Key Takeaways from Medi-Cal Redetermination Data
by Amy Adams, Senior Program Officer, Improving Access
August 14, 2024
After a roughly three-year hiatus under federal policies designed to help people keep their health coverage during the pandemic, California has returned to requiring enrollees to annually renew their Medi-Cal coverage. California will need to redetermine Medi-Cal eligibility for over 15 million enrollees, an unprecedented undertaking.
To understand how this process (commonly referred to as “the unwinding”) is going, CHCF is monitoring detailed monthly data provided by the California Department of Health Care Services (DHCS), which administers Medi-Cal. Scroll down to our first update, posted on November 4, for an explanation of data measures and an analysis of the first quarter of data. Subsequent updates will be provided on a rolling basis as new data become available.
Update: 90-Day Updated Redetermination Data (June 2023–February 2024)
Back in April, we examined the first five months of 90-day updated Medi-Cal redetermination data (covering June 2023–October 2023). As we explained, the 90-day data can help provide a fuller picture of the impact of the unwinding than the data released monthly because people who have been disenrolled from Medi-Cal have 90 days (sometimes called the “cure” period) to get reinstated and because the updated data may capture progress on renewals still in process.
DHCS has now released 90-day updated data through February 2024, meaning there are now nine months of this more “settled” data. As we reported in the August 5 update below, the official unwinding period ended as of May 2024, and all of the monthly (or “pre-90-day”) data are now available, but we are still waiting for the final three months of 90-day updated data. Stay tuned for more once that update becomes available.
The nine months of “post-90-day” data now available continue to point to some important trends:
- Fewer renewals remain “in process.” Nearly half of the three million renewals initially identified as in process were completed. The 1.5 million renewals still in process as of February represent 16% of all renewals due.*
- The procedural disenrollment rate is better, but still high. The procedural disenrollment rate for February 2024 was 81% in the “pre-90-day” data and 50% in the “post-90-day” data.
- About half of those who are procedurally disenrolled and seek reinstatement are ultimately determined to be eligible.
- About one-third of procedural disenrollees take advantage of the “cure” period to try to get reinstated, and about half of them succeed. For example, the February data show that about 32,000 fewer people were counted as procedurally disenrolled after the 90-day cure period, and about 16,000 people had their Medi-Cal reinstated.
- In total, more than 219,000 people initially disenrolled had their Medi-Cal coverage reinstated between June 2023 and February 2024.
- The “post-90-day” data continue to show that the non-MAGI population (older enrollees and those in Medi-Cal because of a disability) are not being disenrolled at a disproportionately high rate. Although the “pre-90-day” data had shown a disproportionately high rate, the post-90-day data show that the non-MAGI population made up 9% of all disenrollments and 10% of all renewals due.
The 90-day updated data do not include demographics, so we cannot report on whether the new data show differences by race, ethnicity, age, gender, or language.
Stay tuned for more analysis as updated data become available.
Explore more of the 90-day updated data, available under Document Downloads, below.
* As was the case with the previous 90-day data, updated data revise the number of renewals due each month for various reasons (see previous post). This impacts the number of renewals in process and the disenrollment and continuance rate. Note that in all redetermination data sets, the month of July appears to be an outlier, possibly due to a reporting or processing glitch.
Update: Redetermination Data for the Full Unwinding Period (June 2023–May 2024) Now Available
Posted August 5, 2024
The unwinding period is officially over as of May 31, 2024. We now have preliminary data for all months of the unwinding and can take a quick look at how Medi-Cal enrollees fared — and what challenges remain.
Nearly two million people have been disenrolled from Medi-Cal, but that figure will change. Of the 13.3 million people who had Medi-Cal renewals due, 1.8 million were disenrolled during the unwinding period. This is a preliminary number likely to change for at least these two reasons:
- Nearly 3.7 million enrollees…