Rewinding the unwind
Like all states, Minnesota maintained health care coverage for its Medicaid enrollees during the COVID-19 pandemic. During the pandemic, Minnesotans who newly gained eligibility or already had eligibility for in Medical Assistance (Minnesota’s Medicaid program) or MinnesotaCare remained enrolled in the coverage regardless of most changes in their lives that previously would have affected their coverage. Continuous coverage helped Minnesotans access care during a global pandemic and maintained high insurance coverage rates in the state.
With these continuous coverage provisions in place, enrollment in Medical Assistance and MinnesotaCare grew by more than 30%, to more than 1.5 million Minnesotans. Roughly one in four residents living in the state were getting their health care coverage through these public health care programs.
Congress passed legislation requiring states to return to standard Medicaid eligibility procedures, which included an annual eligibility review through a renewal process, in spring 2023. Given the caseload growth, restarting renewals represented a significantly larger volume of work than had ever occurred in the state’s public health care programs history. Experts across the country agreed that the resumption of these renewal processes created the biggest challenge to health care coverage since the implementation of the Affordable Care Act.
DHS and its partners made meaningful change during the unwind in the midst of this unprecedented volume of work. Minnesotans stayed connected to health care as the state and its partners improved renewal outcomes. For the first time, disparities in renewal outcomes were eliminated for Black, American Indian and Pacific Islander enrollees; disenrollment disparities also decreased for Hispanic/Latine enrollees. Overall disenrollment rates dropped by more than 6% during the unwind. And overall, 88% of Minnesota kids who had to renew kept their insurance.
DHS also removed red tape during the unwind by increasing the automatic renewal rate nearly fivefold. Automatic renewals use trusted data from reliable sources to confirm enrollee eligibility electronically, behind the scenes. This allows eligible enrollees to skip the paperwork and seamlessly keep their insurance. Autorenewals rose to more than 80%.
Read two reports summarizing successes and lessons learned from the unwind: