States of Unwinding: May 26, 2023

State Health and Value Strategies

As more states are beginning the redetermination and termination process, communication and outreach remains a key focus for states as they seek to get the word out to enrollees about the importance of returning renewal forms. States continue to coordinate their outreach efforts across agencies and partner with other stakeholders to reach enrollees. Some states are helping enrollees with completing their renewal paperwork by hosting in-person events and creating how-to videos. Some specific state highlights:

• New Mexico is offering financial incentives to encourage enrollees to return paperwork and post about it on social media. 
• California and Pennsylvania are both automatically enrolling individuals who lose Medicaid coverage in Marketplace plans to support transitions to coverage.
• More states (15 and the District of Columbia) are publishing data and launching dashboards—Oregon has created a dashboard that will track the transfer of individuals losing Medicaid coverage to the Marketplace. 

Coordinating Unwinding Communications and Outreach

Colorado Medicaid, the Division of Insurance and the Marketplace launched a joint website. The Colorado Department of Health Care Policy & Financing, the Colorado Division of Insurance, and Connect for Health Colorado (the state’s official health insurance Marketplace) launched a joint webpage, KeepCOCovered.com, which includes partner resources and information for those who may need to transition to other coverage.

Kentucky Medicaid is joining monthly stakeholder meetings hosted by the Marketplace. Kynect, the state’s official health insurance Marketplace, is hosting virtual stakeholder forums with the Department of Medicaid Services. Consumers with questions about unwinding are encouraged to submit questions in advance of the monthly meetings. During the May stakeholder meeting, the Cabinet for Health and Family Services presented on the state’s renewal caseload planning, priorities, renewal updates, outreach, reporting to CMS, and how providers can support patients through renewals.

Michigan is working across agencies to warn consumers about scams. The Michigan Department of Health and Human Services and the Michigan Department of Insurance and Financial Services are warning Michiganders to protect themselves against scams as Michigan resumes Medicaid eligibility redeterminations.

Outreach Partnerships With Other Stakeholders

Maryland launched a media campaign in partnership with the state’s Marketplace and MCOs. The Maryland Department of Health (MDH) announced a “Medicaid Check-in” public awareness campaign to prompt Maryland’s nearly 1.8 million Medicaid enrollees to reapply for benefits during the redetermination period. The campaign is a joint effort of MDH, Maryland Medicaid managed care organizations, the State-Based Marketplace (Maryland Health Connection), the Maryland Department of Human Services, and the state’s designated health information exchange (Chesapeake Regional Information System for our Patients). The campaign features television, radio, social media, transit ads, and direct communications in English, Spanish, Mandarin, Vietnamese and Haitian Creole to current Medicaid enrollees through grassroots efforts with a focus on hard-to-reach populations. MDH and the Department of Human Services held a bi-lingual press conference in English and Spanish to launch the campaign.

Massachusetts’ Medicaid is providing grants to community based organizations to support redeterminations. The Executive Office of Health and Human Services announced that MassHealth will provide $1.25 million in grant funding to help older adults and those who need assistance in completing the redetermination process. The grant funding will also fund enrollment events across the state, particularly for those who do not have access to existing supports. Twenty-three faith- and community-based organizations (FBOs/CBOs) will receive funding through sub-grants awarded by Health Care For All to train existing staff to become certified application counselors (CACs). CACs are certified individuals who can help MassHealth members with renewals and receive specialized instruction on assisting older adults. The application process and eligibility criteria for many people over age 65 are more complex than for many other applicants.

Pennsylvania continues to partner with federally qualified health centers to host events about unwinding. The Pennsylvania Department of Human Services joined representatives from The Wright Center for Community Health and Pennie (the state’s official health insurance Marketplace) to highlight how the state and community organizations are collaborating to support Pennsylvanians through renewing their Medicaid coverage. The Wright Center for Community Health’s dedicated provider teams have been educating patients, families, and the communities served about the end of the Medicaid continuous coverage requirement since July 2022. Enrollment staff and community health workers are an invaluable resource for anyone who needs assistance assessing their eligibility and applying for Medicaid or CHIP and will also assist with enrollment in Medicare low-income subsidy programs or a marketplace insurance plan. 

