As Medicaid redeterminations restart, about 73% of state’s recipients remain enrolled

About 73% of Illinois’ Medicaid recipients remain on the rolls after the first redetermination cycle following the COVID-19 pandemic, while about 660,000 recipients have been disenrolled.

Speaking at a news conference in Chicago, Gov. JB Pritzker celebrated the fact that 2.6 million Illinoisans remained on the rolls despite redeterminations beginning anew, saying “this is what good government looks like.”

“I am proud to announce that Illinois is among the leading states in the country with a retention rate of 73%, one of the highest in the entire nation,” he said. “We made every effort to automate renewals, give customers more time and information, and to build the capacity necessary to manage the caseload and work to avoid letting people slip through the cracks.”

During the early stages of the COVID-19 pandemic, Congress enacted changes to Medicaid requiring states to keep patients continuously enrolled through the public health crisis, even if they might have become ineligible due to changes in their income or family circumstances.

That continuous enrollment program expired in March 2023, forcing states to resume the process of requiring Medicaid enrollees to reapply each year and determine if they still were eligible.

Federal officials estimated at the time that 17.4% of all the people enrolled in Medicaid and the Children’s Health Insurance Program would be disenrolled through redeterminations. That would have translated to about 15 million people nationwide, and 700,000 in Illinois.

The Department of Healthcare and Family Services said at the time it hoped to lessen the impact of the change and hold the number of people disenrolled to about 384,000.

But on Monday, HFS reported more than 660,000 Illinoisans had been disenrolled from state health insurance in the past year. About two-thirds of those people lost coverage because of procedural reasons, like submitting incomplete information or not completing forms in time. The remaining were disenrolled due to finding new coverage, moving states or making too much money to be eligible for Medicaid.

A report by the national health nonprofit KFF, formerly the Kaiser Family Foundation, noted procedural disenrollment can be “concerning because many people who are disenrolled for these paperwork reasons may still be eligible for Medicaid coverage.”

Illinois had a high mark of almost 4 million residents on Medicaid during fiscal 2023, but redetermination effectively lowered the number of people on Illinois Medicaid down to pre-COVID levels.

Elizabeth Whitehorn, director of HFS, said reliance on publicly funded insurance grew due to the onset of COVID.

“At the beginning of the pandemic, the federal government implemented the continuous Medicaid coverage requirements directing states to stop the regular practice of annual redeterminations for Medicaid,” she said. “During the three years that the continuous coverage requirement was in place, our Medicaid enrollee population in Illinois grew by nearly one million people.”

More than 300,000 Illinois Medicaid recipients are still in the midst of redetermination, a majority of whom have not submitted paperwork, according to HFS. Paperwork is pending for about 90,000 of those cases, according to the department note.

Pritzker said the state launched an advertising campaign to remind residents about redetermination and applying to renew Medicaid status in 15 languages and installed new methods of renewal.

“We added text messaging capabilities and telephone helpline improvements to make it as convenient as possible for Illinoisans,” he said. “We are seeking federal approval to make permanent many of the capacity and efficiency boosting practices that we adopted.”

Since last May, the Department of Human Services reported taking more than 75,000 medical redetermination phone calls, where IDHS workers can provide technical assistance and allow customers to submit information required for redetermination.

Redeterminations of Medicaid customers will continue on an annual basis, HFS said. People in need of immediate assistance with insurance coverage can visit getcovered.illinois.gov or abe.illinois.gov to apply for state benefits.

Cole Longcor and Peter Hancock contributed.

Capitol News Illinois is a nonprofit, nonpartisan news service covering state government. It is distributed to hundreds of newspapers, radio and TV stations statewide. It is funded primarily by the Illinois Press Foundation and the Robert R. McCormick Foundation, along with major contributions from the Illinois Broadcasters Foundation and Southern Illinois Editorial Association.