Utah Medicaid to observe FMAP reduction in April as renewal reviews continue


Boram Kim


On April 1st, Utah will observe a reduction in its enhanced federal matching rate (FMAP) for Medicaid from 6.2% to 5%. The rate reduction is the first in a series of decreases scheduled for the year before the enhanced FMAP ends on Jan. 1st of 2024. 


Stay one step ahead. Join our email list for the latest news.



Utah’s Medicaid and Children’s Health Insurance Program (CHIP) enrollment grew by 61% during the pandemic from 315,000 members in March 2020 to more than 500,000 members this year, according to the Utah Department of Health and Human Services (DHHS). 

DHHS plans to conduct renewals for more than 289,000 households over the next 12 months. The Department of Workforce Services (DWS) initiated its review process for Medicaid renewals at the start of this month and the state will begin disenrolling members who are no longer eligible for Medicaid in May. 

The record caseload growth has forced DWS to implement staffing strategies during the process, which includes teleconferencing to work and train from home, hiring rural staff, increasing wages, and enlisting retired staff. 

CMS approved five waivers around flexibility in conducting renewals for Utah. These allowances include authorizing ex parte or automatic renewals for individuals with no income and no data returned, facilitating renewals for individuals with no Asset Verification System data, extending timeframes on fair hearing requests that take administrative action, and partnering with managed care plans and national address directories to update beneficiary contact information.

Based on new federal guidance, DHHS and managed care plans can utilize robocalls and texts to inform Medicaid beneficiaries of enrollment changes. DHHS has been using a variety of tools and channels, including social media, texts, and emails, and working with providers and partners to communicate the continuous eligibility unwinding. Members can update their information and access information on their renewals online

In cases where the review process determines ineligibility or requires more information to complete, DHHS will flag and prioritize those individuals for additional action, including transitioning them to a state exchange plan.

The Kaiser Family Foundation estimates that between five and 14 million people could lose Medicaid coverage nationwide during this process. 

Meanwhile, the Biden/Harris administration marked the 13th anniversary of the signing of the Affordable Care Act on Thursday by highlighting enrollment in marketplace and state exchange plans—which are likely to see significant growth in coming months—reached 16.4 million consumers during the 2023 open enrollment period.