Unwinding Guidance & Resources
What is the Renewal Process?
Each year, states review people currently getting Medicaid and Children’s Health Insurance Program (CHIP) coverage to find out if they’re eligible to keep getting benefits. This means your state will use the information they have to decide if current beneficiaries still qualify for Medicaid or CHIP coverage. If your state needs more information to make a coverage decision, they’ll send the beneficiary a renewal letter in the mail. Please note, most children can still get coverage through CHIP, even if their parents no longer quality for Medicaid.
How have we prepared to keep people covered?
Due to unique barriers in Indian Country, we educated states and external partners on ways to best reach the AI/AN community during the COVID-19 pandemic. This included presenting information like "Strengthening Tribal and State Partnerships to Prepare for Unwinding" to the National Association of Medicaid Directors. As Medicaid and CHIP renewals resumed, many of the lessons learned to strengthen Tribal and state partnerships remain important.
In this presentation, we highlighted that some AI/AN families share post office boxes and some Indian reservations’ post offices are over 100 miles away from their homes. We also explained that broadband services are limited. According to the Federal Communications Commission (FCC) data, broadband services reach 95.6% of the nation as a whole, but just 79.1% of people on tribal lands – and only 46.5% of tribal households.
To address these barriers, we strongly encourage partnering with Indian Health Service (IHS), Tribes and Tribal organizations, and urban Indian organizations (collectively, ITU). ITUs are a trusted resource to help with reaching and retaining AI/AN beneficiaries. They can help communicate with Indian Country and overcome those unique barriers.
CMS communicated with states in a SHO letter in January 2023, encouraging states to share data to help with updated contact information for Tribal Medicaid beneficiaries. They also released an FAQ in May 2023 stressing how states should share enrollment data with ITUs.
What can you do?
Spread the word: Share information about Medicaid renewals. We’re asking for help from Tribal leaders, Tribal health directors, IHCPs, and others in the Tribal communities to get the message out to Medicaid and CHIP enrollees across Indian Country.
Help people with the renewal process: Partner with your State Medicaid/CHIP agency to help individuals and families complete the renewal form.
Tribal Renewal Resources
- National Indian Health Board (NIHB), in collaboration with the Indian Health Service (IHS), created a Medicaid Toolkit for Tribal Enrollment Assisters.
- The National Council of Urban Indian Health (NCUIH) released a Medicaid toolkit for Urban Indian Organizations (UIOs).
- CMS offers Medicaid and CHIP renewal outreach and informational materials you can use with those in the renewal process.
- A Partner Call To Action outlines steps to help keep beneficiaries covered.
- Medicaid.gov includes an interactive map with links to Medicaid agencies in each state.