After months of vague, general assertions about shortcomings in states’ efforts to redetermine the eligibility of their Medicaid participants as part of the post-pandemic continuous Medicaid unwinding process, the federal government is now revealing which states are having problems – and what those problems are.

In public letters to the 50 states, the Centers for Medicare & Medicaid Services cites three major shortcomings in states’ efforts:  paperwork problems, long call center waiting times, and the slow processing of applications.

According to the letters, 36 states are falling short on at least one of these measures and five are failing on all three.  The five worst offenders are Alaska, Florida, Montana, New Mexico, and Rhode Island.

While it has been suggested that Republican-run states are hurrying through the redetermination process and causing problems as a result, Democratic-run states are having significant problems as well.

To date, an estimated four million people have lost their Medicaid coverage.

The Medicaid unwinding process is especially important to community safety-net hospitals, such as those that are part of the Alliance of Safety-Net Hospitals, because those hospitals care for so many more Medicaid and other low-income patients than the typical hospital.

Learn more about the challenges states are facing redetermining the eligibility of their Medicaid enrollees from the Politico article “Biden administration warns states as millions lose Medicaid” and go here to find the letters CMS has sent to the state.