Texas co-hosted an event with a food bank. The Texas Health and Human Services Commission’s Community Partner Program, in partnership with Feeding Texas and the San Antonio Food Bank, hosted a community event in San Antonio to help Texans with their Medicaid renewals. Staff were available to assist Texans with questions or help them renew their benefits. Consumers were also able to receive assistance and more information about their Medicaid coverage, including how to create and manage a Your Texas Benefits account. 

Medicaid Communication and Outreach Efforts

New Mexico is offering financial incentives to enrollees to complete renewal forms. New Mexico is incentivizing enrollees to complete their Medicaid renewal during the unwinding and become a “Renew NM SuperStar.” Eligible individuals who update their contact information will earn $5 in Centennial rewards, which can be used to shop a curated catalog. Enrollees have the opportunity to earn another $15 by posting about Renew NM on social media, sending a thumbs up photo in support of Renew NM, or by sharing a short story about how Medicaid has made a difference in their life or the life of someone they love. The state is also encouraging individuals to submit a Renew NM video and will select a winner every two weeks to earn a $100 visa gift card.

The District of Columbia released a “how to” video on completing Medicaid renewal forms. The video includes instructions on how to update information through the District of Columbia Benefits Portal, time and hours that enrollees can contact the call center and the call center number for enrollees who are visually impaired or hard of hearing. 

Minnesota is texting enrollees about completing renewal forms. The Minnesota Department of Human Services (DHS) announced it is texting important updates and announcements to remind people about Medicaid and MinnesotaCare (the state’s Basic Health Program) renewals. Enrollees will receive renewal forms by mail, and the text messages will notify them to watch their mail for the renewal packet and remind them to submit the forms by the deadline.

Missouri launched a new portal for Medicaid enrollees and a “how to” video about renewals. The Missouri Family Support Division new benefit portal is designed to help Missourians access important updates about their benefits and submit information to FSD. Medicaid enrollees can use the portal to find when their Medicaid annual renewal is due and submit their renewal form as well as view a notice to alert them that FSD successfully completed their annual renewal. FSD will also send information about annual renewals, including a yellow annual renewal form to participants by mail. To support enrollees as they navigate renewals, FSD created a “how to” video that explains the redetermination process and how enrollees can provide requested information. 

Oklahoma is warning Medicaid enrollees about scams. The Oklahoma Health Care Authority issued a warning to Medicaid members of recent scam attempts involving callers asking Medicaid members for personal information over the phone.

Marketplace Communication and Outreach Efforts

California has created videos for individuals no longer eligible for Medicaid whose accounts are transferred to the Marketplace. Covered California, the state’s official health insurance Marketplace, has created outreach videos targeting Medicaid enrollees who lose coverage during the unwinding. The videos include information on what individuals can expect if they are transferred from Medicaid to Covered California, and how-to video guides with step-by-step enrollment support for individuals with a $0 monthly premium and individuals with monthly premiums of $1 or more.

Connecticut’s Marketplace is hosting enrollment fairs in June. Access Health CT, the state’s official health insurance Marketplace, will host free, in-person enrollment fairs in June to support individuals no longer eligible for Medicaid enroll in a Marketplace plan. Connecticut residents who need assistance with the enrollment process or have questions can get help from an enrollment specialist at the fairs.

Minnesota’s official health insurance Marketplace, created a webpage to assist individuals who need help replacing Medicaid or Basic Health Program coverage. The MNsure website directs consumers who are unsure about their eligibility renewal status to the Minnesota Department of Human Services’ (DHS) webpage on renewals. For individuals who receive a notice that they are no longer eligible for Medicaid or MinnesotaCare, MNsure has created a guide on how to get new coverage through the Marketplace with information about the available special enrollment period, free enrollment help through a MNsure-certified assister, and available financial assistance through the Marketplace.

Oregon has created a webpage aimed at helping Oregonians transition to Marketplace coverage during the unwinding. The webpage includes information for Medicaid members such as a list of frequently asked questions (FAQs) and information for partners including a webinar from the Oregon Health Authority and FAQs. The state has also created resources for employers, including a set of FAQs.

