26 April 2024 | Health

KanCare Unwinding Updates

Heather Braum | Updated April 26, 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 February 29, cumulatively, 166,456 Kansas kids have had their KanCare coverage renewed; 28,646 Kansas kids have been determined to be no longer eligible for coverage; and 5,875 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 — 73,179 — 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.

As the state nears the end of this unwinding process, the scheduled yearly renewal process has already started back up. If you work with the KanCare population, especially if you work with children, please work on outreach emphasizing that parents/guardians look for renewal forms each year and return them so their children keep their health insurance coverage.

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:

February 29 Data*
December 31 Data
November 30 Data
October 31 Data
Changing Timelines and Policies throughout the Unwinding
How Advocates Can Continue Much-Needed Outreach
Past Updates (June, July, August, October, and November)

*The state did not publicly release data for January 31, 2024, on their tracking website; however, the February data release is cumulative.

Data through February 29, 2024

526,979 individuals sent a KanCare renewal letter 
272,693 individuals renewed (including 170,343 in “family medical”)
60,767 individuals (including 52,247 in “family medical”) determined ineligible and their KanCare coverage was discontinued
11,255 individuals (including 9,439 in “family medical”) had KanCare coverage discontinued for procedural reasons but can re-enroll within the reinstatement window review period 
- 52.2 percent of those in the reinstatement window are children

February Analysis

In total, more than 330,000 KanCare members, including around 195,000 children, had their renewal process completed and determined to be eligible or ineligible for coverage based on redetermination criteria. This is an increase of 65,000 (including 40,000 children) since December, the most recent public data release.

Throughout these periodic analyses, we have unpacked the reinstatement window category, as this reflects KanCare members who have yet to return their renewal form and were discontinued for “procedural reasons,” not because they were determined to be ineligible based on KanCare eligibility criteria.

As of February 29, the reinstatement window category is now down to 11,255 members because, beginning with the November 30 data release, the state created 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 disaggregated by age or county, we are unable to determine how many children are in this category. We wish it were possible for the state to disaggregate this new category in the future so we know how many kids no longer have KanCare coverage (yet likely remain eligible) and must reapply to the program again to have coverage re-instated.

That said, 52.2 percent of those in the reinstatement window who have yet to return a renewal form are children. Children in Clark, Comanche, Gray, Harper, Hodgeman, Kearny, Logan, Sherman, Stafford, Stanton, Stevens, Trego, Washington, and Wichita counties make up more than two-thirds of those in the reinstatement window in each of those counties. As with previous months, many of these counties are clustered in Southwest Kansas.

Several other counties’ reinstatement numbers for kids remain above 60 percent, including those in Chase, Clay, Ford, Jackson, Kingman, and Norton. Many more counties continue to see percentages above 50 percent for children who lost their coverage due to procedural reasons.

For several months, we have highlighted that older children (ages 13-18) appeared in this reinstatement window category more frequently than other ages of children. For the late February data release, however, 2,192 young children (ages 0-4) are in the reinstatement window. This is a concerning finding, as the income thresholds for young children are much higher than older children; health insurance coverage for young children is critical for their growth, well-being, and overall health.

Local advocates should continue targeted outreach to children and families in their area, especially for those in Southwest Kansas who work with young children. 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 due to paperwork reasons.

Data through December 31, 2023

467,818 individuals sent a KanCare renewal letter 
214,835 individuals renewed (including 136,154 in “family medical”)
53,444 individuals (including 46,468 in “family medical”) determined ineligible and their KanCare coverage was discontinued  
22,480 individuals (including 19,261 in “family medical”) had KanCare coverage discontinued for procedural reasons but can re-enroll within the reinstatement window review period 
- 54.9 percent of those in the reinstatement window are children

December Analysis

In total, nearly 270,000 KanCare members, including nearly 160,000 children, had their renewal process completed and determined to be eligible or ineligible for coverage based on redetermination criteria. This is an increase of 30,000 (including 20,000 children) since the previous month.

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 54.9 percent of those in the reinstatement window who have yet to return a renewal form are children.

Children in Clark, Comanche, Elk, Ford, Hodgeman, Kearny, Meade, Rawlins, Seward, 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, Finney, Grant, Gray, Hamilton, Johnson, Ottawa, Sherman, Stanton, Thomas, Trego, Wallace, 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 (4,622) continues to account for a higher rate of procedural disenrollments.

Local advocates should continue targeted outreach to children and families in their area, especially in Southwest Kansas. 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 due to 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.

Starting with the November 30 data release, the state created 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 still 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 (yet likely remain eligible) and must reapply to the program again to have coverage re-instated.

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.

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.

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

The state’s timelines and policies now 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 at least nine times (April, July, October, November, December, January, February, March, and April) 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, November, December, January, and February for those with renewal dates in April, May, June, July, August, September, October, November, December, January, February, and March. That means the state has reached the end of sending out renewal notices as part of the unwinding process, and at least with the renewal notice mailings, will return to regular operations. However, there are still several more months-worth of processing and eligibility redeterminations for the state to complete.

Here are a few specifics of how disenrollment timelines changed since the beginning of the unwinding, based on the April, May, June, July, September, October, November, December, January, February, and March 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.
September due date group: The state ran discontinuances for this group in mid-December, and coverage was discontinued on January 1. An extra process was run in this report to catch those who should have been renewed automatically, addressing the system’s glitch.
October due date group: The state ran discontinuances for this group in mid-January, and coverage was discontinued on February 1. An extra process was run in this report to catch those who should have been renewed automatically, addressing the system’s glitch.
November due date group: The state ran discontinuances for this group in mid-February, and coverage was discontinued on March 1. An extra process was run in this report to catch those who should have been renewed automatically, addressing the system’s glitch.
December due date group: The state ran discontinuances for this group in mid-March, and coverage was discontinued on April 1.
January and February due date groups: The state ran discontinuances for this group in mid-April, and coverage will be discontinued on May 1.
March due date group: The state will run discontinuances for this group in mid-May, and coverage will be discontinued on June 1.

How Advocates Can Continue Much-needed Outreach

Insurance coverage plays an important role in covering doctor’s 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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