More Outreach to Families Needed During the Unwinding; Some States Are Stepping Up Their Game

KFF released new survey data that finds two-thirds of Medicaid enrollees are unprepared for the renewal process as states begin the process of “unwinding” the Medicaid continuous coverage requirement that was lifted by Congress on March 31. The KFF survey includes more interesting data that reveals that large majorities across demographic groups are not aware that states are allowed to remove people from Medicaid if they are no longer eligible or do not complete the renewal process. This finding is consistent with prior research by the Urban Institute showing that most adults enrolled in Medicaid were unaware that Medicaid renewals would be resuming in the near future.

These data, along with reports of large numbers of people losing coverage for not returning renewal forms emerging from states that started the unwinding process early, point to the need to boost communications through a variety of messengers and modes of communications. And more communications resources and messages are needed to explain to parents that their eligibility may be different from that of their children. Anecdotally, we have heard that some parents know they are no longer eligible and assumed their children would lose eligibility as well, but that is generally not the case as family income eligibility is higher for children than adults. (You can find your state’s income eligibility on CCF’s state data hub.)

CMS is starting to focus on this shortcoming in current communication resources. In today’s CMS sponsored “Medicaid and CHIP Continuous Enrollment Unwinding: What to Know and How to Prepare, A Partner Education Monthly Series,” the agency unveiled a new postcard aimed at kids and families but it’s not yet included among the downloadable resources on CMS’s unwinding page under Communications Toolkits. The agency says they are working on a campaign to target children and families. We’ll let you know when these resources become available.


Some states are stepping up. Just last week, Laura Herra Scott, Maryland’s Secretary of Health (and a former MACPAC commissioner that I had the pleasure of serving with) launched its Medicaid Check-In campaign urging Marylanders to ensure that they don’t lose Medicaid coverage. And a while ago, California launched its DHCS Coverage Ambassador project to engage trusted messengers from diverse organizations to reach out to enrollees in culturally and linguistically appropriate ways. And Louisiana has contracted with stakeholders to amplify state communications, conduct door-to-door outreach, and host community events. Pennsylvania launched a long-term media and outreach strategy to help enrollees stay covered.

This is an “all-hands on deck” moment but community partners need targeted resources if we are going to keep all eligible children enrolled. Remember that ASPE projects that 3 out of every 4 children who are disenrolled from Medicaid will actually remain eligible. CCF has posted resources on our unwinding pages here. The State Health & Values Strategies (SHVS) has posted a number of outreach videos and other social messaging resources available for download and customization. And Young Invincibles has created a communications toolkit aimed at young adults. This is just a sampling of tools that are available.

Pharmacies, health care providers, public health organizations, navigators and assisters, community-based organizations, faith-based organizations, retail stores, subsidized childcare agencies, schools, and Headstart, among other types of organizations, can help but some may need to be educated about the unwinding and encouraged to reach out to their constituencies. Even if your organization doesn’t have direct interactions with enrollees, you can help by connecting the dots for others who directly serve children and families and motivate them to do their part. At the end of this long process, when potentially hundreds of thousands of lower-income children and families become uninsured, none of us will want to look back and realize we could have done more. The time is now –  so let’s double down on our efforts and help keep children connected to coverage.

[Editor’s Note: This is the 34th blog in the Unwinding Wednesday series. For more information, visit our PHE Unwinding resource page where you’ll find other blogs in this series, reports, webinars and the 50-state tracker.]

Tricia Brooks is a Research Professor at the Center for Children and Families (CCF), part of the McCourt School of Public Policy at Georgetown University.