Medicaid, Kid Care disenrollments fall amid ‘unwinding’

The number of people who’ve lost access to government health coverage during the “Medicaid unwinding” in Wyoming has fallen.

As of Sept. 30, the Wyoming Department of Health states that Medicaid and Kid Care CHIP benefits for about 9,000 people — most of them children — have ended. Kids are the largest enrolled group.

About 7,800 of the newly uninsured lost coverage due to “procedural reasons,” like not turning in paperwork. Others were deemed ineligible.

Still, the number of people who’ve lost coverage through the unwinding that followed the end of COVID-era prohibitions on disenrollments has actually shrunk. July estimates put that figure at about 10,700 — roughly 1,700 more than the latest numbers. 

Since that time, the number of people whose benefit renewals have been approved has more than tripled to nearly 24,000. 

People responding to renewal requests contributed to the decrease in those who’ve lost coverage, according to Wyoming Department of Health spokesperson Kim Deti.

Another driver, she said, was a change in how the department renews coverage, prompted by the Centers for Medicare and Medicaid Services. 

The unwinding

Medicaid unwinding involves states confirming that those who have coverage under these insurance programs are still eligible — a federally required annual process that was paused for three years of the pandemic. 

Starting in April, Wyoming began reaching out to some Medicaid and Kid Care recipients for renewal documentation. The unwinding will be a year-long process, with groups of beneficiaries receiving notices and reminders in waves. 

Between April and June, Wyoming held off from disenrolling people for procedural reasons, like missing paperwork. In July, it began pulling coverage for those who haven’t returned paperwork.

Initially, the health department estimated 10,000-15,000 people would lose access to their Medicaid or Kid Care CHIP coverage over the course of the year. When the number of those who’d lost their coverage grew to over 10,000 by the end of July— mostly due to procedural issues — the department recalibrated.

“Average monthly enrollment in Wyoming Medicaid before the pandemic was around 55,000,” said Medicaid agent and health department administrator Lee Grossman in a press release. “Because eligibility could not be reviewed until recently, this year it’s reached a historic high of about 87,000. It is not unreasonable to expect enrollment to return much closer to the range we saw before the pandemic.”

However, on Aug. 30, CMS sent a letter to state Medicaid directors about a possible issue with auto-renewals, which may have led thousands to unnecessarily lose coverage.

According to the federal agency, these renewals “are one of the strongest requirements states must implement to keep eligible people enrolled in Medicaid or CHIP coverage during the renewals process.”

“Federal rules require states to use information already available to them through existing reliable data sources (e.g., state wage data) to determine whether people are still eligible for Medicaid or CHIP and to do so for each individual in a household, regardless of the eligibility of other household members,” CMS stated in an Aug. 9 press release. “Auto-renewals make it easier for eligible people to renew Medicaid and CHIP, helping to make sure individuals are not disenrolled due to red tape.” 

According to federal findings on Sept. 21, Wyoming was among more than half of U.S. states reporting that they were not following these federal auto-renewal guidelines, possibly affecting between 10,000 and 49,999 Wyomingites. 

This request for individual auto-renewals — otherwise known as ex parte renewals — was part of a change in guidance and expectation from CMS, according to Deti.

“Our unwinding plan was approved by CMS early in the year,” she stated. “Later, CMS guidance was changed in regards to the individual ex parte issue.”

The health department has been aware of the issue for “some time,” Deti said, and employees have been “manually reviewing thousands of cases to help ensure coverage was continued for people who remain eligible.”

CMS has now approved Wyoming’s updated plans, she added, and the department is working with its vendor to adjust its capabilities to review clients at the individual level rather than the household level.

The American Cancer Society’s Cancer Action Network called on the state to halt its unwinding process entirely in August, citing the 10,000 who’d been removed from the insurance at that time, the Jackson Hole News & Guide reported.

That group is now applauding the recent decrease in the number of people who’ve lost coverage in Wyoming. 

“With the latest data release, we are pleased to see that a combination of federal and state actions are reducing the number of enrollees impacted by systems level challenges in the renewal process,” Kristin Page-Nei with the Cancer Action Network said in a statement. 

Page-Nei added that the group appreciates Wyoming Medicaid Administrator Lee Grossman’s transparency and looks forward to working further with the governor’s office in making sure eligible people can transition into affordable health plans offered through the federal marketplace.

“ACS CAN remains committed to advocating for Medicaid expansion as a means to more sustainably close the health coverage gap in Wyoming,” she stated. 

The state estimates that Medicaid expansion could cover 19,000 additional Wyomingites over two years.

To the phone lines

While Wyoming was one of many states that were asked to re-work their renewal process, it’s been among the top states in the nation for its responsiveness over the phone. 

A recent CMS report found that, as of June, Wyoming’s average wait time for callers needing help with their Medicaid or Kid Care renewal was zero minutes. Wyoming’s dropped call level was also among the lowest at 0.4%.

That’s compared to Montana, which had the nation’s highest call wait times in June — an average wait of 49 minutes — and one of the nation’s highest dropped call rates at 43%. 

Calls and texts coming out of Wyoming’s Medicaid offices are important, too.

If someone’s insurance can’t be auto-renewed, they’ll be sent forms in the mail 60 days before coverage ends along with a text reminder around the same time, Deti said.

“If a renewal form is returned by the post office, staff attempts to reach the client or their representative by phone,” she added. “If an individual’s case is closed, they get another text and notice with 90-day redetermination information.”

Losing benefits

If you have lost Medicaid or Kid Care CHIP coverage during this process, there are options, according to Deti. People can provide additional information up to 90 days after coverage has ended and gain backdated benefits for that time, she said. People can still apply at any point after those 90 days if their situation has changed, too. 

If someone feels they were incorrectly denied access to Medicaid or Kid Care, there is also an appeals process. 

For those who have already received their renewal notices, they can update their contact information and renew coverage at www.wesystem.wyo.gov or by calling 1-855-294-2127.

If someone is no longer eligible for Medicaid or Kid Care, other insurance options can be found at enrollwyo.org or residents can seek out insurance navigators embedded within the state’s larger hospitals.