As part of my colleague’s blog series on renewals, I wanted to share how hard work is paying off on Medicaid renewals in Washington state. Washington is among the first states in the country to get started on MAGI-based renewals. What are MAGI-based renewals? Just like new applications, renewals in Medicaid will be based on “modified adjusted gross income” rules for counting income and household size. The state needs to collect new information regarding tax-filing status and access to affordable employer based minimum essential coverage. Washington learned the hard lesson that extra time and resources are needed to get enrollees over this MAGI information collection hump.
In November 2013, when Washington started MAGI-based renewals, they saw a dramatic decrease in the number of enrollees who were able to complete the renewal process after receiving a letter in the mail instructing them to reenroll. More than 80 percent of the state’s caseload that month would have lost coverage if the state had not acted! But, the state quickly came up with a serious plan of attack to follow up and renew coverage (see below). This hard work paid off. Washington ended up renewing 92 percent of enrollees up from last November (meaning that only 8 percent did not renew), and hopes to continue to meet or surpass that mark.
Washington’s new and improved renewal strategy includes:
• Receiving permission from CMS to extend the renewal period an additional month for the months of November, December, January and February.
• Sending by mail three advanced notices (at 60 days, 40 days and 20 days prior to the renewal deadline) to reenroll on wahealthplanfinder.org, by phone, or with an included paper application
• Contracting with a nonprofit that called each household that had not renewed. The organization, which had conducted outreach for Apple Health for Kids coverage (Washington’s CHIP Program), received an additional stipend for every successful renewal
• Hiring additional staff to focus on processing renewals.
• Sending a simple attestation tool (and a self-addressed stamped envelope to make return mail easier) with the final closure letter.
Washington has continued to provide regular updates about improvements to the renewal procedures and has shared renewal data with advocates and other stakeholders regularly.
At least twenty-two other states have delayed Medicaid renewals until fall 2014. We are hopeful that other states can learn from Washington and put in place a plan of attack before MAGI-based renewals get started!
