10 January 2024 | Health

KanCare Unwinding Updates

Heather Braum | Updated January 10, 2024

As the state continues moving forward in the unwinding process for KanCare, we are changing up our monthly blog post series on the data the state releases each month. Moving forward, this will turn into a brief recap each month as the latest data gets posted, along with brief analysis.  

As of November 30, cumulatively, 118,044 Kansas kids have had their KanCare coverage renewed; 22,983 Kansas kids have been determined to be no longer eligible for coverage; and 20,184 Kansas kids have had their coverage discontinued because paperwork didn’t make it back to the state in time, but they still have time to submit their renewal form without needing to reapply for coverage.

And we now know that an unknown number of kids must have a new application for coverage submitted. We don’t know how many as we only have the total number – 43,571 — which includes adults. For now, it is not disaggregated by county or age.

Too many kids are losing coverage in this unwinding process who should be keeping it, showing there are longstanding issues with how the renewal process works. The unwinding has exposed many issues in our eligibility system that need to be fixed. Kansas has changed some things in response to advocate feedback, but there is always room for improvement.   

It is unacceptable that it should be this hard to access coverage, especially for children. This unwinding process has shown there is much work the state must do to ensure every eligible child can get — and keep — the health care coverage they need to grow up healthy. One solution would be implementing multi-year continuous eligibility for young children. 

How does Kansas compare to other states? Check out the KFF Unwinding Tracker and the Georgetown Center for Children and Families tracker for comparisons as more states continue to publicly release their unwinding data.   

Jump to:

Data through November 30, 2023

  • 436,942 individuals sent a KanCare renewal letter  
  • 191,321 individuals renewed (including 122,219 in “family medical”) 
  • 48,039 individuals (including 41,700 in “family medical”) determined ineligible and their KanCare coverage was discontinued   
  • 35,868 individuals (including 30,961 in “family medical”) had KanCare coverage discontinued for procedural reasons but can re-enroll within the reinstatement window review period  
    • 56.3 percent of those in the reinstatement window are children  

Note: In the recent data releases, the state switched from using “90-day window” to “reinstatement window” for procedural reasons.  

November Analysis

In total, nearly 240,000 KanCare members, including more than 140,000 children, had their renewal process completed and determined to be eligible or ineligible for coverage based on redetermination criteria.

The data continues to improve for those who no longer have coverage due to procedural reasons, though much more work needs to be done, as 56.3 percent of those in the reinstatement window who have yet to return a renewal form are children.

Children in Edwards, Elk, Finney, Ford, Grant, Greeley, Kearny, Seward, Stanton, Stevens, and Wichita counties make up more than two-thirds of those in the reinstatement window in each of those counties. Most of these counties are clustered in Southwest Kansas. Several other counties’ reinstatement numbers for kids remain above 60 percent, including those in Chase, Comanche, Gray, Harper, Hodgeman, Kingman, Meade, Rush, Russell, Scott, Sherman, Thomas, and Wyandotte. Many more counties continue to see percentages above 50 percent for children who lost their coverage due to procedural reasons.

Of all child age breakouts, the 13-18 age group (7,605) continues to account for a higher rate of procedural disenrollments.

Local advocates should continue targeted outreach to children and families in their area. As kids’ eligibility thresholds for Medicaid and CHIP are much higher than adults, it remains concerning that so many kids throughout Kansas are losing coverage for paperwork reasons.

There are significant declines in the reinstatement window data after the passive renewal (“ex parte”) fix was fully implemented by November 30, but we can’t easily draw conclusions yet about what that means.

Significant decreases exist between the October and November reinstatement window numbers for each child age group.

Age Group October Numbers November Numbers
Ages 0-4 9,157 4,848
Ages 5-8 8,031 3,900
Ages 9-12 7,695 3,831
Ages 13-18 13,763 7,605

In the latest data release, the state released a new category called “new application required” for those individuals who are past their reinstatement window and must reapply for coverage. These cases are no longer reflected in the reinstatement window category of data.

However, as the new “new application required” category is not yet disaggregated by age or county, we are unable to determine if the decline is because more of these kids had their eligibility fully reviewed or because they moved over into the “new application required” category. We hope the state will disaggregate this new category in the future so we know how many kids no longer have KanCare coverage (and yet likely remain eligible) and must reapply to the program again to have coverage re-instated.

Data through October 31, 2023

  • 372,738 individuals sent a KanCare renewal letter  
  • 152,119 individuals renewed (including 97,143 in “family medical”) 
  • 36,724 individuals (including 31,580 in “family medical”) determined ineligible and their KanCare coverage was discontinued   
  • 67,648 individuals (including 59,863 in “family medical”) had KanCare coverage discontinued for procedural reasons but can re-enroll within the reinstatement window review period  
    • 57 percent of those in the reinstatement window are children  

Note: In the recent data releases, the state switched from using “90-day window” to “reinstatement window” for procedural reasons.  

