Unwinding Wednesday #22: Updates to 50-State Tracker with One Month Until Unwinding Start Date

We are officially in final unwinding countdown with exactly one month until states are allowed to begin Medicaid terminations. In preparation, we have been updating our 50-state tracker with new information including revised state unwinding plans and state renewal reports that were submitted to CMS.

Since the 50-state tracker first went live in September 2022, we have seen notable progress in state transparency. All states now have posted information for enrollees about the need to update their contact information and almost all states (48) have a set of frequently asked questions on the unwinding. Most states (42) also have communications materials or a toolkit, which is especially critical in the current period before unwinding begins, to help inform enrollees about forthcoming changes to Medicaid and potential actions they may have to take to maintain coverage. While only a handful of states have committed to publicly posting key unwinding data in their public-facing documents, there has been improvement from the beginning of our tracking when only four states indicated plans to do so.

The number of states posting their unwinding plan or a summary of the plan has grown as well. Nearly all states (44) now have unwinding plans posted compared to only 19 states when we launched the tracker. However, some plans have not been updated and contain old information and timelines that do not reflect the changes made by the Consolidated Appropriations Act, which added new guardrails and set a date to begin winding down the continuous enrollment protection. To signal which plans are older versions, the tracker indicates plans that have not been updated with the notation “pre-CAA.”

Additionally, as Tricia Brooks detailed two weeks ago, states had to submit renewal reports to CMS no later than February 15th describing how they plan to approach processing renewals (prioritization and distribution) and steps the state is taking to mitigate inappropriate coverage losses during the unwinding. In the two weeks since then, 10 states have shared their renewal reports online or upon request, which we have now added to the 50-state unwinding tracker.

The improvements in publicly available information on the unwinding is encouraging as transparency and accountability are critical given that health coverage for millions of children and families is at risk. A great example of state transparency is West Virginia – the state has created a webpage that will post all documents the state is required to submit to CMS (renewal report, baseline and monthly unwinding data reports).

The more transparent states are and the more information they make available, the easier it will be for stakeholders to understand their state’s approach to the unwinding and support or supplement the state’s efforts. Understanding the timeline and approach is also essential to monitoring the unwinding to identify recurring problems and advocating for mid-course corrections when needed to ensure eligible enrollees maintain coverage and assist those who are no longer eligible in transitioning to other sources of coverage.

[Editor’s Note: For more information, visit our Medicaid continuous coverage unwinding resource page where you’ll find other blogs in this series, reports, webinars and the 50-state tracker.]

Allie Gardner
Allexa Gardner is a Senior Research Associate at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.