230,000 WA residents lost Medicaid coverage since unwinding began [The Seattle Times]

Jul. 29—About 230,000 residents have lost access to their Medicaid, or Apple Health, coverage since Washington's renewal process for the health insurance plan began this spring, according to new state and national data.

State insurance officials say it's too early to reflect on overall disenrollment trends because Washington only began terminating plans two months ago, but they acknowledged the initial counts seem high.

"The numbers are high — there's no doubt about that," said Jason McGill, the state Health Care Authority's director of Medicaid programs. "We care deeply about the people we serve and wanting to ensure nobody is inappropriately disenrolled and, more importantly, everybody has all the chances to stay enrolled."

"But the fact remains, those numbers are as expected and they are reasonable," he continued. "It's almost right on as predicted."

Of the roughly 230,000 Washingtonians who lost Apple Health coverage in May and June, about 175,249, or 76%, were dropped because they did not respond to renewal or verification requests, according to the state's enrollment data.

Before the unwinding process began in April, about 2.4 million Washingtonians were enrolled.

Nationwide, at least 3.8 million Medicaid members had been disenrolled from their plans as of Friday, according to Kaiser Family Foundation's Medicaid Enrollment and Unwinding Tracker, which includes the most recent data on monthly Medicaid enrollment, renewals and disenrollments reported by states to the U.S. Centers for Medicare & Medicaid Services. The tracker includes data from 39 states and Washington, D.C.

According to KFF's tracker, disenrollment rates range widely among states — from 82% in Texas to 8% in Wyoming — though some of the variation is likely due to differences in renewal policies, systems capacity and data reporting.

While Washington ranks third highest in the country in number of disenrollments on the tracker, after Texas and Florida, McGill said the state isn't being accurately compared to other states.

CMS data only includes terminations for members whose plans are due for renewal in a particular month, while the state Health Care Authority shared data with KFF that includes all terminations regardless of renewal months.

If a Medicaid member is due for renewal in December but they moved out of state in June, for example, Washington would include them in the disenrollment count for June — and CMS would not, said Maggie Clay, section manager of the state's Office of Medicaid Eligibility and Policy.

"That's why numbers are looking really high compared to other states," Clay said. "I expect us to be somewhere more in the middle once the map gets updated with our CMS reports."

She expects the KFF dashboard to be updated within the next week.

"It'll be hard to say what exactly Washington will be when they update it, but not number three after Texas and Florida," McGill said. "Not usually a place where you'll see Washington."

Because the state ran renewals throughout the national public health emergency and extended members on a three-month basis if they were no longer eligible or if they didn't respond to renewal notices, state officials expect disenrollment counts to be highest during the first three months of the unwinding, McGill said.

"We're expecting numbers to normalize over the next 12 months to what would be, in essence, a pre-pandemic level," he added.

The state has also seen an increase in new Apple Health application numbers in the past three months — not including those who are renewing their plans.

"We saw about 28,000 new applicants coming into the caseload, which was really interesting and unexpected," Clay said, adding the bump is likely due to the state and health care organizations' increased outreach.

The Health Care Authority hopes to continue sharing disenrollment and trend data over the next several months to see where some gaps might be emerging, Clay said.

The first renewal letters went out at the start of April, and the first terminations for failure to renew happened at the end of May. Over the next year, the state will continue to send postcards, call and text those whose plans are up for renewal.

For those who have been disenrolled in coverage, there's a 90-day period for automatic retro reenrollment, though the state is encouraging members to visit its website at hca.gov/pca as soon as possible for more information about how to apply or renew coverage.

The state has started an ambassador program to increase outreach among community members and encourages residents to look out for messages from volunteer teams.

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