Barriers to Enrollment, Procedural Denials, and Loss of Medicaid Coverage: A Randomized Trial to Identify Effective Outreach Solutions

Each year, millions of Medicaid beneficiaries must redemonstrate their eligibility to avoid losing coverage. Challenges with the required paperwork can result in eligible people losing their benefits for procedural reasons (i.e. because their paperwork was missing or contained errors). In 2023 alone, 9 million people lost Medicaid coverage for procedural reasons. The proposed study will be the first, to our knowledge, to evaluate an intervention aimed at averting and remediating the loss of Medicaid coverage for procedural reasons among eligible individuals. The experimental population includes 425,000 households in Wisconsin who lost Medicaid coverage for procedural reasons. The implementation partner is Covering Wisconsin, Wisconsin’s federally certified Navigator organization. Experimental arms include a group receiving a pre-recorded outbound call, a group receiving a live outbound call from a Navigator, and a no-outreach control group. We hypothesize that outreach from a Navigator will increase Medicaid re-enrollment, and although a pre-recorded call will be the most cost-effective option, a live call will be more effective among underserved or harder-to-reach populations. This research will identify novel outreach methods to help low-income people maintain access to benefits and thus will facilitate the advancement of equity in access to the safety net.