Looking Beyond the Unwinding: Recommendations for Improving the Efficiency and Accuracy of Medicaid and CHIP Eligibility Determinations

The Connecting to Coverage Coalition (CCC) has published a new white paper detailing key lessons learned during the unwinding, including what tactics worked especially well, how to address historic disenrollments in the immediate aftermath, and which enrollment flexibilities provided by CMS should continue beyond this period. The CCC held a virtual briefing on the white paper and the state of Medicaid unwinding on June 26 from 1-2 PM EST. Click here to watch a recording. 

Who We Are

During the COVID-19 public health emergency, Congress passed laws to ensure that people with Medicaid would have continuous health coverage during the pandemic. Now, with over 90 million people covered by Medicaid, new federal laws require states to return to normal operations. State Medicaid programs are “unwinding” from COVID-era policies and are resuming verification of people’s continuing eligibility for Medicaid.

​The Connecting to Coverage Coalition (CCC) represents a diverse collection of stakeholders partnering to minimize disruptions in health coverage associated with the resumption of state Medicaid renewals or “redeterminations." As states return to their normal Medicaid operations, the CCC is coordinating with community leaders to ensure that people have access to trusted, reliable information that helps them enroll in health insurance coverage to protect their health and financial security. 

​“Medicaid and CHIP are critical to our nation’s health, as millions of individuals, families, and children are insured by these health coverage programs. During the COVID Public Health Emergency, millions more were able to get coverage. This brought peace of mind to some of our nation’s most vulnerable communities. Today that coverage is at risk as fifteen million people could lose coverage. CHA has developed an initiative, Protect What’s Precious, with tools our members can use to help their patients keep their coverage. We look forward to working with the Connecting to Coverage Coalition to help beneficiaries secure their coverage during this Medicaid redetermination process.” 

​– Sr. Mary Haddad, RSM, President and Chief Executive Officer, Catholic Health Association of the United States

​“With the Medicaid redetermination process already underway, millions of Americans will be looking for trusted, reliable information to guide them. The Connecting to Coverage Coalition will be an essential resource to help them through Medicaid redetermination, and to learn more about the health care coverage that is best for them.”


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– Matt Eyles, President and CEO, AHIP

​“The goal of this coalition is simple and essential  – ensuring  Americans don’t lose access to health coverage they count on. As the Medicaid redetermination process begins, millions of our nation’s most vulnerable seniors, disabled, poor, and children across the country are at risk of getting lost in a sea of misinformation, confusion, and bureaucratic paperwork – we must protect them. We look forward to working with those in the Connecting to Coverage Coalition to ensure everyone currently covered can continue to get the vital care they need and deserve.”
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– Chip Kahn, President and CEO, Federation of American Hospitals

​“With the protections that were temporarily instituted during the Coronavirus Public Health Emergency beginning to end, including preventing disenrollment from Medicaid, we do not want to see vulnerable people slip through cracks and ending up uninsured. The Cancer Support Community (CSC) believes that it is important to equip people with knowledge and reliable resources to navigate the Medicaid redetermination process.”


– Debbie Weir, Cancer Support Community CEO

​“Millions of Americans are at risk of losing their Medicaid coverage. Our commitment is simple: Everyone should have access to high-quality, equitable and affordable care, in times of trouble like the pandemic, and every other day. We are proud to join the Connecting to Coverage Coalition and are actively working to help individuals and families transition coverage.” 


​– Kim Keck, President and CEO, Blue Cross Blue Shield Association
“Coverage plus care equals good health. That’s why ACHP and its nonprofit member companies are so focused on a smooth Medicaid redetermination process. As states resume normal operations, we are proud to be a part of the Connecting to Coverage Coalition, working closely with local groups to minimize disruption and ensure everyone continues to have access to high-quality, affordable coverage and care.” 

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​– ​Ceci Connolly, President and CEO, Alliance of Community Health Plans
"Millions of vulnerable seniors and individuals with disabilities living in our nation’s nursing homes and assisted living communities rely on Medicaid for their long term care needs. They require around-the-clock assistance that can’t afford to be disrupted. AHCA/NCAL is proud to join the Connecting to Coverage Coalition to help ensure Medicaid beneficiaries—especially the aged, blind, and disabled—have consistent coverage and access to care."

​– Mark Parkinson, President and CEO of AHCA/NCAL (American Health Care Association/National Center for Assisted Living
“The National Council for Mental Wellbeing supports the important work of the Connecting to Coverage coalition and its efforts on Medicaid ‘redetermination.’ As states begin to redetermine who is eligible to receive coverage, it’s important to understand what’s at stake for people experiencing mental health and substance use challenges who rely upon Medicaid coverage to access lifesaving treatment services.”

