Return to sender mail may eliminate Medicaid benefits

Last year, Colorado state officials determined that returned mail related to Medicaid and other public benefits could eliminate that person’s eligibility in the programs. 

In the southern part of the state, the amount of returned mail that arrives each day has resulted in 250 potential un-enrollments daily. Reporting from Kaiser Health News estimates that about 15% of the 12 million letters from public assistance programs to 1.3 million members statewide are returned — some 1.8 million pieces of undelivered mail each year.


Get the latest state-specific policy intelligence for the health care sector delivered to your inbox.


Once the mail is returned, it is up to individual county staff to locate the individual, correct their address, and determine their eligibility status. This task occurs on top of their current workload and position requirements. 

If the person is unreachable after one attempt, Medicaid and other public assistance programs can be revoked. Reporting explains that Medicaid, food stamps, and other public assistance programs still rely on paper communication, rather than online correspondence. 

“…tightening returned mail policies could save states some money, and those cut from the benefits yet still eligible for them would experience only a temporary gap in their care. But even short delays can exacerbate some patients’ chronic health conditions or lead to expensive visits to the hospital,” reporting from Kaiser explains. 

Late last year, Colorado lowered its threshold for acting on returned mail. The state went from acting on three pieces of returned mail daily, to just one. 

From May 2017 to May 2019, enrollment in Medicaid and the Children’s Health Insurance Program dropped 8.5% in the state — more than three times the national decline of 2.5%, according to the Medicaid and CHIP Payment and Access Commission, a congressional advisory panel.

The state has not set up a way to track the number of people who are losing Medicaid benefits thus far.