Most states are not set up to reach Medicaid recipients via text: Shot 8

States must reach out to all Medicaid registrants to let them know that their qualifications need to be re-evaluated, but many of these states will not employ a core strategy: texting.

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States must reach out to all Medicaid registrants to let them know that their qualifications need to be re-evaluated, but many of these states will not employ a core strategy: texting.

Sopa Image / Sopa Image / Light Rocket Getty Images

West Virginia will use the U.S. Postal Service and an online account to connect with Medicaid envoys about the expected termination of the COVID-19 public health emergency this summer, putting many recipients at risk of losing their coverage.

What West Virginia will not do is use a form of communication that is universal: text messaging.

“West Virginia is not set up to text its members,” Alison Adler, the state’s Medicaid spokeswoman, wrote in an email to KHN.

In fact, most state-of-the-art Medicaid programs will not send textbooks to enrollers, despite the need to reach out to them about renewing their coverage. A report by the Kaiser Family Foundation, published in March, found that only 11 states said they would use text to warn Medicaid recipients about the end of the Covid public health emergency. In contrast, 33 states plan to use Snail Mail and reach at least 20 individual or automated phone calls.

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Kinda Serafi, a partner at consulting firm Manate Health, said: “Nowadays, it doesn’t make sense when texting how most people communicate.”

For months, state Medicaid agencies have been preparing for the end of the public health emergency. As part of a COVID relief law enacted in March 2020, Congress prohibits states from excluding anyone from Medicaid coverage unless they leave the state during a public health emergency. Once the state of emergency is over, state Medicaid officials must re-evaluate the qualifications of each enlisted person. Millions of people may lose their coverage if they earn too much or fail to provide the information needed to verify income or housing.

As of November 2021, approximately 86 million people are enrolled in Medicaid, according to the Center for Medicare and Medicaid Services. It rose to 71 million in February 2020, before the Kovid nation began to perish.

There are more than 600,000 Medicaid registrations in West Virginia Adler said about 100,000 of them may lose their eligibility at the end of a public health emergency because the state has determined they are ineligible or they have failed to respond to requests to update their income information.

“It’s frustrating that texting is a means of meeting people where they are and not over-selected by states,” said Jennifer Wagner, director of enrollment for Medicaid Qualifications and the Washington-based Center on Budget and Policy Priorities. Research team.

The problem with relying on the postal service is that a letter may be hidden in “junk” mail or fail to reach those who have moved or are homeless, Serafi said. And email, if people have an account, could end up in a spam folder, he noted.

In contrast, studies show that low-income Americans are just as likely to have smartphones and cellphones as the general population. And most people use regular texting.

In Michigan, Medicaid officials began using text messaging to communicate with registrants in 2020 after creating a system with the help of the Federal COVID Relief Fund. They say that texting is a lucrative way to reach the registered.

“It costs us 2 cents per text message, which is incredibly cheap,” said Steve White, enrollment coordinator at the Michigan Department of Health and Human Services. “It’s a great return on investment.”

CMS officials have told states that they should consider texting with other communication methods when trying to reach out to registrants at the end of a public health emergency. But many states do not have the technology or information about registrants to do this.

Attempts to add texting also face legal hurdles, including a federal law that prohibits people from sending texts without their consent. The Federal Communications Commission ruled in 2021 that state agencies are exempt from the law, but it is unclear whether the counties that administer Medicaid to some states and Medicaid-operated care agencies operating in more than 40 states are also exempt, Matt Salo said. , Executive Director of the National Association of Medicaid Directors.

CMS spokeswoman Beth Link said the agency was trying to determine how Medicaid agencies, counties and health plans could send texts to enrollers within the limits of federal law.

Several states have told KHN that Medicaid health plans will help connect with registered ones and they hope the plans will use text messaging. But the need to get consent from the registrants before texting may limit that effort.

This is the situation in Virginia, where only 30,000 Medicaid registrants – more than a million – have agreed to receive direct text messages from the state, spokeswoman Christina Knuckles said.

In an effort to increase that number, the state plans to ask registrants if they want to opt out of receiving text messages instead of asking them to opt in, he said. As such, registrants will only contact the state if they do not wish to text. The state is reviewing its legal options to make this happen, he said.

Meanwhile, Nuckols added, the state expects Medicaid health plans to contact registrants to update their contact information. Four of Virginia’s six Medicaid plans, which serve the majority of state registrants, are allowed to text about 316,000, he said.

Craig Kennedy, CEO of Medicaid Health Plan, a trade group in the United States, says most plans use texting and that Medicaid officials will use multiple strategies to connect with registered ones. “I don’t see it as harmful that states are not sending information about re-enlistment,” he said. “I know we can help.”

In March, California officials instructed Medicaid’s health plans to use a variety of communication methods, including texting, to ensure members could retain coverage if eligible. Officials say the health plan says they can seek consent through preliminary lessons.

California officials say they plan to seek the consent of registrants to text enlistment applications, although federal approval for the changes is not expected until after the fall.

Several state Medicaid programs have experimented with pilot programs in recent years, including texting enrollment.

In 2019, Louisiana worked for America to send text messages with nonprofit group codes that remind people to provide income information for coverage renewal and verification. Medicaid spokeswoman Alison Neal said that compared to traditional communication methods, texts led to a 67% increase in enrollment for coverage and a 56% increase in enrollment for verifying their income in response to inquiries.

Nonetheless, the state does not plan to text Medicaid registrants about ending public health emergencies because it has not set up a system for it. “Medicaid has not yet been able to implement its own text messaging system due to the priorities of other organizations,” Neil said.

KHN (Kaiser Health News) is a national newsroom that creates in-depth journalism about health issues. It is an editorially independent operating program KFF (Kaiser Family Foundation).

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