​– Chuck Ingoglia, President and CEO, National Council for Mental Wellbeing
“The National Association of Community Health Centers is proud to join forces with the Connecting to Coverage Coalition. Community Health Centers serve over 30 million patients, including one in five Medicaid beneficiaries and one in three people living in poverty. This is why Community Health Centers across the nation play an essential role in the Medicaid redetermination process. They employ dedicated staff, such as health navigators and outreach and enrollment workers, who help patients understand and enroll in health insurance coverage such as Medicaid and CHIP.”

​– Rachel A. Gonzales-Hanson, Interim President and CEO, National Association of Community Health Centers
“One of the most important things we can do as health care organizations is to protect and care for the most vulnerable in our communities. This coalition unites us in a common goal to do that and join forces to ensure the Medicaid redetermination process does not devastate millions of American families and children by jeopardizing coverage they have come to rely on. Hospitals and health systems serve on the front lines caring for everyone who comes through our doors, and we remain deeply committed to making sure no one loses access to critical coverage and care.” 

​​– ​Rick Pollack, President and CEO, American Hospital Association
“With Medicaid redeterminations underway, Medicaid managed care organizations play a critical role in ensuring that enrollees continue to have health insurance. We are proud to be a part of the Connecting to Coverage Coalition to help equip vulnerable Americans with resources to successfully navigate and complete the redetermination process and maintain access to high quality, affordable health coverage and care.” 
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​​​​– ​Craig Kennedy, President and CEO of the Medicaid Health Plans of America
“ASHA is thrilled to join the Connecting to Coverage Coalition to ensure that our members, more than 200,000 audiologists and speech language pathologists, can be a critical touchpoint for Medicaid beneficiaries during a time of enrollment upheaval. As one of the first provider advocacy groups to join the Coalition, we are working to safeguard patients from lapses in coverage that would prevent them from receiving the audiology and speech-language pathology services they need.” 

​​​​​– ​Vicki Deal-Williams, Chief Executive Officer, American Speech-Language-Hearing Association

CCC Applauds Recent Medicaid Redetermination & Renewal Measures 

The Connecting to Coverage Coalition (CCC) has issued a statement thanking the Centers for Medicare & Medicaid Services (CMS) for implementing key measures aimed at maintaining enrollment for individuals eligible for Medicaid and the Children’s Health Insurance Program (CHIP), as well as assisting those who are no longer eligible with securing alternative health coverage options through the federal or state-based Marketplace, Medicare, or employer-provided coverage.
​“One thing health plans have learned from the Medicaid unwinding it that every speed bump in the redetermination process is a way for people who are eligible for Medicaid to needlessly lose coverage We’re delighted that CMS has taken these common-sense steps to smooth out the road to re-enrollment.” — Margaret A. Murray, CEO, Association for Community Affiliated Plans.
“UnidosUS joins its partners in thanking the Biden-Harris Administration for its extraordinary work protecting families’ health care, despite historic challenges posed by Medicaid unwinding.  CMS’s hard work and creativity have made a huge difference limiting coverage losses for Latinos and members of other historically disadvantaged communities.” — Stan Dorn, Health Policy Director of UnidosUS, the nation’s largest Latino civil rights and health advocacy organization.
“Health care coverage is the key to ensuring the most vulnerable patients have access to needed care. The ongoing Medicaid redetermination process is having an impact on the lives of millions of Americans. We must continue to work diligently to ensure those eligible for Medicaid, CHIP, and ACA exchange coverage are made aware of how they can maintain or gain access to these vital health care coverage programs. We commend the Biden Administration for doing everything in its power to assure Americans don’t fall through the coverage cracks.” — Chip Kahn, President and CEO of the Federation of American Hospitals.
“Medicaid is the life blood of Community Health Centers and their ability to serve high-need urban, rural, frontier and island communities. Both coverage and access to affordable primary care services are essential to achieving health equity, improving population health, and lowering healthcare costs.  Medicaid helps to assure people get necessary, life-saving primary care – from vaccines and cancer screenings to the outpatient management of acute and chronic conditions and the prevention of unnecessary hospitalizations, ER and specialty visits.  We all suffer when people lose their Medicaid coverage with broad, deep, and longstanding impacts across families, communities, and the public health and healthcare system.” —  Kyu Rhee, MD, MPP, National Association of Community Health Centers President and CEO.
“We applaud CMS for its work to permanently allow managed Medicaid plans to collect signatures on behalf of enrollees. This measure will minimize unnecessary coverage loss for a vulnerable population while bringing trusted partners, like health plans, into the fold to help consumers navigate a complicated eligibility process.” — Ceci Connolly, Alliance of Community Health Plans President and CEO.
“CMS has been a valuable partner in helping to ensure that Medicaid-CHIP eligible patients are able to renew coverage and patients who are no longer eligible are able to successfully transition to marketplace or some other type of coverage. By further strengthening patient protections and closing coverage gaps, CMS will help millions of Americans gain or keep coverage and access care. That’s a prescription for a healthier life.” — American Medical Association President Jesse M. Ehrenfeld, M.D., MPH.
“We thank the Administration for finalizing a rule ensuring that Medicaid and CHIP enrollees can easily enroll, renew, and maintain their coverage, bringing peace of mind to some of our nation’s most vulnerable families and communities. CHA is guided by our longstanding call to increase access to health care for everyone and developed an initiative, Protect What’s Precious, which equipped our members with tools to help their patients keep their coverage during the Medicaid redetermination period and beyond. We encourage CMS to continue working with the Connecting to Coverage Coalition on policy solutions that keep people connected to their Medicaid and CHIP coverage, allowing individuals and families to be healthy and flourish.” — Sr. Mary Haddad, RSM, President and CEO of the Catholic Health Association of the United States.
"MCOs have played a key role in preserving coverage during the Medicaid unwinding period. The Healthcare Leadership Council (HLC) applauds CMS for responding to stakeholders, taking additional steps to streamline continuity of coverage, and reducing the substantial administrative burden for enrollees." — Maria Ghazal, President and CEO of the Healthcare Leadership Council