October Analysis

In total, almost 190,000 KanCare members, including more than 110,000 children, had their renewal process completed and determined to be eligible or ineligible for coverage based on redetermination criteria. 

For individuals who no longer have coverage due to procedural reasons, there's a silver lining in the improving statistics, though the overall news is still not particularly uplifting: 57 percent of those in the reinstatement window who have yet to return a renewal form are children. 

Children in Ellsworth, Ford, Hamilton, Seward, Stanton, and Stevens counties make up more than two-thirds of those in the reinstatement window in those counties. Most of the counties are clustered in Southwest Kansas. This is fewer counties than in previous reports. Yet, several additional counties’ reinstatement numbers for kids remain above 60 percent, including those in Clark, Finney, Grant, Gray, Greeley, Jewell, Kearny, Morton, Rawlins, Rice, Scott, Sheridan, Thomas, and Wyandotte counties.  Most counties continue to see percentages above 50 percent for children who lost their coverage due to procedural reasons. 

Of all child age breakouts, the 13-18 age group (13,763) continues to account for a higher rate of procedural disenrollments. There are many reasons why this could be occurring, but anyone who works with teenagers likely to have KanCare coverage should be aware.  

Local advocates should continue targeted outreach to children and families in their area. As kids’ eligibility thresholds for Medicaid and CHIP are much higher than adults, it remains concerning that so many kids throughout Kansas are losing coverage for paperwork reasons.  

We do anticipate some changes in next month’s data release, as it will account for the remaining kids impacted by the systems glitch reported on and addressed this fall. Their coverage was to be reinstated by November 30. 

Changing Timelines and Policies throughout the Unwinding

At the halfway point in the unwinding process, the state’s timelines and policies look different compared to when the state began redetermining eligibility for KanCare members in April. All changes have been implemented to overcome numerous administrative barriers and situations outside members control, as well as responding to CMS directives and guidelines.   

Generally, the state sends renewal forms to KanCare members one month before their renewal due date when more information is needed to determine eligibility than what the state has access to. When the state had access to enough information about a member to renew coverage, their coverage was renewed passively (called an “ex parte” renewal).   

Initially, members had to return their renewal form by the 15th of their renewal month or lose coverage, but beginning with the May group, that due date was backed up several months after postal delays and other administrative issues were uncovered early in the process. Since May, members are still strongly recommended to return their form by the 15th of their renewal month.  If forms aren’t returned by the 15th of the due date month, the longer period before coverage is discontinued due to an unreturned form gives advocates, providers, and managed care companies additional time for outreach. 

Also, a report is normally scheduled to run by the state mid-month to discontinue coverage on the first of the next month for those who didn’t return a signed renewal form on time (some refer to this as “procedural disenrollments”). However, throughout these past seven months, the state has now run the report four times (April, July, October, and November) due to numerous pauses to change internal processes and to sort out the systems glitch.  

The state sent out renewal notices in March, April, May, June, August, September, October, and November for those with renewal dates in April, May, June, July, September, October, November, and December. Those with August due dates were moved to months at the end of the unwinding period, so the state could use August as a catch-up month.  

Here’s a few specifics of how disenrollment timelines changed since the beginning of the unwinding, based on the April, May, June, and July due date groups.  

  • April due date group: The state ran discontinuances in mid-April for the April due date group, and coverage was discontinued May 1. However, the state had to reinstate coverage for many of these members in May due to postal system delays and other uncovered issues. Additional members in the April due date group had their coverage reinstated by Nov. 30 to the previously described systems glitch. Most of these will be children.  

  • May due date group: The state ran discontinuances for this group in mid-July, and coverage was discontinued on August 1. Additional members in the May due date group will also have coverage reinstated shortly due to the previously described systems glitch. Again, most of these were children.  

  • June due date group: The state ran discontinuances for this group in mid-October, and coverage will be discontinued on November 1. An extra process was run in this report to catch those who should have been renewed automatically, addressing the system’s glitch.  

     

  • July due date group: The state ran discontinuances for this group in mid-November, and coverage was discontinued on December 1. An extra process was run in this report to catch those who should have been renewed automatically, addressing the system’s glitch. 
  • Later due date groups: To be determined. 

How Advocates Can Continue Much-needed Outreach

Insurance coverage plays an important role in covering doctors appointments, vaccinations, time-sensitive treatments, and therapies for kids. Yet it is now painfully clear that thousands of Kansas kids may no longer have access to medical care because they have had their KanCare coverage discontinued due to paperwork reasons 

We continue to ask all Kansans — including community, education, religious, and health organizations; businesses; public officials; and the media — to reach KanCare members across the state about the ongoing renewal process so eligible Kansans — especially children — keep their coverage. Organizations that work with children in schools, early childhood settings, and after-school settings are particularly important in these efforts.

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, so parents must send back the renewal form.

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