KFF survey finds many Medicaid recipients unprepared for eligibility renewal process

A KFF survey of Medicaid enrollees largely fielded prior to states resuming their efforts to redetermine Medicaid enrollees’ eligibility reveals many enrollees are unprepared for the renewal process that could result in some losing their coverage either due to eligibility changes or paperwork issues. 

During the COVID-19 pandemic, states suspended their Medicaid eligibility renewals in exchange for additional federal funding, ensuring continuous health coverage for enrollees. States recently have resumed eligibility renewals and as of April 1 could start to disenroll people who either no longer qualify or who do not complete the renewal process.

The survey found that nearly two-thirds (65%) of Medicaid enrollees were unsure whether states could remove people from the program if they no longer meet the eligibility requirements or don’t complete the renewal process. An additional small share (7%) incorrectly believe that states couldn’t do this.

More than four in 10 enrollees whose sole coverage is Medicaid say that if the state told them they were no longer eligible for Medicaid coverage, they would not know where to look for other coverage (27%) or end up uninsured (15%).

Other findings include:

• Nearly half (47%) of Medicaid enrollees say they have not previously been through the Medicaid renewal process, including two-thirds (68%) of Medicaid enrollees who are 65 and older. This group may be less likely to understand the importance of completing the renewal paperwork to maintain their coverage.
• A third (33%) of enrollees say they have not provided updated contact information to their state Medicaid agency in the past year. Some in this group may miss critical eligibility renewal notices that would require action on their part to maintain coverage.
• About half (52%) of enrollees say they prefer to get Medicaid information via the U.S. mail, which is the primary way most states contact enrollees, though nearly half of enrollees say they would prefer to get Medicaid information another way - through email (29%), an online portal (11%), or text messages (8%).
• About a third of Medicaid enrollees say they have had a change in income or other change that could now make them ineligible for Medicaid or are unsure if they have had such a change, but most enrollees (65%) say their circumstances have not changed, suggesting they are still eligible. Those who are still eligible could lose coverage if they don’t complete the renewal process.
• The vast majority (85%) say that it would be useful if they had a navigator to help with the renewal process and look for other coverage if needed.

Designed and analyzed by public opinion researchers at KFF, the survey was conducted February 21-March 14, 2023, online and by telephone among a representative sample of 3,605 adults in the U.S. with health insurance coverage, including 1,212 individuals with Medicaid coverage. Interviews were conducted in English and in Spanish. The margin of sampling error is plus or minus 4 percentage points for those with Medicaid coverage. For results based on other subgroups, the margin of sampling error may be higher.