Courtney (left) and Taya Morgan (right), with their son Zayvior at The Family Partnership preschool in north Minneapolis on July 17, 2023. Credit: Aaron Nesheim | Sahan Journal

Medicaid coverage was instrumental for preparing Taya Morgan’s three kids for school.

All three attended The Family Partnership, a preschool in Minneapolis that offers therapy for special needs children in underserved families. And all three received specialized training that they needed to pass entrance exams before starting kindergarten. 

It started when Morgan, 44, noticed that her eldest, Jamar, had trouble speaking, was sensitive to loud noises, and wasn’t meeting developmental milestones as a toddler. He was later diagnosed with autism. Now 14, Jamar has avoided an individualized education plan—the program schools assign special education students—for his entire educational career, something Morgan credits to the specialized training he received in his early childhood care.

The training was paid by Medicaid, the federal insurance program that provides healthcare to low-income people. In Minnesota, Medicaid is called Medical Assistance. 

Any other childcare center would say, “‘Do the therapy on your own,’” Morgan said.

But people like Morgan may soon be in danger of inadvertently losing the healthcare coverage that makes this kind of therapy possible. Starting next month, people enrolled in Medical Assistance and MinnesotaCare, a similar state-run health insurance program, will have to reapply for their coverage for the first time since the start of the pandemic.

The end of continuous enrollment, or automatically enrolling clients back into the programs, is the result of Congress winding down emergency relief measures the federal government enacted during the COVID-19 pandemic. The federal Centers for Medicare & Medicaid Services has authority over both Medical Assistance and MinnesotaCare. 

Approximately 1.5 million Minnesotans will be impacted. People of color will be disproportionately affected; they make up nearly half of the Minnesotans who will have to re-enroll while their numbers make up 20 percent of the state’s total population.

Between 225,000 and 375,000 of those up for renewal will lose their healthcare coverage because of the change, according to estimates from the Minnesota Department of Human Services (DHS). As many as 187,000 of those who do lose their coverage could still be eligible to re-enroll, according to DHS.

The reason for the projected dropoff, said government officials and advocates, is because state government is sending letters in the mail to notify people who are impacted, using addresses from 2019—the last year enrollees had to manually renew their coverage. 

“A lot of our families are very housing unstable—they don’t live in the same place anymore, so they’re not even going to see it [the letter],” said Sandy Klein-Mirviss, the developmental therapies director at The Family Partnership, a preschool in Minneapolis that offers therapy for special needs children in underserved families. 

Morgan will not need to worry about re-enrollment because her youngest child will finish preschool next month and will no longer need Medical Assistance to pay for it. Morgan is insured through her work. But she worries that people in similar situations will lose their insurance by getting lost in the bureaucracy. 

Morgan’s two other kids, Courtney, 13, and Zayvior, 5, exhibited behaviors similar to their brother and also received specialized training from The Family Partnership. In preschool, Zayvior had trouble pronouncing the first part of his name, which is close to an ‘s’ sound. He improved with speech therapy by sliding his right finger down his left arm like a snake and mimicking a snake’s hissing sound. 

“He loved it,” Morgan said. “He liked the challenges.”

Like his older siblings, Zayvior cleared his school entrance screening and is set to start kindergarten this fall.

So what can Medical Assistance and MinnesotaCare enrollees do to ensure they don’t lose their coverage, and what resources are available to them? Sahan Journal breaks it down below.

What is continuous enrollment?

For the entire history of Medical Assistance and MinnesotaCare, people insured under both programs were required to re-enroll every year to ensure they were still eligible for coverage. That changed for the first time ever in 2020, when Congress passed the Families First Coronavirus Response Act. The law suspended the yearly renewal requirement and kept families and individuals enrolled for the time being.

“As the public health emergency began, it became abundantly clear that people were going to need healthcare,” said Julie Marquardt, an assistant commissioner at DHS. 

All 50 states and four U.S. territories opted to use continuous enrollment. The entire process was unprecedented, Marquardt said. 

Why is continuous enrollment now ending?

Congress passed the Consolidated Appropriations Act last December, which ended continuous enrollment. The U.S. government declared in May that COVID-19 was no longer a federal public health emergency.

Minnesota initially planned to have clients using Medical Assistance to begin re-enrolling in the programs on July 1, but moved that to August 1 to avoid interfering with the July 4th holiday. 

Will all 1.5 million people affected have to renew at the same time?

No. People on Medical Assistance will receive renewal forms in the mail in the same month they had enrolled or re-enrolled for coverage in 2019. Those forms began circulating this July. Clients have 45 days to mail the form back to their county government for renewal. 

The state calls each group of monthly renewal people cohorts. The first cohort will combine all July and August renewals and is expected to impact 100,000 people.

People who use MinnesotaCare must re-enroll by December 31 to continue receiving healthcare. They will also get renewal forms in the mail.

What will the renewal form look like in the mail? 

The form, which is for both Medical Assistance and MinnesotaCare, will come in a standard envelope with a big blue circle that reads: “Important information enclosed.” Take a look at an example of what the envelope looks like here: 

Can people access the renewal form in multiple languages? 

The renewal form will be mailed in English, but people can call DHS for multilingual support at 651-297-3862 or 800-657-3672. 

I forgot which month I signed up for Medical Assistance or MinnesotaCare in 2019. How can I find out when I’m up for renewal? 

If you have your case number or member number, you can enter them on this website to look up your renewal date: 

If you do not know your case number or member number, call your county offices for support. A list of all telephone numbers for all Minnesota counties can be found here:

What should I do if my home address has changed since 2019?

People who have moved since 2019 can update their contact information in multiple ways:

Where should I submit my renewal application?

Medical Assistance recipients should submit their renewal forms to their county office. All county addresses can be found here:  

MinnesotaCare recipients should submit their renewal forms to the Minnesota Department of Human Services at 540 Cedar St., St Paul, MN 55101.

I’m worried I won’t receive my renewal form. Who can I contact for help? 

People who are insured under Medical Assistance and who do not know their case number or member number should call their county offices for support. A list of all telephone numbers for all Minnesota counties can be found here:

DHS also advises all people receiving Medical Assistance or MinnesotaCare through a health plan to call the health plan directly. Contact information for all health plans can be found here:

Can I renew my coverage online? 

Yes, but you still must fill out the form you receive in the mail and upload the completed form to the website. Upload the form here:

You can also send the completed form by FAX to the county you live in. All county fax numbers are listed here:

What happens if I miss the renewal deadline? 

Generally, people will receive their forms six weeks before the deadline. If people miss the deadline, they can still submit the forms late. In fact, the state encourages people who miss the deadline to submit their forms anyway.

“We can still renew them even after that deadline, and if they’re on Medical Assistance, it is possible to get them retroactive coverage,” Marquardt said.

Correction: A previous version of this story misspelled Zayvior Morgan’s name.

Joey Peters is a reporter for Sahan Journal. He has been a journalist for 15 years. Before joining Sahan Journal, he worked for close to a decade in New Mexico, where his reporting prompted the resignation...