UPDATED: State pauses Medicaid disenrollments amid ‘unwinding’ process

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(Updated to show that disenrollments have resumed.)

Kansas has paused cutting people off Medicaid as it unwinds from a federal law that blocked beneficiaries from being removed from the federal health insurance program for low-income adults, children, pregnant women, seniors and people with disabilities.

The Kansas Department of Health Environment confirmed that it halted “discontinuances” in May and June because of concerns about postal service delays and other “challenges interfering with the federally required thirty days for members to return their renewals.”

It was not immediately disclosed on Monday or Tuesday how long that pause would last. On Wednesday, the agency said the disenrollments resumed on July 18.

Last week, it was reported that 12 states halted disenrollments and reinstated coverage because a majority of the people cut off of Medicaid were cut for procedural reasons where a beneficiary didn’t complete the process because they didn’t receive the forms or didn’t submit them on time.

The Centers for Medicare and Medicaid Services revealed it halted the eligibility verifications to address the procedural disenrollments. CMS didn’t disclose the 12 affected states. Kansas officials said they made the decision to pause of their own volition.

The latest “unwinding” numbers made public by KDHE hadn’t shown much change since they were first released in early June.

In early June, the state data showed that 51,487 beneficiaries had their Medicaid coverage ended, including 45,820 who lost their coverage for procedural reasons.

The most recent number for Kansas on June 30 showed that 53,269 lost Medicaid coverage, either for procedural reasons or because they were no longer eligible.

Out of the 53,269 Kansans who had lost their coverage, 45,837 were cut off for procedural reasons, but were given a 90-day window to submit and complete their eligibility review if they missed their deadline or had more information to report.

States across the country are now “unwinding” from the continuous enrollment provision in federal law that allowed beneficiaries to remain on Medicaid rolls during the pandemic without needing to have their eligibility determined.

The federal government suspended those eligibility reviews during the COVID-19 pandemic emergency, but they started up again in April under legislation passed by Congress. The change is forcing millions of people off the Medicaid rolls.

The Kaiser Family Foundation reported this week that 3.7 million people nationally have lost Medicaid coverage during the unwinding process.

KFF reported that 73% of all people disenrolled had their coverage terminated for procedural reasons in states with available data.

Texas leads the country with total disenrollments at 501,000 followed by Florida at 408,000, Washington at 230,000, California at 225,000 and Arkansas at 219,000.

KFF reports that Kansas had the fourth highest disenrollment rate in the country at about 65%.

Texas also had the highest disenrollment rate at 82% followed by Idaho at 76% and South Carolina at 72%.

“Despite all the preparations and what we know has been a tremendous amount of work at the state level and in the community, we are very concerned about the level of terminations, meaning disenrollment, that we are seeing across the country,” Daniel Tsai, director of the Center for Medicaid and CHIP Services, told reporters in a meeting reported last week by CNN.

It was always anticipated that the unwinding process would leave people without Medicaid coverage.

National polling showed that many Medicaid beneficiaries were not prepared for the new administrative process and were even unaware they could lose coverage.

A poll done by Kaiser Family Foundation before the unwinding process started in April found that many beneficiaries were not ready for the renewal process.

The Kaiser survey found that 65% of Medicaid beneficiaries were not sure whether states could remove them from the program if they aren’t eligible or didn’t finish the renewal process.

Another 7% wrongly believed states couldn’t remove them from the Medicaid program.

More than four in 10 recipients who relied only on Medicaid  said they wouldn’t know where to search for health care coverage or would be left uninsured if they were found to be ineligible for Medicaid, the survey found.

The Kaiser Family Foundation estimated between 7.8 million and 24.4 million people nationally will be affected during the 12-month unwinding period.

Officials in Kansas estimated at 125,000 people were at risk of losing insurance coverage.

Heather Braum, health policy adviser for Kansas Action for Children, was upbeat about the pause in disenrollments but still had serious reservations about the fact that children are disproportionately affected by the unwinding.

She pointed to new data released by the state health department on Tuesday showing that a vast percentage of people affected by the unwinding in Kansas are children.

The state health department broke down by age group the number of Kansans who were placed in the 90-day window during April and May when they were discontinued for procedural reasons.

About 62% of those beneficiaries who were placed in the 90-day window were 18 and younger, the data shows. About 15% were 4 and under, the data shows.

“We are encouraged to hear the state has given KanCare members more time to return their renewal forms, as these Kansans can continue to have access to necessary health services,” Braum said in a statement.

“With today’s data release breaking out some of the numbers by age and county, we finally begin to have a picture of how the unwinding is going for children,” she said.

“These numbers confirm our deep concern that Kansas children are at high risk of losing their coverage, yet remain eligible for KanCare,” she said.

“We will continue pushing for Kansas families to be targeted in outreach efforts in the months ahead.

The state health department has been seeking help from the federal government, getting approval for waivers from the Centers for Medicare and Medicaid Services to give the state the flexibility to help people get their eligibility determined.

The approved waivers give the state the ability to take some of the burden off of recipients to renew their coverage.

For instance, they allow the state to renew coverage for individuals with no income without requesting additional information or documentation from the beneficiary under certain circumstances.

Those waivers also allow the managed care organizations that administer the Medicaid program to update contact information for beneficiaries or allow the state to update that information using the U.S. Postal Service or the National Change of Address database.

The state also is seeking federal approval for other measures that would permit managed care plans to provide assistance to beneficiaries to complete and submit Medicaid renewal forms.

The state also is seeking permission to reinstate eligibility effective on the individual’s prior termination date for anyone cut off because of a procedural reason and are subsequently determined eligible for Medicaid during a 90-day reconsideration period.