Focus on Medicaid Eligibility Renewals

Posted December 8, 2023
By Aditi Mallick, M.D.
Acting Director, Centers for Medicare & Medicaid Services, Office of Minority Health

Earlier this year, state Medicaid and the Children’s Health Insurance Program (CHIP) began the process of conducting renewals for health care coverage, following the end of the COVID-19 public health emergency. While many individuals and families who are no longer eligible for Medicaid or CHIP have or will transition to other forms of coverage during this process, many people are at risk of becoming uninsured and having a harder time accessing critical health services.

The Centers for Medicare & Medicaid Services (CMS) is committed to connecting with underserved communities that are medically underserved so that they have the resources needed to determine if they or a family member will still qualify for Medicaid and CHIP, or an alternate form of coverage, such as through HealthCare.gov.

What Happens During Medicaid Renewals
Medicaid and CHIP renewals are a multi-step process, and states must begin the process by attempting to complete renewal of coverage based on information available to them without contacting the individual. If that is not possible, agencies must send renewal notices and requests for information to enrollees.

Many individuals enrolled in Medicaid may have moved during the pandemic and may not receive renewal notices at their new addresses. Others may receive notices but may not know that Medicaid renewals have restarted, or they may face barriers as they take steps to complete renewals. These challenges may lead individuals to be disenrolled from Medicaid or CHIP, even if they are still eligible, leading them to lose access to necessary health care services and medications, or their health care coverage may be interrupted or discontinued.

While each state is approaching Medicaid and CHIP renewals differently, racial and ethnic minority communities that are underserved are likely to be disproportionately impacted. Medicaid and CHIP disproportionately provide coverage to individuals and families from racial and ethnic minority communities and people living in rural areas. Higher rates of homelessness or language barriers may further impede the ability of these communities to receive or understand renewal notices crucial to ensuring continuity of coverage.

Medicaid Renewals 101
In March 2020, as part of COVID-19 relief, Congress authorized additional Medicaid funding for states on the condition that they satisfied a “continuous enrollment” condition, which generally prohibited states from terminating most Medicaid enrollees’ enrollment until the end of the COVID-19 public health emergency. This helped to ensure millions of people could remain enrolled in Medicaid coverage without interruption during the pandemic. The continuous enrollment condition ended on March 31, 2023, allowing states to begin to return to normal operations around eligibility and enrollment, including conducting Medicaid renewals, beginning on April 1, 2023.

States have independent obligations under federal civil rights laws to ensure that individuals and families continue to have access to Medicaid and CHIP, as states conduct renewals. For example, states are required to take reasonable steps to provide meaningful language access for individuals with limited English proficiency and ensure effective communication with individuals with disabilities. Ensuring access to information is vital and required.

Know Who is Affected
Millions of people could be disenrolled from Medicaid and CHIP during this renewals process, with people from racial and ethnic minority communities at higher risk. Children and young adults, as well as Latino and Black individuals, are predicted to be disproportionately impacted. Seamless transitions to other forms of coverage, such as through HealthCare.gov, will play an important role for many in maintaining coverage for those who are no longer eligible for Medicaid and CHIP coverage.

Nearly one-third of those predicted to be disenrolled from Medicaid are Latino individuals (4.6 million) and 15% (2.2 million) are Black individuals. As the single largest payer for mental health services in the United States, Medicaid is critical in the treatment and success of those with mental illness. With health care coverage, mental health patients have access to ongoing treatment, medicines, and care that help keep them out of hospitals, emergency rooms, and the cycle of chronic homelessness. Furthermore, individuals with serious mental illness often have co-morbid physical health conditions and substance use disorders, making continuous health care coverage even more critical.

Know How to Help
Without health coverage, people from racial and ethnic minority communities and other populations that are underserved could see a lapse in the progress they were able to make during the pandemic when Medicaid enrollment was continuous. Information on the Renew Your Medicaid or CHIP Coverage webpage is a great starting point for helping people better navigate Medicaid and CHIP renewals. The webpage outlines how to get ready for the renewal process, what to do if you no longer qualify for Medicaid or CHIP, and where to go for more help, including how to contact each state’s Medicaid office. Find toolkits, drop-ins, creative assets, and translations on the Medicaid and CHIP Renewals Outreach and Educational Resources webpage and be sure to download the All Hands-on-Deck Toolkit to get started in your community. Keep the conversation going throughout Open Enrollment! Find your state here to learn more.

By sharing these resources and information with your networks and communities, you can help continue to improve mental and behavioral health in all communities.

Let’s be intentional about helping to educate all racial and ethnic minority communities and others who are underserved on ways to better understand the Medicaid unwinding process, their health coverage and how to access care and services. Join CMS and share Medicaid and CHIP renewal information and resources to help more people keep their coverage.