Pamela Herd, Eric Giannella, Jeremy Barofsky, Luke Farrell, Donald P. Moynihan
Burdensome Medicaid renewal processes are a known source of coverage loss among eligible people. In spring 2023, the pause in Medicaid disenrollment resulting from the COVID-19 public health emergency ended, and states began redetermining eligibility for more than ninety million beneficiaries. In the early months of these redeterminations, a large majority of those disenrolled lost coverage for procedural reasons, such as missing paperwork. We examined an effort by the federal government to work with four states to increase automated ex parte Medicaid renewals with the goal of reducing procedural denials and coverage loss. Our analysis of state Medicaid enrollment data found that compared with other states, ex parte renewals in the four states increased by 21.6 percentage points, overall renewals increased by 7.7 points, and procedural denials decreased by 8.3 points. Reducing burdens by automating Medicaid renewals ensures that eligible beneficiaries remain in the program. Our results also highlight that policies and rules only work when states have the capacity to implement them.