Up to 4,000 Wisconsinites Determined Ineligible for Medicaid During Renewal Will Have Coverage Reinstated After Error Discovered

Tuesday, September 26th, 2023 -- 11:00 AM

(By Hope Kirwan, Wisconsin Public Radio) Up to 4,000 Wisconsinites who were determined ineligible for Medicaid during the annual renewal process will have their coverage reinstated after federal officials identified an error in the state's automatic renewal system.

According to Hope Kirwan with Wisconsin Public Radio, Wisconsin is one of 30 states that reported having an error in their automatic process after the Centers for Medicaid and Medicare Services, or CMS, sent a letter to states on Aug. 30.

The federal agency found some state systems "were inappropriately disenrolling children and other enrollees, even when the state had information indicating the person remained eligible."

The agency said in a press release that half a million children and families across the country were affected by the problem. In Wisconsin, the issue affected people who are eligible at the individual level but did not receive automatic renewal due to the eligibility of someone else in their household.

DHS spokesperson Jennifer Miller said in an email the issue of whether states were passively renewing at the household or individual level had not been raised during preparation for resuming annual Medicaid enrollment.

After receiving guidance from CMS in August, Miller said the state agency added a temporary manual process last month to ensure eligibility is extended for affected members, which will continue indefinitely.

Miller said in the email that the agency expects to reinstate coverage for the roughly 4,000 affected members by the end of October and is providing information on how people can obtain coverage for unpaid medical bills that occurred after their disenrollment. 

Even with the correction, tens of thousands of people have lost their coverage. Annual renewals for Medicaid coverage were suspended in March 2020 as part of the federal government's response to the COVID-19 pandemic.

After the federal public health emergency ended this spring, the state Department of Health Services resumed the regular yearly renewal process in June for BadgerCare Plus; Elderly, Blind, or Disabled Medicaid and other programs.

So far, state data shows coverage ended for nearly half of the people renewing their Medicaid coverage each month this summer. Throughout June, July and August, about 50 percent of people in all Medicaid programs with renewals due had retained their coverage.

Roughly 48 percent of people had seen their coverage end, with some people still waiting for their renewals to process. In the latest data from August, just over 72,000 people were due to renew their coverage through BadgerCare Plus, which assists low-income children, pregnant people and adults.

More than 35,000 of those people, or about 49 percent, were no longer eligible for the program and had their coverage ended. Almost 31,000 people, or about 42 percent, retained their coverage. More than 6,000 people were still waiting for their renewal to be processed at the end of the month.

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