With between individuals poised to lose Medicaid protection through the redetermination course of, the Kaiser Household Basis (KFF) has 9 metrics that states are following to mitigate losses.

Medicaid redetermination is the method states use to find out if enrollees are nonetheless eligible for Medicaid. In the course of the public well being emergency, states have been banned from disenrolling individuals from Medicaid by way of the continual enrollment provision, which ended March 31.

The 9 metrics KFF discovered fall underneath three classes:

Renewal insurance policies

• The state is taking 12 to 14 months to finish Medicaid renewals
• The state is following up on returned mail
• The state is following up with enrollees who haven’t responded to a renewal request earlier than ending their protection

System capability measures

• The method for renewing enrollees is “principally automated”
• Fifty p.c or extra of renewals are finished on an “ex parte foundation,” renewing protection with out the enrollee finishing necessities
• The state is engaged on bettering ex parte renewal charges

Eligibility insurance policies

• The state has expanded Medicaid
• The state prolonged postpartum protection to 12 months
• The state has 12-month steady eligibility for youngsters in Medicaid and CHIP

KFF’s evaluation discovered that solely Colorado has adopted all 9 of those metrics, and one other seven states have adopted at the very least eight (together with Washington, New Mexico, Illinois, Indiana, Virginia, North Carolina and Massachusetts). One other seven states are solely assembly 4 or fewer of those metrics (together with South Carolina, Missouri, Arkansas, Oklahoma, Nebraska, South Dakota and Wyoming). 

Nevertheless, Arkansas, Nebraska and North Dakota didn’t present information on the share of ex parte renewals and Ohio and Texas should not included within the evaluation. KFF additionally famous that the report exhibits information from January and that it’s potential that some states have modified their insurance policies since then.

The report additionally found that 42 states don’t meet all three of the system capability measures metrics.

“The executive burden on each workers and enrollees is more likely to be increased in these states and they’re going to doubtless face distinctive challenges as they work to finish the elevated quantity of renewals through the unwinding interval,” the report said.

As well as, solely 14 states have all three of the eligibility insurance policies in place, KFF confirmed.

“Whereas these insurance policies should not instantly associated to the flexibility to finish the renewal course of, they do have an effect on how continuously an enrollee could have their eligibility redetermined, and within the case of adoption of the Medicaid enlargement, the chance that nonelderly adults will be capable to retain protection when their eligibility is redetermined through the unwinding interval,” the researchers said.

KFF added that simply having these insurance policies isn’t the one factor that’s going to have an effect on Medicaid protection.

“Whereas this evaluation examines state insurance policies, how states implement these insurance policies might be simply as necessary a think about how the unwinding proceeds throughout states,” KFF stated. “Implementation, in flip, might be affected by state staffing capability, the effectiveness of state outreach to and communications with enrollees, and state engagement with key stakeholders, together with MCOs, suppliers, and neighborhood organizations, to help with enrollee outreach efforts.”

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