First States Begin Medicaid Redetermination Process Following COVID-19 PHE Unwinding

Over the weekend of April 1, Medicaid continuous and expanded coverage, authorized throughout the duration of the COVID-19 public health emergency (PHE), ended in five states: Arizona, Arkansas, Idaho, New Hampshire, and South Dakota. This has resulted in some Medicaid enrollees losing their coverage due to lack of current eligibility, failure to submit paperwork on time, or in some cases, state error. The unwinding process will continue in all other states in the coming months, as explained in a helpful table provided by CMS.

When the COVID-19 pandemic began, Congress passed the Families First Coronavirus Response Act (FFCRA). One of its provisions required Medicaid programs to keep individuals enrolled until the end of the month in which the COVID-19 public health emergency (PHE) concludes, in return for temporary increased federal funding for Medicaid. This continuous enrollment provision has played a significant role in the substantial growth of Medicaid enrollment and the reduction of the uninsured rate. However, once this provision expires, millions of people may lose their coverage. Some estimates expect between 5 million to 14 million people will lose coverage once the continuous coverage ends.

In essence, due to COVID-19, Medicaid renewals had been paused for the last three years, but due to the ending of the PHE, states will begin, or have begun, redetermining Medicaid beneficiaries’ eligibility.

Any individuals who may be Medicaid or CHIP eligible will be required to go through a redetermination process. For beneficiaries with intellectual and developmental disabilities (I/DD), this will look very similar to years past, but with a 3-year backlog on redeterminations, ANCOR expects this process may take time for states to complete.

The Centers for Medicare and Medicaid Services (CMS) have created a communications toolkit to ensure clear and accurate messaging to the public during the redetermination process. To make the renewal process smoother and avoid any potential issues, individuals can follow these recommendations from CMS:

1. Update your contact information – Make sure your state agencies have your current mailing address, phone number, email, or other contact information. This way, they’ll be able to contact you about your Medicaid or CHIP coverage.

1. Check your mail – Your state will mail you a letter about your coverage. This letter will let you know if you need to complete a renewal form to see if you still qualify for Medicaid or CHIP.
2. Complete your renewal form (if you get one) – Fill out the form and return it to your state right away to help avoid a gap in your coverage.