How Medicaid ‘Unwinding’ Varies from State to State

September 20, 2023

Pennsylvania’s state leaders are urging Medicaid beneficiaries to update their contact information to ensure they are ready for reenrollment.

Earlier this year, the pandemic-era provision requiring states to keep beneficiaries on the Medicaid rolls came to an end. States have restarted renewal determinations, but the process looks different across the U.S.

"Everyone deserves the dignity and peace of mind of having access to affordable, high-quality health care and knowing they can go to the doctor when they need it," Dr. Val Arkoosh, Department of Human Services (DHS) secretary, said in a statement highlighting reenrollment earlier this month.

Among the key takeaways:

• Overall trend:  Through Tuesday, nearly 6.8 million Medicaid enrollees have been disenrolled, according to the Kaiser Family Foundation (KFF). More than 200,000 in Pennsylvania have been disenrolled.
• By states:  Texas, Idaho, and Wisconsin have the highest disenrollment rates, with more than 60 percent of enrollees removed from coverage. Michigan (9%), Maine (14%), and Oregon (14%) have the lowest disenrollment rates.
  • Pennsylvania is in the middle of the pack for its disenrollment rate at 33 percent, according to KFF.
• Reasons for lost coverage:  Nationally, about 72 percent of all people disenrolled from coverage were terminated for procedural reasons, meaning they did not complete renewal information or could not be reached due to outdated contact information.
  • In Pennsylvania, about 44 percent of enrollees lost coverage for procedural reasons.
  • New Mexico, Nevada, and Utah have the highest rate for procedural terminations, with each state at 94 percent or higher.
• Demographics:  Children account for 42 percent of Medicaid disenrollments in the 16 states that report by age. They account for about 25 percent of Pennsylvania's disenrollments among the Medicaid maintained population.
• Quotable:  “DHS' goal throughout the renewal process is to make sure that all Pennsylvanians stay covered, so they have that peace of mind,” Arkoosh said. “The best way to do that is to update your contact information and be ready for when it's your turn to renew so when your packet comes, you can act quickly and stay covered.”

HAP encourages Medicaid beneficiaries to be sure their contact information is up to date and to be on the lookout for their renewal packet. Additionally, Pennsylvania’s health insurance marketplace has options available for those who need coverage following the redetermination process. In many cases, people will qualify for support to reduce the cost of coverage.

With the end of continuous enrollment, DHS—in partnership with provider organizations, including HAP—has developed resources to help providers share important information with patients.

DHS’s stakeholder toolkit includes printable education materials, scripts for conversations with patients, and digital assets, such as social media posts and website graphics. The toolkit is available online.