As states prepare for the end of the federal COVID-19 public health emergency (PHE) and the Medicaid continuous coverage requirement, state Medicaid agencies are actively communicating with residents about upcoming changes, encouraging them to update their contact information, and providing information about other health coverage options.

State officials are aiming to ensure as much coverage continuity as possible when the continuous coverage requirement ends. A main priority is to contact all residents who are at risk of losing Medicaid coverage with the end of the PHE and inform them of actions they may need to take to renew their coverage. In preparation, states are developing and sharing plans for unwinding PHE policies and crafting communication strategies. While states differ to some degree in their approaches, highlighted below are some recurring features of their communication plans.

Educating and Engaging Consumers

With the primary goal of effectively educating and engaging consumers and community partners about the upcoming changes, states are focusing their efforts on messages and actions that matter most. For example:

• Oklahoma’s outreach goals are to educate members, engage potentially affected persons and providers, and establish a feedback loop to share input for planning. Using multiple forms of outreach, Oklahoma is working to reach enrollees with unwinding information, gain feedback, and develop a consistent message with various partners.
• California aims to educate consumers about next steps, engage community partners to reach beneficiaries, and provide a consistent voice across partners. The state provides a communication toolkit and resources for ambassadors to spread this message.

Updating Contact Information Is a Priority

In each state plan, updating enrollees’ contact information is a central strategy for ensuring that state Medicaid agencies have up-to-date information to communicate with individuals regarding their coverage. To convey this priority, states are using simple language in their messaging, which aligns with the Centers for Medicare and Medicaid Services (CMS)’ advice to avoid vague language and provide individuals with clear instructions. CMS also issued a toolkit as a guide for state communication processes that many states have used as a model for developing their messaging. For example:

• Arkansas’s email message to Medicaid clients begins with “Don’t risk losing your Medicaid coverage — Update your contact information” to convey the urgency of the situation and how consumers can avoid losing coverage.
• California’s social media posts include phrases like “Don’t miss out on receiving important information about your Medi-Cal health coverage” to emphasize the importance of individuals taking action to update their contact information with their local county office.

States are also offering enrollees many ways to update their contact information to make the process convenient and accessible.

• In Utah’s letter to Medicaid members, the state gives individuals many options to update their information, including via a website, fax, mail, phone, or in person.
• Arizona offers consumers a number to call, a website to submit updated information, and community assistors to contact.
• Arkansas similarly offers the option to call a hotline, visit a county office, or use an online website. Their email message to clients states, “No matter how you like to communicate with us, we have you covered!”
• Nevada uses QR codes to direct consumers to a website, as well as provides addresses of in-person offices, forms to email, fax, or mail, and a number to call with questions.  

States are leveraging postal service data to identify members with address changes and are directing their resources towards populations most likely to need to update their contact information.

• Wisconsin’s social media messages include “Do you have a new address or phone number? No problem. Let us know.” By starting with a question, states are catching the eyes of consumers who might otherwise miss advertisements.
• One of New Hampshire’s social media posts reads “#Moving? Make sure DHHS has your current address and phone number.” This is followed with multiple ways to update information–in person, online, through the phone, or via mail.

Using Multiple Modes of Communication to Reach All Consumers

Offering many forms of communication allows states to connect with a broader group of consumers and facilitates updating contact information. States recognize the importance of adapting to new technology and media, and are putting out Facebook, Instagram, and Twitter posts. In addition, by using multiple avenues, states can reach individuals with differing levels of digital literacy and internet access.

• Nevada’s consumer outreach includes flyers, rack cards, conference cards, email signature options, social media posts, QR codes, and a NV Medicaid app.
• Illinois offers messaging partners call scripts, emails, text messages, and social media posts.
• New York aims to reach individuals through social media posts, videos, text alerts, articles, emails, and calls.

To supplement social media outreach, states are also using traditional forms of public messaging, such as signs and flyers. CMS suggests posting these messages in social services establishments, community centers, and in health care provider offices.

Also, when sending information via mail, some states such as Hawaii, Maryland, and New Hampshire are using colored paper or envelopes to help alert individuals about the importance of these letters.

Tailoring Communications and Application Assistance to Meet Individuals’ Needs

Multilingual communications and other types of accommodations allow states to reach a wider audience with their messaging about how individuals can maintain coverage.

• Colorado’s communication materials are printed in Spanish and English (including newsletter, flyers, and social media posts), providing easier readability for Spanish-speaking consumers.
• Alabama’s outreach information provides language assistance and interpretation for those who are Deaf or visually impaired, making information accessible for a wider range of individuals.
• Considering its proximity to the Mexican border and the state’s many Spanish-speaking residents, Texas offers flyers, social media graphics, handouts, and FAQs in both English and Spanish.

Some states make explicit note of navigators, assistors, or other resources that can help consumers identify health coverage options. These individuals are trained to navigate Medicaid/CHIP renewal processes and can also help consumers explore their options for coverage in marketplaces if they do not qualify for Medicaid.

• Arizona offers links to community assistor organizations, which assist individuals in renewing their Medicaid or CHIP plans.
• Indiana advertises on its government website that navigators can help Hoosiers find healthcare coverage outside of Medicaid.
• The Alabama Medicaid agency offers training for Medicaid Application Assisters that can help individuals renew or apply for Medicaid coverage. These Application Assisters help recipients develop their online Medicaid application free of charge.

By employing a wide range of communication strategies and making updating contact information convenient and accessible, states are trying to protect individuals who are at-risk of losing coverage. For more information regarding state-specific efforts to unwind the Medicaid continuous coverage requirement, see this earlier NASHP blog.