15 June 2023 | Health

First Data Release from State Shows Thousands Lose KanCare Coverage Due to Unwinding

Heather Braum | June 15, 2023

Concerns remain that too many kids will lose coverage due to red tape caused by the end of continuous coverage

Kansas has finally released data that shows how the beginning of the year-long unwinding and renewal process of all KanCare members has been going in its first few months.  

Kansas kids are at a significantly higher risk of losing their KanCare coverage during this process, even if they remain eligible for coverage. With this first data release, it appears that tens of thousands of Kansans (mostly in the “family medical” category) have had their KanCare coverage discontinued. In fact, at 89 percent, Kansas has an extremely high rate for those removed from the program for procedural reasons, which means the state needs more information to determine eligibility. Some media reports, including comments from the state, indicate mail delays may be a major culprit.

Data breakdown, reported as of June 6, 2023:  

  • 207,273 individuals sent a KanCare renewal letter 
  • 22,465 individuals (including 14,721 in “family medical”) renewed 
  • 5,667 individuals (including 4,929 in “family medical”) determined ineligible, and their KanCare coverage was discontinued  
  • 45,820 individuals (including 39,993 in “family medical”) had KanCare coverage discontinued for procedural reasons but can re-enroll within the 90-day review period 

What the Data Means 

At first glance, it appears that nearly 5,000 Kansans in the “family medical” category (including children) are no longer eligible for KanCare. Their re-enrollment forms were reviewed, and they were determined to no longer qualify for assistance.  

However, an additional 40,000 Kansans in the “family medical” category have also had their KanCare coverage discontinued for procedural reasons. This does not mean they are ineligible. In fact, children are more likely to remain eligible for KanCare even if their parents are not.  

What is not clear in the data are the reasons for delayed submissions. For instance, mail delays may have resulted in parents never receiving a notice (even when their contact information is updated with the state), the state may not have successfully received documents, or parents couldn’t get through to a call center to address issues. One Kansas family had their coverage discontinued and later reinstated because they never received their renewal packet in the mail until after the deadline had passed!  

We suspect that because 62 percent of KanCare enrollees are children, thousands of Kansas kids have had their coverage discontinued. However, we can’t know for certain as the state chose not to release this data broken out into categories beyond family medical/MAGI (kids, pregnant women, and parents/caretakers of children) and non-MAGI (long-term care, elderly, and disabled). 

While there is a 90-day window for eligible families to submit the necessary documents to reinstate KanCare, kids might not have the health coverage they need when they need it. When kids lose their coverage and remain eligible — and they wait for that coverage to be reinstated — important, time-sensitive medical appointments, immunizations, screenings, and treatments will be delayed. Delay in medical care for kids is serious, and it will cost the state additional money to re-enroll these eligible kids. 

The call center wait times and abandonment rate data points are also concerning. For many KanCare members, sitting on a phone indefinitely may mean running out of minutes on a cell phone plan or abandoning a call because a breaktime ends at work. We will be watching this data closely, especially in light of the troublesome history with previous call center vendors.  

How does Kansas compare to other states? So far, it appears we have significantly high procedural disenrollments compared to other states. Check out the KFF Unwinding Tracker for comparisons as more states continue to release or update their unwinding data.  

Missing Data 

When looking at other states’ unwinding data, Kansas is missing several key data points, many of which were submitted in a mandatory report to the federal government but were not posted publicly to the state’s unwinding website. These data include: 

  • The number of pending reviews. These include information that was turned in but hasn’t been reviewed yet. This number could tell us if the state and the contracted call center fall behind on review processes, indicating more staff should be hired or processes should be further streamlined.  
  • The percentage of reviews happening through automatic processes (ex parte reviews) or pre-populated forms. This could eliminate some of the red tape and administrative burdens families face. 

We also would find it helpful to see a breakdown of data for why individuals ended up in that 90-day window/procedural disenrollment group, with coverage discontinued. Understanding the different reasons for procedural disenrollments can direct targeted outreach and shift messaging or change state policies.  

Finally, we continue to raise the need to break down the data into child and adult groups. This helps advocates gain a better understanding of what types of targeted outreach may be needed to reach parents and other population groups.  

We need much more data, and we need it broken down further to know how the unwinding process is really impacting Kansas kids. 

Possible Changes by the State and Further Outreach Needed 

With this initial data release, it is already apparent that changes are needed so fewer eligible Kansans lose their coverage due to procedural reasons. The federal HHS Secretary sent a letter to all governors on June 12 urging states to take full advantage of all flexibilities available for the unwinding process to greatly reduce the number of those losing coverage due to procedural issues. The Center for Medicare and Medicaid Services (CMS) has a tracker identifying which states have been approved for the available flexibilities. Kansas is already taking advantage of four of the available flexibilities; however, some of the options will not be possible in Kansas, as we have yet to expand Medicaid.  

Also, Kansas currently sends out renewal notices 30 days before they are due. Yet, other states are allowing for a longer response time.  

Research has shown many Medicaid and CHIP beneficiaries are unaware of the renewal processes ahead. We call on all Kansans — including community, religious, and health organizations; businesses; public officials; and the media — to continue ongoing outreach to KanCare members across the state about the ongoing renewal process so eligible Kansans — especially children — keep their coverage. 

The state has provided toolkits on their website (English; Spanish; other resources) for messaging options; additional messaging tools are available through CMS. Join the Kansas Medicaid Renewal Helper network to participate in monthly calls and receive important updates.  

Review this national call to action to discover specific steps for enrollees to take. In general, KanCare enrollees must:  

  • Keep their contact information updated with the state. 
  • Watch their mail for renewal mailings from the state. 
  • Return signed forms as soon as possible (even if only partially completed). 
  • Watch for and quickly respond to follow-up communications.  

Even if parents/caretakers are no longer eligible for KanCare, their children may remain eligible due to higher income limits. 

What’s Next? 

This is only the first of many monthly data releases to come as the unwinding process continues over the next year. The releases provide high-level, yet delayed, insight into how the process may be going, and so far in Kansas, it doesn’t appear to be going well.  

Only time will tell how many Kansas kids have lost coverage due to procedural reasons yet remain eligible for KanCare. Parents or caregivers of these children will either need to submit their renewal paperwork during the 90-day grace period after their eligibility is discontinued or fill out a new application for KanCare after the grace period has ended. We will continue to monitor these data releases, advocate for the state to change directions where it can, and continue to work with partner organizations and the public to reach families with KanCare coverage to ensure everyone who is still eligible keeps their coverage during this unwinding period. 

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