Winding Up New York’s Medicaid Unwinding

For the past year, New York State has made substantial investments to make sure as many people as possible stay enrolled in health insurance, including Medicaid and other public coverage options. The 2023 rollback of a pandemic-era federal policy that prohibited states from terminating Medicaid enrollees’ health insurance requires that states recertify all Medicaid beneficiaries. Known as the “Medicaid unwinding,” it’s meant that New York has been reassessing eligibility and renewing coverage for all eligible Medicaid, Essential Plan, and Child Health Plus enrollees since last May, through the end of next month.

I previously wrote about how some states saw the end of the continuous coverage requirement as a welcome opportunity to shrink their public health insurance rolls. In contrast, New York saw it as a moment to go all-in on preserving coverage for millions of New Yorkers.

I’m proud of how New York has fulfilled its promise. As of March of this year — the latest data available, about three-quarters of the way through the total unwinding period — New York had initiated more than 5 million coverage renewals. Overall, 82% of eligible New Yorkers’ coverage has been renewed — 79% of adults and 91% of children. New York has been among the top five states for keeping kids covered. An Urban Institute analysis of unwinding data through last November shows New York had the 10th-lowest rates of coverage disenrollment among states. KFF’s latest data tracker shows similar relative performance as of March, with New York ranked 12th best among states.

What’s been the secret to New York’s success? A few things:

• Flexibility through Federal Waivers: The State has applied for and received numerous federal waivers that have allowed for additional flexibility in maintaining coverage for eligible enrollees. For example, New York can renew Medicaid eligibility for people whose income is verified to be at or below the federal poverty level, without requiring additional paperwork. Another waiver allows for streamlined reenrollment into the Children’s Health Insurance Program (CHIP) for individuals who receive Supplemental Nutrition Assistance Program (SNAP) benefits. Cutting some of that red tape has been a big boon to New York’s enrollment numbers.
• Robust Outreach and Communication: The State has sent out roughly 7.5 million e-mails, 4.5 million text messages, and 3.7 million consumer notices alerting people of the need to recertify to stay covered. The New York State of Health call center has answered more than 4.5 million inquiries (with an average wait time of less than 2 minutes — pretty impressive!). And the State has developed a communications toolkit that includes shareable resources like how-to videos, sample social media posts and infographics, fact sheets, posters, and more. This library makes it easy for the State’s partners to consistently use tested messages and language.
• Cross-sector Partnerships and Support: The unwind has been the single largest outreach and enrollment effort since the passage of the Affordable Care Act. State government stepped up and led but recognized that success would require additional support and coordination beyond government. I’m proud that the New York Health Foundation was one of numerous philanthropic partners to support on-the-ground outreach efforts to keep New Yorkers covered. Led by the Community Service Society, a network of community-based organizations across the State have had more than 44 million touchpoints to educate and engage eligible New Yorkers and get more than 54,000 people reenrolled so far. These organizations serve as trusted messengers, reaching people through conversations, social media posts, advertisements, and flyers in the language they speak. And they’re connecting with people where they are — libraries, schools, doctors’ offices, places of worship, citizenship classes, community festivals, museums, and food pantries — to maximize their reach.

There’s always more work to do, always an imperative to reach people who may still be falling through the cracks as they’re required to renew their health insurance coverage. At a meeting earlier this week, New York State officials made clear they’re not resting on their laurels. New York is in the homestretch of this recertification period and is pulling out all the stops to maximize renewals. It is improving enrollment and renewal systems and opening new channels for submitting applications, including options for easy enrollment via smartphones and other devices.

One of the few silver linings of the pandemic is that New York achieved record high insurance coverage rates. So much work has occurred to preserve those gains. It’s easy to get caught up in the numbers, the comparative data, the benchmarks, but ultimately this year has been about the millions of New Yorkers who can maintain the peace of mind that comes with having health insurance. New York should take a bow, and keep it up.