States of Unwinding: May 3, 2024
States have completed redeterminations for two-thirds of the individuals who were enrolled in Medicaid as of the end of the continuous coverage requirement. As more states return to routine operations, this States of Unwinding post will be the last in this series. State Health and Value Strategies will continue to add materials to our one-stop resource page designed to support states as they implement unwinding.
With many states in the last months of conducting redeterminations, several are reflecting on lessons learned from unwinding. Kentucky is evaluating unwinding by conducting a survey of individuals who went through renewal, while California published an issue brief highlighting how leveraging federal flexibilities improved the renewal process during unwinding. States continue to communicate and outreach to enrollees about unwinding: Indiana launched a “return to normal” website while Michigan proclaimed April “Medicaid Awareness Month.” Rhode Island released a third-round of mini grants to support outreach partnerships with other stakeholders.
To preserve coverage for medically-fragile enrollees, New Mexico is extending coverage for seniors receiving long-term services and supports and individuals with disabilities for 12 months. States have also worked hard to support transitions to Marketplace coverage: in Minnesota Navigators helped 30,000 individuals apply, while Rhode Island reports successfully transitioning 14,000 individuals.
Evaluating Unwinding
Kentucky is surveying Medicaid members. In mid-April, Kentucky sent emails to Medicaid members who have gone through a renewal in the last year to ask them to complete a survey. Through the survey, the Cabinet for Health and Family Services hopes to gather feedback from Medicaid enrollees on the renewal process and the Department for Medicaid Services’ communications to members. The survey is being fielded in English and Spanish.
Leveraging Federal Flexibilities
California published an issue brief highlighting how it leveraged federal flexibilities. The California Health & Human Services Agency published an issue brief summarizing the flexibilities California leveraged from the federal government to improve auto-renewal processes. The issue brief highlights how California partnered with the U.S. Digital Service to automate income-based waivers in eligibility and enrollment systems, which increased California’s ex parte rates significantly from an average of 34% from June to November, 2023 to 66% in December 2023.
Medicaid and Marketplace Communication and Outreach Efforts
Indiana launched a “Return to Normal” website. To support enrollees during unwinding and beyond, the state launched a “Return to Normal” website, which provides examples of Medicaid/CHIP notices, frequently asked questions, stakeholder meetings, and more, to aid in the process of helping consumers to transition between coverage types. The website also includes information on the restart of cost-sharing for enrollees, which will begin July 1, 2024.
Michigan proclaimed April Medicaid Awareness month. Governor Gretchen Whitmer proclaimed April Medicaid Awareness Month to highlight the importance of the Medicaid program and encourage residents to submit their renewal paperwork. In addition to the Governor’s proclamation, Meghan Groen, Michigan’s Medicaid director, was featured in a video that provided an overview of Medicaid benefits and reminded Michiganders to watch for their renewal packet and submit needed information to ensure they keep their healthcare coverage.
Outreach Partnerships With Other Stakeholders
Rhode Island provided a third round of mini-grants to community-based partners. The McKee administration’s Executive Office of Health and Human Services announced more than $204,000 in mini-grants to 21 community-based organizations to support Medicaid renewal outreach. This is the third cycle of the Medicaid renewal mini-grant program. In total, the state has distributed close to $288,000 to 32 organizations across the three cycles.
Preserving Coverage for Medically-Fragile Enrollees
New Mexico is extending coverage for LTSS members and individuals with disabilities. The New Mexico Human Services Department (HSD) announced a 12-month extension of Medicaid coverage for seniors receiving long-term care and individuals with disabilities. Eligible Medicaid members include individuals whose Medicaid renewals were due after April 1, 2023, and have not yet been processed by HSD and are enrolled in various Medicaid waiver programs. Medicaid enrollees affected by this change will receive a notice by mail stating that their eligibility has been extended for an additional 12 months, with no need for further action on their part.
Supporting Transitions to Marketplace Coverage
Minnesota Navigators helped over 30,000 Minnesotans apply for Marketplace coverage. Libby Caulum, CEO of MNsure, highlighted that since the unwinding began, Navigators have helped more than 30,000 Minnesotans apply for Medical Assistance or MinnesotaCare coverage or complete their renewal. Broker partners have helped more than 1,000 families make the transition from public program coverage to a qualified health plan. Since last spring, more than 11,500 people who lost Medical Assistance or MinnesotaCare have enrolled in private health insurance plans.
Rhode Island transitioned 14,000 individuals to Marketplace coverage. HealthSource RI, the state’s official Marketplace, announced it transitioned more than 14,000 former Medicaid customers to qualified health plans on the Marketplace, often at little to no initial cost due to federal financial assistance and state support programs put in place to ease the transition.
Making Information About Unwinding Public
Michigan has renewed coverage for more than 1.5 million individuals since the start of unwinding. The Michigan Department of Health and Human Services renewed Medicaid and Healthy Michigan Plan coverage for an additional 141,471 people whose eligibility was up for redetermination in March, bringing the total to more than 1.5 million.
West Virginia has completed all unwinding redeterminations. The West Virginia Department of Human Services Bureau for Medical Services released updated data following the completion of the state’s Medicaid unwinding period. During the unwinding period, a total of 520,729 Medicaid and CHIP renewals were conducted, and from the available information from April 2023 through December 2023, 279,952 individuals were approved for ongoing coverage and 207,674 were not.