Medicaid Redeterminations Have Started for 19 States, Some Concerned by High Disenrollment Volume

As states proceed with Medicaid redeterminations after three years of a pause on eligibility review, hundreds of thousands of Americans are losing insurance coverage, according to early data reports. The Centers for Medicare and Medicaid Services (CMS) are stressing the importance of limiting the number of lost enrollees and facilitating transfers to ACA Marketplace plans.

However, many enrollees have lost coverage simply because they could not be located to verify their eligibility, the New York Times reports. For example, Arkansas has removed 73,000 people from the program thus far, including 27,000 children ages 17 and under.

States appear to be shorthanded to address the high volume of redeterminations. According to a Brookings report on the so-called Great Unwinding, more than half of all Medicaid plans reported personnel and call center staffing shortages. Additionally, half of states have little experience with ex parte renewals, or renewals with data on hand instead of direct contact with enrollees.

On Tuesday, Center for Medicaid and CHIP Services Director Daniel Tsai expressed concern at the high levels of reported disenrollments from states like Arkansas and Florida, but stressed that the states with high disenrollment rates have not violated federal redetermination requirements, Inside Health Policy reports.

What we don’t have the authority to do is just to look at where various numbers are and to act like we’re finding specific violations of federal rules. I think what we are using this as an opportunity is: In some cases, states are following federal rules, and yet we’re still finding that individuals are not aware that Medicaid redeterminations have started. And [in] that sort of instance, we’re calling on people to go far and above what the federal minimum requirements are.

For its part, the Arizona Health Care Cost Containment System (AHCCCS) has issued a number of public advisories on redeterminations, including a set of Renewals Awareness Toolkits for managed care organizations, tribal communities and providers.

AHCCCS also published a press release reiterating that AHCCCS members who have lost AHCCCS coverage and are now otherwise insured may be able to continue seeing prior providers and continue courses of treatment.

The Kaiser Family Foundation has established a Medicaid Enrollment and Unwinding Tracker to streamline data on the Unwinding process by state and nationally. According to the Tracker, Arizona has lost 56,278 enrollees since redeterminations began.