UHF’s Fourth “Unwinding” Convening Highlights Coverage Renewals, Future Plans

New York is nearing the end of its massive effort to unwind COVID-19-related continuous coverage provisions and ensure millions across the state enrolled in Medicaid, the Essential Plan, and Child Health Plus can maintain health insurance coverage.

Hundreds of state officials, providers, health plan staff, assistors, and other stakeholders gathered May 21 at United Hospital Fund to discuss this critical juncture of the year-long unwinding process. The event—the fourth in a series of convenings hosted by UHF—included the latest enrollment data as well as an exploration of lessons and strategies that could spark both a strong finish and a better marketplace long-term.

“We're in the homestretch...but it’s clear that even once that deadline comes, the work will continue,” UHF President and CEO Oxiris Barbot, MD, told the 250 participants in the hybrid event. “We are in this together to make the system as responsive to the needs of New Yorkers that we’re trying to serve as possible.”

Three quarters of the way through the unwinding, New York has initiated more than 5 million renewals and successfully renewed coverage for 4.1 million—or 82 percent—of those consumers. This includes 79 percent of adults and 91 percent of children, New York State of Health Marketplace Deputy Director Sonia Sekhar said.

Compared to other states, New York ranks 10th lowest in the rate of consumers who were disenrolled from coverage during the unwinding, according to an analysis by Matthew Buettgens, senior fellow at the Urban Institute. Dr. Buettgens' research report, released in May, compared reenrollment rates as of November 2023 to projections from an earlier Urban Institute report that estimated 14.8 million people could lose Medicaid or Children’s Health Insurance Program (CHIP) coverage nationally during the unwinding. Several states have surpassed those disenrollment predictions. Due in part to certain policy decisions, New York disenrollment only reached 35 percent of the report’s projections.

These policy decisions included waivers offered to states by the federal Centers for Medicare & Medicaid Services (CMS) to provide more flexibility in their renewal efforts. New York received approval for a total of 10 waivers. According to the Urban Institute report, states that took advantage of 10 or more of these optional waivers had a lower disenrollment rate than those that used fewer. The report noted particular success with the use of “ex parte” waivers, which allow states to redetermine eligibility for certain consumers with agency data rather than information obtained directly from the individual. New York used seven ex parte waivers, more than 41 other states.

At the convening, officials gave an update on New York’s efforts to extend these waivers indefinitely to allow long-term efficiencies in the Medicaid renewal process. CMS has already noted it will extend eight of the 10 through June 2025, officials said.

“We’re going to be working closely with CMS because we think these are very important,” said Gabrielle Armenia, director of the New York State Department of Health (NYS DOH) Division of Eligibility and Marketplace Integration.
Attendees also heard an update about the state’s plan to create a more consumer-centric Medicaid system, known as the Medicaid Eligibility Modernization Project. The project will extend through 2027.

“The continuing modernization of New York State Medicaid will support the department’s vision and mission to improve and promote health, productivity, and well-being of all New Yorkers by embracing a modern way to access health care,” said Sara Oberst, deputy director of NYS DOH Division of Eligibility and Marketplace Integration.

See below for an agenda, slide presentation, and video from the event: Surviving the Unwinding Part IV: Finishing Strong in the Home Stretch and Preparing for the Future.

 
Published
June 14, 2024
Focus Area
Coverage and Access
Initiatives
Health Insurance ProjectMedicaid Institute