On August 30, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) instructing states to assess whether they are in compliance with federal Medicaid regulations that require all renewal processes be conducted at the individual level. This expert perspective reviews the Federal Financial Participation match available to states as they work to come into compliance with the requirements of the SMDL.

Given the potential to reduce coverage losses during the unwinding, there is intense interest in data that monitors transitions between Medicaid and Marketplace coverage. State-Based Marketplaces (SBMs) that operate their own eligibility platform should consider releasing available data on Marketplace transition outcomes. This expert perspective highlights recommendations for SBMs, such as providing context and making the data easy to find. The expert perspective includes an interactive map with links to SBMs reporting Marketplace transition outcome data and a table of the indicators that states are reporting on. SHVS will continue to update this EP as more SBMs publish unwinding data.

On August 30, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) instructing states to assess whether they are in compliance with federal Medicaid regulations that require all renewal processes be conducted at the individual level. This expert perspective summarizes the SMDL, which lays out immediate actions that states must take to determine if they are out of compliance with the federal renewal requirements and mitigate compliance issues. In addition to its SMDL, CMS released a Mitigation Plan Template that states may, but are not required to, use to communicate required information regarding their compliance assessments and proposed strategies for mitigation. States must submit the required information to CMS using the template or another format via email (CMSUnwindingSupport@cms.hhs.gov) no later than September 13, 2023.

State updates as of August 18, 2023.

State updates as of August 11, 2023.

As states are operationalizing the unwinding, policymakers, advocates and the media are watching state and federal administrative data closely to quantify the number of successful Medicaid renewals and coverage terminations. However, this data is limited in telling the story of what happens to enrollees after leaving Medicaid. This expert perspective describes how states can use consumer surveys to better understand coverage transitions during the unwinding. The EP highlights survey recommendations, such as survey mode, target population and timing, communications best practices and agency coordination, and includes a list of sample survey questions for states to download.

State updates as of August 4, 2023.

On July 28, 2023, the Centers for Medicare & Medicaid Services released publicly state-reported data providing a window into how the unwinding of the federal Medicaid continuous coverage requirement is progressing. This expert perspective summarizes the data release, provides a timeline for CMS’ continued release of unwinding data and highlights the importance of context and the imperative for stakeholders to tread carefully when making interpretations about the data.

State updates as of July 28, 2023.

State updates as of July 21, 2023.