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Case Study: Strategies for States to Maximize Medicaid Ex Parte Renewals and Limit Coverage Losses

More than 80 million people rely on Medicaid for their health insurance. If states do not proceed carefully when the federal COVID-19 public health emergency (PHE) declaration ends, a significant number of Medicaid enrollees will be at risk of losing coverage. Throughout the PHE, states have suspended the disenrollment of ineligible beneficiaries in an effort to stabilize health insurance coverage during an unprecedented and tumultuous time. When the PHE ends, states will resume terminations of those who are found ineligible or fail to respond to request for information notices and successfully renew coverage. Researchers estimate that, if past eligibility determinations are a sign of what is to come, between 13 million and 16 million people would lose Medicaid coverage, many of whom would remain eligible but lose coverage unnecessarily.

This issue brief highlights the successes and opportunities that other state Medicaid agencies can use when preparing for upcoming redeterminations at the end of the PHE. We interviewed state Medicaid agency officials from six states, three of which had pre-pandemic ex parte renewal rates of 75-90%, to understand their existing redeterminations processes, including the use of ex parte renewals, and to share best practices for states to consider prior to resuming terminations once the PHE ends. Based on our interviews, we highlight seven strategies for states to help ensure that eligible people who rely on Medicaid for their health insurance will not lose their coverage unnecessarily in the coming months.

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