The Arizona Health Care Cost Containment System (AHCCCS) automatically renewed 67 percent of Medicaid beneficiaries last month, with the regular renewal process having begun in April. Medicaid eligibility renewals are taking place throughout every state in the country, and Arizona expects to redetermine the eligibility of about 2.5 million individuals until March of 2024.
During the federal public health emergency (PHE), AHCCCS—the agency that oversees Arizona’s Medicaid program—experienced about a 35 percent enrollment increase due to the federal pause on eligibility renewals, which ended this spring.
Throughout the PHE, if AHCCCS received information that members were factually ineligible or procedurally ineligible, those members kept their Medicaid coverage and were identified as part of the “COVID Override Group.” Factual ineligibility means that individuals no longer meet the income or other eligibility requirements, while procedural ineligibility means that an individual’s eligibility status is incomplete due to missing documentation, etc.
Although the Centers for Medicaid and Medicare Services recommended states undergo redeterminations within a 12-month timeframe, Arizona’s House Bill 2624 has allowed for a condensed timeline for a certain population.
Renewals within the COVID Override Group will be completed within the statutorily mandated nine months, or until December. A fraction of this group will be redetermined each month, and AHCCCS will prioritize those who are factually ineligible, followed by those who are procedurally ineligible from the oldest to most recent application.
While many individuals who have undergone redeterminations have kept Medicaid coverage, 18 percent of beneficiaries have been disenrolled. Of those who were disenrolled in June, 21 percent were factually ineligible while 79 percent were procedurally ineligible.
Of those who were procedurally ineligible:
- 97,094 were over-income and didn’t respond to AHCCCS within the 30-day response period
- 23,989 aged out and were deemed ineligible for another Medicaid program category
- 36,578 were disenrolled for other procedural reasons
Arizonans who are disenrolled will receive a notice of when their enrollment ends, information on how to appeal the decision if the disenrollment is believed to be an error, and other information about health coverage options, including the Healthcare Marketplace. Tribal members under the American Indian Health Program, and Fee-for-Service members, including Federal Emergency Services enrollees, are included in the renewal process.
To date, 41 percent of renewals AHCCCS has received so far (450,422) have been approved. Of the 18 percent of members who were disenrolled, the majority (61 percent, or 122,024 individuals) were ages 19 to 64. Disenrollments for individuals under 19 years, including for KidsCare and other child Medicaid programs, made up 35 percent of the disenrolled population (70,397 individuals).
Maricopa County has seen the highest rate of Medicaid disenrollments at about 60 percent, followed by Pima County at about 14 percent.
Out of those who have reapplied for coverage, 44 percent, or 21,749 individuals, have been approved, while 42 percent, or 20,505 of individuals who reapplied, have been denied.
As thousands fall off of Medicaid, AHCCCS continues to process new applications each month, and received a total of 42,057 applications as of July 1st. The agency recently launched a live chat and automated phone call line to assist enrolled members with renewal questions due to the high volume of work. Kristin Challacombe, deputy director of AHCCCS’ business operations, spoke about these new options in a press release.
“Live chat and automated phone calls are just a few tools AHCCCS is using to help members complete their renewal when it’s their turn to do so,” she said. “We don’t want any eligible member to lose coverage. Each member will receive multiple touch points to encourage them to complete their Medicaid renewal, including a renewal notification one month prior to their renewal month and phone calls, texts, and/or email reminders, as well as an alert if their renewal is not completed by the response deadline.”
The automated phone calls will be directed towards any individual whose physical renewal correspondence is returned due to an incorrect address, etc. The live chat feature is active during business hours, and after hours, AHCCCS says the chatbot is able to answer more than 40 common questions about the renewal process.
Renewals are frequently based on the month when individuals first enrolled, and in most cases, individuals renewing can remain on the same health plan unless they moved or their current plan is unavailable in their new location. Members who are disenrolled can renew within 90 days of disenrollment.