States Warned Not To Lose Medicaid Participants in the Renewal Process

You may have heard the familiar saying, “Getting lost in the process.” That’s just was the Department of Health and Human Services (HHS) is trying to prevent judging by a recent letter HHS Secretary Xavier Becerra sent to state governors regarding Medicaid redeterminations.

As flexibilities allowed for Medicaid enrollment during the COVID-19 pandemic now lapse, states are reviewing their rolls of participants eligible for Medicaid to begin the full renewal process. However, in his letter, Becerra warned states that “it is critically important to ensure that individuals do not lose coverage due solely to administrative processes. I urge you to adopt all options that we have offered to help eligible individuals and families maintain their health coverage during this process and leverage all state partners to support individuals and families to complete renewal forms.”

As HHS’ Centers for Medicare and Medicaid Services monitors changes in Medicaid and Children’s Health Insurance Program (CHIP) enrollment, Becerra explained that he is “deeply concerned with the number of people unnecessarily losing coverage, especially those who appear to have lost coverage for avoidable reasons that state Medicaid offices have the power to prevent or mitigate.”

To avoid individuals losing coverage due to administrative processes, Becerra called on states to review their currently elected flexibilities and consider going further to take up existing and new policy options that HHS has offered to protect eligible individuals and families from procedural termination. Among these options include:

• spreading renewals for all populations out over 12 months, which will provide more time conduct the renewal process and prevent systems from getting backlogged;
• maximizing the use of data sources, such as renewing individuals on the basis of their eligibility for other programs (e.g., the Supplemental Nutrition Assistance Program or Temporary Assistance for Needy Families), thereby reducing the need for some individuals to fill out and return a Medicaid renewal form; and
• partnering with managed care plans and using data available from the U.S. Postal Service to update people’s contact information so that they actually receive the renewal forms states are sending out.

Becerra also encouraged states to better engage with Medicaid and CHIP families, noting that a recent survey of Medicaid enrollees found that two-thirds of people were not sure if their state was returning to regular Medicaid operations. “We must all do much more to ensure that everyone with Medicaid or CHIP coverage knows that they must check their mailbox and/or email for a renewal form and return it immediately to maintain their coverage,” he added. “States must comply with federal rules regarding how they conduct Medicaid and CHIP renewals, and individuals must be afforded the due process to which they are entitled in order for states to continue to receive enhanced federal funding.”

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