AHIP Announces Medicaid Redeterminations Coalition and Associated Report

AHIP to lead Connecting to Coverage Coalition, a one-stop shop for multi-stakeholder redetermination resources.

As many as 18 million people could lose Medicaid coverage after the COVID-19 Public Health Emergency (PHE) ends. April 1 is the deadline for states to start redetermining eligibility of Medicaid beneficiaries.

In response, AHIP has co-founded and will lead the Connecting to Coverage Coalition (CCC), "a national coalition committed to being a single source of trusted information about the Medicaid redetermination process."

The CCC "will also work to convene stakeholders to support information sharing, build on best practices, and develop solutions to ensure Americans are able to enroll in coverage that is right for themselves and their families."

Coverage options range from remaining on Medicaid for those still eligible or transitioning to an employer-sponsored, CHIP or commercial plan, with options for the latter including the individual and ACA marketplaces.

On the new CCC website, AHIP President and CEO Matt Eyles commented: "With the Medicaid redetermination process already underway, millions of Americans will be looking for trusted, reliable information to guide them. The Connecting to Coverage Coalition will be an essential resource to help them through Medicaid redetermination, and to learn more about the health care coverage that is best for them."

New redetermination resources

The CCC website includes the following redetermination resources for Medicaid enrollees, healthcare navigators, industry and community leaders, and other stakeholders:  

• Background research on knowledge and perceptions surrounding the Medicaid redetermination process.
   
• Redetermination FAQs for Medicaid enrollees and family members.
   
• CMS and other federal agency guidance on redeterminations.
   
• Best practices and toolkits for eligibility pathways.

In its CCC press release, AHIP stated that the coalition is committed to helping people "enroll in affordable coverage choices to protect their health and financial stability."

Combating low awareness and understanding

Help for current Medicaid enrollees will be pivotal. HealthLeaders recently reported that 64% of adults in a Medicaid-enrolled family have no idea that they may lose coverage with the return to regular Medicaid renewal processes. That figure—based on analysis from the Urban Institute, funded by the Robert Wood Johnson Foundation—is only slightly higher than the 62% of beneficiaries who reported being unaware of redeterminations.in June 2022.

The most recent survey uncovers that 16% of adults have heard only a little about the return to regular renewal processes, while 13.9% have heard some, and 5.1% have heard a lot.

Awareness does not differ significantly across the U.S. Lack of awareness is highest in the Midwest (67.6%) and lowest in the West (61.3%). There is also little difference in states that have expanded their Medicaid programs, where awareness is 64.5% versus 63.7% in non-expansion states.

State-by-state coverage analysis

Nuances across states matter. As part of the CCC, AHIP has also released the Medicaid Redetermination Coverage Transitions Report.

The report—based on analysis conducted by NORC at the University of Chicago with AHIP support—estimates the current Medicaid enrollees who will lose eligibility, what programs they will transition to, and variations across states:

• Most enrollees will have access to employer-provided coverage (EPC).
   
• This is true in nearly all U.S. states, with NORC estimating that Georgia will have the lowest EPC transition enrollment (48.9%) and Delaware the highest (57.1%).
   
• Approximately 3.8 million current Medicaid enrollees will become uninsured (21.2%).
   
• This compares to the 18 million originally projected to lose Medicaid coverage.
   
• NORC has determined that uninsured rates due to Medicaid redeterminations will grow the most in South Dakota (26.2%) and the least in Massachusetts (17.7%).

The NORC report includes a coverage-transition modeling dashboard based on two core figures: the Urban Institute's estimate of a state's total Medicaid coverage loss during redetermination and the percentage of the state's population that is currently enrolled in Medicaid and CHIP.

The modeling includes a breakdown of not only EPC, CHIP and marketplace coverage transitions, but those Medicaid enrollees who are projected to receive subsidies on the ACA exchange and those who will transition to other healthcare insurance programs such as military-based and Medicare.

Despite state differences, the CCC hopes to identify best practices that could apply more generally to Medicaid redeterminations for smoother transitions with fewer negative impacts.

CCC leadership organizations

Three payer organizations are among the CCC's founding members: Association for Community Affiliated Plans, Blue Cross Blue Shield Association (BCBSA), and Medicaid Health Plans of America.

On the CCC website, BCBSA CEO and President Kim Keck commented: "Millions of Americans are at risk of losing their Medicaid coverage. Our commitment is simple: Everyone should have access to high-quality, equitable, and affordable care, in times of trouble like the pandemic, and every other day."

Additional members include: American Cancer Society Cancer Action Network, The Arc of the United States, Cystic Fibrosis Foundation, Cancer Support Community, Mental Health America, Catholic Health Association of the United States, Unidos US, American Benefits Council, National Association of Benefits and Insurance Professionals, National Association of Community Health Centers, Federation of American Hospitals, and American Health Care Association.