Ex Parte Options and Recommendations for the non-MAGI Medicaid Population to Reduce Churn

Almost 15 million people may lose Medicaid and CHIP next year, 7 million of whom will lose coverage despite remaining eligible when the COVID-19 Public Health Emergency (PHE) ends. At that point, Medicaid agencies will have to process renewals for all enrollees. To prepare, states have been drafting plans, training staff, and creating messaging to prepare for the largest transition in healthcare since the Affordable Care Act. 

Some of the most vulnerable Medicaid populations are at a high risk of churning, also known as cycling on and off of Medicaid coverage, such as the non-MAGI (Modified Adjusted Gross Income) population. Enrollees that fall into this category can include low-income older adults, people with disabilities, children in foster care, and individuals with high medical needs. It is estimated that around 10 percent of these non-MAGI enrollees are expected to lose coverage when the PHE ends, primarily due to changes in income and returned mail.  

At the same time, states complete less than 1 in 4 of their non-MAGI renewals using a simplified process known as ex parte, where states automatically renew coverage by using verified information that it already knows about the individual. Ex parte renewals are sometimes called automated renewals or passive renewals. There are a number of strategies for state and county agencies available to increase the number of ex parte renewals for their non-MAGI population, including: 

  • Streamlining zero-income verification; 
  • Expanding the number and type of data sources used;  
  • Aligning MAGI and non-MAGI renewal policies; and 
  • Creating a unified eligibility system interface for both MAGI and non-MAGI populations  

Additional strategies for preserving benefits for eligible non-MAGI populations include:  

  • Removing requirements for in-person interviews;  
  • Increasing continuous eligibility; and  
  • Sending pre-populated renewal forms to clients 

As a part of Benefit Data Trust’s Medicaid Churn Learning Collaborative, BDT has created a memo describing policy options and state examples for Medicaid administrators to reduce churn for non-MAGI Medicaid enrollees. To learn more and see specific state examples, download our “Ex Parte Options and Recommendations for non-MAGI Medicaid Population to Reduce Churn” memo. 

If you have additional questions, or would like to request technical assistance, please contact Miriam Lipschutz, Policy Analyst, at mlipschutz@bdtrust.org or Jamila McLean, Healthcare Policy Manager, at jmclean@bdtrust.org.   

This publication was created as a part of Benefit Data Trust’s Medicaid Churn Learning Collaborative. Support for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.