We are now nearing the home stretch in the Medicaid unwinding. Minnesota is more than 8 months through the year-long process, and more than 1 million enrollees of the approximately 1.5 million total who had to renew have had their eligibility for Medical Assistance or MinnesotaCare rechecked through a renewal.
Today, the state released the latest renewal outcome data that captures the last several months of renewal work to get us to this point. The latest data impacts a significantly larger number of Minnesotans than previous data releases. That’s because multiple renewal deadlines converged at the end of January: Medical Assistance enrollees who renew in November had received a three-month renewal deadline extension, and Medical Assistance enrollees who renew in January as well as MinnesotaCare enrollees received a one-month renewal deadline extension on top of the Medical Assistance enrollees due to renew in February. These Minnesotans all had a deadline of Jan. 31 to complete their renewal paperwork. In addition, Medical Assistance and MinnesotaCare always experience higher renewal volumes at the end of the year, as more enrollees tend to apply for coverage during MNsure’s open enrollment period.
Of the more than 500,000 enrollees due for renewal Jan. 31, 67% — or 334,000 — maintained their coverage. The percentage of enrollees keeping their coverage has steadily increased throughout the unwinding. At DHS, we know that is thanks to the collaboration and hard work of partners – including counties, Tribes, health plans, health care providers, Tribal health partners and community groups.
Meanwhile, coverage ended for about 156,000 people in the same group. Approximately 29,000 of those submitted renewal forms and were found ineligible or qualified for affordable insurance through MNsure, the state’s health insurance marketplace. About 125,000 closed for procedural reasons. Some likely didn’t submit their renewal forms because they already had insurance from an employer or knew they no longer qualified for the program. Others may not have received their forms in the mail or realized that the documents were important. It’s important to remind Medical Assistance enrollees that most who missed their renewal deadline can still turn in their renewal form and possibly receive retroactive coverage if they remain eligible.
Minnesota’s unwinding performance has improved significantly since the start of the unwinding effort. Automatic renewal rates have increased while procedural disenrollments have dropped. These improvements will have far reaching impacts on the Minnesotans we serve long after the unwinding ends. We have made renewal outcomes better, and that’s despite the confluence of events leading into this unprecedented situation that could have created a high loss of coverage for eligible enrollees.
Automatic renewal rates tripled in Medical Assistance, going from about 17% in METS in July 2023 to almost 51% in METS in April. Renewing coverage automatically not only allows enrollees to skip renewal paperwork. It also eases the workload strain on state, county and Tribal eligibility staff, whose renewal work volume increased by more than 30% during the pandemic.
Other key strategies for keeping Minnesotans insured during this time have included:
DHS has also instituted IT-system and process changes that will decrease losses of coverage from paperwork issues and been busy working with partners to manually renew thousands of enrollees who should be eligible for automatic renewals under clarified CMS requirements. Low-income children benefitted the most from the mitigations put in place to meet these federal requirements – 97% of enrollees impacted are kids. The mitigations helped nearly 13,000 enrollees have their coverage reinstated, and about 79,000 keep their coverage.
So far, 842,000 enrollees, or about 74% of the total renewals processed, kept their Medical Assistance or MinnesotaCare coverage after completing their renewal during the unwinding. Coverage ended for about 288,000 people, or 26% of enrollees. About 85,000 lost coverage after submitting their renewal forms because they were found ineligible.
Together, we worked hard to get to this point in the unwinding, and then turned around and worked even harder. It took all of us and an all-hands-on-deck approach to get here. We appreciate everyone’s effort to work together, adapt, pivot and learn from changing and evolving circumstances. We have learned so much through this historic effort, and we will carry forward these lessons to keep improving renewals for years to come.
Sincerely,
Julie Marquardt
Deputy Assistant Commissioner and Interim State Medicaid Director, Health Care Administration