The Washington State Health Care Authority (HCA), in partnership with the Washington Health Benefit Exchange (Exchange) and the Department of Social and Health Services (DSHS), released initial data from May 2023, the first month of Apple Health (Medicaid) renewals.
During the COVID-19 pandemic, Apple Health clients did not need to provide renewal information to maintain their health care coverage. With the ending of the public health emergency, federal law requires states to resume eligibility verification over the next year.
More than 2.3 million Washington State residents are covered by Apple Health. The state is engaging in extensive outreach efforts to make sure Apple Health clients update their eligibility information to avoid losing coverage they might still be eligible for.
“Our goal is that every Washingtonian who is eligible for Apple Health stays on Apple Health,” said Sue Birch, HCA executive director. “We urge people to make sure their information is up to date. If you have a friend or family member on Apple Health, please encourage them to reach out to us and update their information.”
After extensive outreach, in the month of May, HCA conducted eligibility reviews for 230,000 clients.
- HCA automatically renewed coverage for about half of those clients using available information from DSHS programs like the Supplemental Nutrition Assistance Program (SNAP) and cash assistance programs, employment and income data, and other available data sources.
- HCA, the Exchange, DSHS, managed care organizations, providers and many other community partners have actively assisted clients through multiple outreach opportunities to help people to update their information and maintain Apple Health coverage.
- Roughly 116,000 people, representing approximately 5 percent of the overall Apple Health covered population, were disenrolled from coverage due to various reasons.
- About 83,000 people were disenrolled after automatic eligibility checks were completed and the person did not respond to multiple requests to update their information. Clients are given at least 45 days to complete a renewal.
- This is a large initial proportion, but it is consistent with expectations. Disenrollment numbers are expected to decrease over the next 12 months, likely meaning that many people who needed Apple Health during the pandemic have regained employer-sponsored insurance or found coverage through Washington Healthplanfinder or now qualified for Medicare.
If an Apple Health client’s coverage is terminated for not renewing, they have a 90-day reconsideration period, which allows them to reenroll and return to coverage. If they are determined eligible for Apple Health, their coverage will be reinstated back to the day they were disenrolled, leading to no gap in coverage. Clients who miss their 90-day reconsideration period can still reapply for coverage at any time.
HCA and the Exchange will work with clients who are no longer eligible for Apple Health to ensure they are provided information on how to enroll for other affordable coverage options through the Washington Healthplanfinder. If they are over 65, they will receive information about applying for programs that help pay for Medicare.
HCA, DSHS and the Exchange are taking proactive steps to ensure eligible individuals are not terminated from coverage due to procedural reasons, including:
- Spreading renewals out over 12 months, which provides time to run a smooth process and prevent systems from getting backlogged. This reduces burden not only on individuals and families, but also on state eligibility systems. Taking the time to do the process correctly will ensure those eligible for continued coverage do not experience a gap in care and those no longer eligible can transition to other sources of coverage.
- Partnering with managed care plans and using data available from the United States Postal Service to update people’s contact information so that they receive the renewal forms.
- Enhanced outreach using text messages, phone calls, social media, radio and TV ads to clients who have not completed a renewal prior to coverage termination.
- HCA’s volunteer ambassador program was launched within communities to help people stay informed on renewal processes. This adds to a robust network of Washington Healthplanfinder’s navigators and brokers who assist people across the state in obtaining and maintaining coverage.
- Maximizing the use of data sources, such as income information from the Employment Security Department, and renewing individuals based on their eligibility for other programs, such as SNAP and Temporary Assistance for Needy Families (TANF). This helps reduce the need for some individuals to fill out and return a renewal form.
"We want to ensure all Washingtonians stay covered, whether it is a new qualified health plan, Apple Health, or employer sponsored," said Ingrid Ulrey, CEO at Washington Health Benefit Exchange powering Washington Healthplanfinder. "For those who are now above income eligibility, they will have the opportunity to enroll in high-value, low-cost Cascade Care plans, now available for as low as $10 or less per month."
Apple Health clients and Washington Healthplanfinder customers are encouraged to update their contact information to ensure they receive their renewal notice over the next year to maintain their health coverage.
Enrollment data will be published monthly at www.hca.wa.gov/phe.