CCC Partner Resource Center

Members of the Connecting to Coverage Coalition have put together a wide variety of Medicaid unwinding resource materials. Click to view the coalition's resource repository containing that contains communications toolkits, videos, one-pagers, and more. 

Lookout for Fraud Related to Medicaid Unwinding

The Connecting to Coverage Coalition has put together high-level messaging related to Medicaid unwinding fraud that can be shared with consumers, and we hope you will keep your ears open and share with us any additional incidents, state advisories, or messaging.

Medicaid Unwinding in the News 

The Connecting to Coverage Coalition curates a weekly list of articles covering national and state-specific developments related to the unwinding of Medicaid's continuous enrollment provision. This repository provides a breakdown of all of the articles that have been published nationally and within each of the 50 states.

Federal Unwinding Developments, Tools, and Resources

HHS Launches Medicaid and CHIP Renewal and Transition Resources Hub

The Department of Health and Human Services (HHS) launched a new resource hub for stakeholders to access Medicaid and CHIP renewal and transition resources from across the federal government. 

WH Urges Employers to Extend Insurance Grace Period as Medicaid Trims Rolls

The Biden administration penned a letter to employers, plan sponsors, and issuers outlining policy options to help keep employees and their families connected to coverage.

CMS Issues Important Updates on Medicaid and CHIP Renewals

Thanks to the advocacy of CCC and its member organizations, HHS has announced that it is providing flexibilities for health plans and community organizations to help keep people connected to coverage during the Medicaid redetermination process.

State Timelines for Resuming Medicaid Eligibility Renewals

CMS has published a chart tracking each of the 50 states' anticipated timelines for initiating unwinding-related renewals. The list is current as of June 29, 2023, and will be updated by the agency as information becomes available. 

Supporting Medicaid and SNAP Unwinding Efforts

This CMS presentation outlines opportunities and challenges that the unwinding presents Medicaid and SNAP (the Supplemental Nutrition Assistance Program), as well as steps to help facilitate the return to normal operations.
FAQs Addressing Special Enrollment & Employers
CMS has published an FAQ responding to policy questions pertaining to the Families First Coronavirus Response Act. The document details coverage provisions and best practices for those on Medicaid during the public health emergency.

CMS Unwinding Resources

Visit CMS's dedicated Medicaid unwinding landing page to access a trove of guidance documents, advocacy toolkits, and other resources to help stakeholders prepare for the return to normal eligibility and enrollment operations. ​

Key Unwinding Timelines and Activities

CMS has published a pair of example timelines that outline the administrative actions states will need to take to prepare for the return to regular operations 

CMS FAQs on Medicaid Continuous Enrollment Unwinding

Key topics addressed within these new frequently asked questions (FAQs) from CMS include: (1) Returned mail condition for states claiming the increased Federal Medical Assistance Percentage (FMAP) available under the FFCRA; (2) Reestablishment of premiums in Medicaid and Children’s Health Insurance Program (CHIP);(3) Renewal requirements for individuals who receive Social Security Income; and (4) Medicaid and CHIP agency capacity to share beneficiary data with enrolled providers to support renewals. 

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