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Iowa Medicaid Unwinding: What you need to know

Background:

During the COVID-19 pandemic, state Medicaid offices were required to provide continuous healthcare coverage for all members to ensure that no one lost their coverage during the public health emergency. 

Iowa was not allowed to disenroll anyone from Medicaid beginning March 18, 2020, regardless of their eligibility status.

What is Medicaid Unwinding?

Because state and federal public health emergency declarations are ending, President Biden signed the Consolidated Appropriations Act. This legislation ends the requirement for states to provide continuous healthcare coverage for all Medicaid members. As of April 1, 2023, states can unenroll individuals from  Medicaid if they no longer qualify for the program or if they fail to complete their renewal packets (also called redetermination forms). 

The State of Iowa began the Medicaid unwinding process on April 1, 2023 and most Medicaid members will undergo a review or redetermination period.

  • After renewal, if an individual is still Medicaid eligible, they will be asked to choose coverage by one of three managed care organizations (MCOs): Iowa Total Care, Amerigroup or Molina Healthcare of Iowa.
  • If an individual is no longer eligible for Medicaid, they will be directed towards the Affordable Care Act (ACA) marketplace to find a plan, including any subsidies that could make the plan more affordable. 

How Many Iowans Will be Affected?

More than 860,000 Iowans are enrolled in Medicaid (as of March 2023). An estimated 17.6% of current Medicaid members (~150,000 Iowans) will be disenrolled during the unwinding period due to no longer meeting eligibility1. Other Iowans may lose Medicaid coverage because they fail to complete the renewal/redetermination paperwork.

Unwinding Process in Iowa

To ease the transition, the state is spreading the unwinding process out over the course of a year. Iowa Medicaid will mail redetermination forms to all Medicaid members, about 50,000 individuals a month. Therefore, not all Medicaid members will get their forms at the same time and it could take a few months for some individuals to receive them. 

Iowans with Medicaid coverage should:

  • Make sure your contact information is up-to-date with Iowa Medicaid.
    To confirm your information is up-to-date, contact Medicaid Member Services (Phone: 1-800-338-8366 | Email: [email protected])
  • Watch for postcards or mail from Iowa Medicaid or your MCO with important information about your healthcare coverage and/or next steps to confirm reenrollment. 
  • Respond to any requests for information from Iowa Medicaid or your MCO as quickly as possible to ensure no lapse in healthcare coverage. 
  • Be alert for phishing and fraud attempts! Iowa Medicaid will never ask you to pay a fee for redetermination or call you and ask for your personal information over the phone. If you’re in doubt about the validity of communications you receive, contact Medicaid Member Services at 1-800-338-8366 or [email protected]. 

Are you a Medicaid member who has been diagnosed and/or treated for cancer while you were covered in the program? Our partners at the American Cancer Society Cancer Action Network are looking for cancer survivors who are or were Medicaid members and are willing to share their story. Contact Jackie Cale, Iowa Government Relations Director, at [email protected] to learn more.

Additional Information:

Sources:

  1. Krebs, N. (2023, March 31). Thousands of Iowans will lose Medicaid coverage in the next year. Here’s what you need to know. Iowa Public Radio. https://www.iowapublicradio.org/health/2023-03-31/thousands-of-iowans-will-lose-medicaid-coverage-in-the-next-year-heres-what-you-need-to-know 
  2. Iowa Department of Health and Human Services. (No date). Continuous Coverage Requirement Unwind. State of Iowa Department of Health and Human Services.  https://hhs.iowa.gov/ime/unwind/CCR 
  3. UI Health Care. (2023, May 3). Helping our Medicaid patients avoid lapse in coverage. The Loop. https://medcom.uiowa.edu/theloop/announcements/helping-our-medicaid-patients-avoid-a-lapse-in-coverage