Pennsylvania’s official health insurance Marketplace created a webpage to inform enrollees about the unwinding. The webpage features an informational video about the renewal process, information for both those who did and did not respond to their Medicaid renewal packet, a list of frequently asked questions, and information on enrollment assistance.

Supporting Transitions to Marketplace Coverage

California is automatically enrolling individuals who lose Medicaid in Marketplace plans. Beginning June 2023, Covered California will automatically select consumers losing Medicaid coverage into the lowest cost silver plan available to maximize premium tax credit and cost-sharing support. The program will ensure that consumers will not experience a gap in coverage if they effectuate their coverage within a month. Covered California will send customized notices to consumers to explain their plan enrollment and financial assistance and educational materials related to coverage, plan benefits, and key insurance terms. A dedicated website will be made available for consumers to direct them to their pre-selected plan and effectuation options, as well as a specialized phone support system with an interactive voice response menu and live assistance.

Pennsylvania will automatically transfer individuals during the unwinding who are determined no longer eligible for Medicaid to the Marketplace. If an individual responds to their Medicaid renewal notice and is found no longer eligible, their information will be automatically transferred to Pennie, the state’s official health insurance Marketplace. A pre-filled application will be created on the enrollee’s behalf, and they will receive a notice with a unique access code for their account and an estimate of financial savings. Individuals will have a 60-day special enrollment period to select a health plan to avoid a gap in coverage.

Continuity of Care

Arizona is highlighting the opportunity to continue receiving care from a previous provider for enrollees who lose coverage. The Arizona Health Care Cost Containment System issued a press release with information for individuals who recently lost Medicaid coverage and are now enrolled with another health insurance company about the option to continue to see their previous healthcare provider. The press release explains how Arizona law allows a new member in a health insurance plan with a life-threatening illness or in the last trimester of pregnancy to continue an “active course of treatment” with their previous healthcare provider when certain requirements are met. The press release provides information on the process for accessing continuity of care and the terms under which the new health plan must comply. 

Educating Employers About Transitions to Employer-Sponsored-Insurance

Oregon has created several resources aimed at employers to help keep people covered during the unwinding. The resources include a flyer for employers on coverage available through the Marketplace, a flyer for employees losing Medicaid benefits to inform them of both employer-sponsored coverage and the Marketplace and suggested newsletter text for employer or association newsletters.

Making Information About Unwinding Public

Kentucky published a snapshot on unwinding. The Kentucky Cabinet for Health and Family Services released a Medicaid renewals snapshot which includes data on the number of passive and active renewals, the number of mailed notices and emails the state has sent, and phone calls made to Medicaid members, and the anticipated renewal case counts for each month through April 2024.

Minnesota is highlighting its unwinding processes and procedures. The DHS issued a bulletin clarifying that all bases of eligibility must be considered before determining ineligibility and ending Medicaid eligibility. DHS also announced that starting with August 2023 annual renewals, certain Medicaid enrollees who are age 65 or older, blind or have a disability may have their eligibility renewed through an ex parte renewal process.

New Hampshire published data on changes in enrollment. The New Hampshire Department of Health and Human Services released a report on Medicaid enrollment which shows that total enrollment declined 10.8% from March to April. The total number of disenrollments for this period was 27,217.

Oregon reported data on Medicaid redeterminations and launched two dashboards. The Oregon Health Authority (OHA) announced that early Medicaid redeterminations data for May shows that 66% of people will retain coverage. OHA also announced that two new dashboards became available in April 2023. The Medical Redeterminations Dashboard for tracking the state’s progress in determining eligibility for medical programs is updated daily, and the types of data in this dashboard will expand over the next few months. Also updated daily, the ONE Customer Service Center Dashboard monitors the customer service experience for people calling the service center to apply for or ask for help with medical, food, cash and child care benefits. Oregon also created a dashboard to track transfers from Medicaid to the Marketplace. The state has launched the Marketplace Transition Project dashboard in anticipation of upcoming redeterminations. The dashboard will publish data on the number of individuals referred to the marketplace as well as call volume and wait times.