Tracking the Unwind of Public Health Emergency Continuous Medicaid Coverage
The federal government ended the continuous Medicaid coverage provision of the Families First Coronavirus Response Act (FFCRA) on May 11, 2023, through the Consolidated Appropriations Act of 2023.1 In June 2023, New York began the process of redetermining Medicaid members’ eligibility for coverage. The redetermination process will continue until the end of the unwinding period, July 2024.2 The dashboards below capture monthly trends in renewals, terminations and program transitions for those who were due to redetermine their eligibility for public insurance coverage in New York State from June 2023 to the present.
Before terminating coverage, states must attempt to complete an “ex parte” renewal which is also known as an auto-renewal or administrative renewal. During the ex parte renewal process, available information such as state unemployment, tax filings, and wage databases are cross-checked to determine whether an enrollee’s eligibility can be independently confirmed. If the ex parte renewal is successful, enrollee’s coverage will be redetermined and continue for another 12 months without the enrollee having to submit a renewal or any additional information.
If the ex parte renewal is unsuccessful, then the enrollee must submit an application to renew their coverage. If the enrollee completes the application and remains eligible for Medicaid, then they will maintain their Medicaid and not have to reapply for another year. If the enrollee completes the application but is not eligible for Medicaid anymore, the state determines eligibility for other public coverage through the New York State of Health Marketplace, such as Essential Plan, Child Health Plus, or Qualified Health Plans. Note, these other public insurance options are only available for people under 65, as people over 65 usually qualify for Medicare for their public health insurance. If the enrollee fails to submit a renewal application, then they will be found ineligible and their Medicaid coverage will be terminated until they submit a new application. In New York there is a grace period when people can submit a renewal application after they missed their recertification deadline. For people who fail to submit a renewal application before the deadline or during the grace period, they can submit a new application for Medicaid, Child Health Plus, or Essential Plan anytime during the year.
What’s Happening with New York Medicaid Renewals?
There are a few outcomes that can occur during the renewal process. As mentioned above, Ex parte renewals, or auto renewals, are the easiest way for an individual to have their coverage renewed, as the renewals are completed on the back end. Additionally, an individual can also be renewed if they complete a “Renewal Form” provided they are eligible and meet criteria for coverage, also known as a manual renewal. Either “Ex Parte Renewal” or “Renewal Form” on the Unwind: Total Renewals or Unwind: Monthly Renewals dashboard indicates a successful renewal.
Some individuals may not have been renewed, but this is not always due to their ineligibility. On the Unwind: Total Renewals or Unwind: Monthly Renewals dashboard, Outcomes labeled as “Procedural Termination” or “Incomplete” may represent individuals who are still eligible, but the renewal was not completed successfully. Specifically, “Procedural Terminations” indicates that the individual did not submit a renewal form, was not able to be contacted, did not receive paperwork, or submitted the forms incorrectly. And, “Incomplete” refers to individuals who were not yet redetermined by the state Medicaid agency within the given month or have not yet enrolled in a health plan. Lastly, “Ineligible” refers to individuals who were determined ineligible based on their renewal application for Medicaid or Child Health Plus during their renewal process.
The Unwind: Total Renewals and Unwind: Monthly Renewals dashboards display cumulative outcomes, from the start of the unwind in June 2023, to present. The monthly view stratifies these outcomes across each month’s renewal cohort. While the monthly renewal types vary, a majority of New Yorkers have renewed and maintained their public insurance throughout the Unwind.
Unwind: Total Renewals
Unwind: Monthly Renewals
