Medicaid Unwinding and State Behavioral Health in South Dakota, North Dakota, Alaska, Vermont, and Wyoming
South Dakota’s 9 Month Medicaid Unwinding Timeline Draw Criticism
The Medicaid unwinding process will begin early, in February 2023, in South Dakota. The state has adopted a speedy 9 month timeline to complete the unwinding process, drawing criticism from some who allege that a truncated review period will lead to a high number of government errors and erroneous de-enrollments.
Compounding the situation is South Dakota’s insistence that every Medicaid recipient receive, review and complete a “Medicaid review form” in order to continue their coverage. While other states are allowing more passive renewals, South Dakota will discontinue the coverage of any enrollee who does not respond.
It’s also worth noting that South Dakota has adopted but not yet implemented Medicaid expansion. The program will come online in the state beginning July 1st, leaving a potential four month gap for those who qualify from the program but were among the first enrollees removed from continuous coverage Medicaid rolls.
Although the Medicaid program in South Dakota grew over 30% during the pandemic, officials say it’s “unclear” how many Medicaid recipients will be struck from the register during the unwinding process.
North Dakota Has One of the Longest Medicaid Unwinding Timelines of Any State
North Dakota’s Medicaid program began “normal operations” on April 1st, 2023 after a three year moratorium on de-enrollments, regardless of eligibility. Now, the state is urging Medicaid families to update their contact information in the SSP, also known as the “self-service portal,” in order to ensure that they receive letters related to the unwinding process. The state has elected to complete the unwinding process within a lengthy 14 month timeline, the longest period allowed by the federal government. The state intends on reviewing eligibility for all 130,000 individuals enrolled in the Medicaid program during that time.
Alaska Will Pursue Passive and Active Renewals During Medicaid Unwinding
Alaska began pregaming the unwinding process long before most states. In late June 2022, Alaska sent reminder letters to Medicaid recipients urging them to update their contact information ahead of redetermination to ensure that unwinding mail reaches its intended destination. The state has committed to a 12 month timeline in which they will begin sending out annual renewals in batches or stages until all Medicaid recipients have received an eligibility check. Alaska resumed “normal operations” on April 1st. The state of Alaska is doing both passive and active renewals, depending on the situation.
That said, the state is vague about the exact timing of annual renewals. In an FAQ, Alaska asserts that letters will be sent “around the anniversary” of when coverage first began but declines to give any more specifics.
Still, no Alaskan Medicaid member will lose coverage until May 31, 2023 at the earliest.
Vermont’s Medicaid Unwinding Renewal Letters Come Marked with a Red Stripe
Vermont’s unwinding plan will begin in April 2023. Vermont is taking the full 14 months allotted by the federal government to complete its Medicaid unwinding process. This is generally seen as the most generous way to go about renewals, as it means the state will have more time to consider renewals and will likely make fewer mistakes in the process, keeping as many people enrolled as possible. Officially notices will come in the mail and those with red stripes on them will need to be met with responses in order for members to stay covered. Vermont will also issue passive renewals in those cases where the state already has access to all the information it needs to renew a member’s plan. These passive renewals will also make it easier for more Vermonters to retain their Medicaid coverage during the unwinding process.
Wyoming’s Reticence to Adopt Medicaid Expansion Will Hurt Enrollees during Medicaid Unwinding
There are currently 85,000 Wyomingites enrolled in Medicaid. Experts wager that between 10 and 15,000 of those enrollees no longer qualify for the program. When the state begins the redetermination process on April 1st, many Medicaid patients in Wyoming stand to lose their coverage.
Wyoming’s unwinding process is complicated by the fact that the state is the only remaining western state that has not adopted or implemented Medicaid expansion. This means that as Wyoming begins ejecting residents from the Medicaid rolls, some of those residents will fall through a “coverage gap.” In this gap, you’ll find individuals who make too much money to qualify for state benefits and too little money to qualify for federal subsidies.
Other Blog Posts About Medicaid Unwinding at the State Level and How it May Affect Behavioral Health Organizations
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