and a consumer guide for individuals enrolling in coverage if their information was not transferred to the Marketplace.

New Mexico’s Marketplace created a toolkit for its stakeholders. beWellnm, the state’s official health insurance Marketplace, created a Medicaid Unwinding Campaign Stakeholder Toolkit which includes information on how to engage with beWellnm, communications goals, key messages, unwinding talking points for community partners, unwinding FAQs, New Mexico’s Medicaid Transition Premium Relief Program FAQs, communications plans, and communications assets.

Canceling Unpaid Premiums

Minnesota is canceling unpaid premiums and waiving premiums through June 2024 for its BHP. The Minnesota Department of Human Services has canceled unpaid MinnesotaCare (the state’s Basic Health Program) premiums and will waive premiums for May 2023 through June 2024 coverage for all enrollees. The state passed legislation in 2021 that prevents DHS from collecting unpaid MinnesotaCare premiums that accrued during the public health emergency. Additionally, the 2023 Minnesota legislature passed a law that temporarily waives MinnesotaCare premiums for all enrollees for coverage from May 2023 through June 2024.

Protecting Access to Medicare Supplement Policies 

Colorado is ensuring access to Medicare Supplement policies. The Colorado Division of Insurance issued an order regarding a Medicare Supplement guaranteed issue period for consumers losing Medicaid coverage due to the unwinding. This will allow individuals who became eligible for Medicare during the continuous coverage requirement and missed the open enrollment window to access Medicare Supplement plans during the unwinding.

Supporting Transitions to Marketplace Coverage

Massachusetts is hosting a webinar for employers on coverage options available through the Marketplace. MassHealth (Medicaid) and the Massachusetts Health Connector, the state’s official health insurance Marketplace, are presenting a webinar, “MassHealth Renewals and Available Resources for Massachusetts Employers” on May 17, 2023. The session will cover the MassHealth renewal process and health coverage options through the Marketplace for those employees who may not be eligible for employer benefits. A toolkit is also available to promote the webinar.

New Jersey is hosting a special enrollment period. The New Jersey Department of Banking and Insurance Commissioner Marlene Caride announced the creation of an extended special enrollment period for individuals who are no longer eligible for NJ FamilyCare (Medicaid) and qualify for health insurance through Get Covered New Jersey. The department has established an extended SEP to allow these individuals 120 days to sign up for coverage and the SEP provides flexibilities that create a streamlined transition between the programs, and offers consumers the option of having an earlier effective date of coverage to avoid coverage gaps. 

Making Information About Unwinding Public

Arkansas released data as it began terminating enrollees from coverage. The Arkansas Department of Human Services reported figures reflecting the first month of redeterminations as part of its six-month Medicaid unwinding effort. The total number of disenrollments in April was 72,802.

Virginia published an unwinding tracker. Users can look at aggregated data to see how many enrollees have been terminated each month. The tracker also provides a breakdown by fee-for-service versus managed care and eligibility type. SHVS updated our expert perspective that is tracking state unwinding dashboards to include Virginia. The EP now includes an interactive map with links to all the dashboards and states publishing CMS unwinding reports. SHVS will continue to update the EP and map as more states publish their unwinding data.