State Medicaid Agencies Face Staffing Shortages as Redeterminations Resume

Many Medicaid agencies’ “frontline eligibility” divisions and call centers are understaffed, according to the Kaiser Family Foundation’s (KFF) just-released annual survey of state Medicaid officials, which was fielded in January. That could complicate income checks and other parts of the eligibility redetermination process, which will resume on April 1 after a yearslong pause due to the COVID-19 pandemic.

State Medicaid programs are ultimately responsible for determining whether a Medicaid enrollee is in fact eligible for enrollment in the program, but Medicaid managed care organizations (MCOs) also have a hand in managing disenrollments — and have strong incentives to keep as many members enrolled as possible. Indeed, the survey found that 41 states are relying on Medicaid MCOs to “conduct outreach and assist members” as they navigate the disenrollment process; 33 states provided MCOs with “advance lists of members up for renewal,” and 26 states have sent out “advance lists of members who may be disenrolled because they have not responded to requests for information.”

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