Medicaid: Renewal Data

The table below tracks general enrollment trends as well as renewals by Medicaid benefit category and program. It is important to track both metrics to have a complete picture of what is happening in each program. While renewal data provides information on actions taken as part of the Unwinding, enrollment data (“total members” in the table below) provides information on all of the actions taken that affect eligibility. This includes renewals as well as actions unrelated to the Unwinding such as new or returning applications, voluntary disenrollments, and eligibility terminations due to individuals moving out of state or passing away.

Above the table are filters that control what data are displayed.

To filter by Medicaid benefit category:

1. Select the radio button of the benefit category you are interested in.
2. Click “Apply.”
3. A second filter will appear with options for further filtering by programs within that benefit category. Selecting a program from the drop-down menu will filter the data for just that program. If you do not select a program, the table will display aggregate statistics for all programs within the benefit category.
4. To view data in a different benefit category, you must select the radio button next to that benefit category and again click “Apply.”

You can also filter the data further by race, ethnicity, and/or social vulnerability index by selecting the filter that interests you from their respective drop-down menus. Multiple filters can be active at the same time.

This table provides enrollment and renewal statistics by month for Medicaid, BadgerCare Plus, and other state-funded programs and subprograms that provide health care insurance coverage. The "Miscellaneous" category includes a number of targeted Medicaid programs with very low enrollment, such as Wisconsin Well Woman Medicaid or Tuberculosis-Only Medicaid. Programs and subprograms that display "N/A" are those that do not require annual renewals. Find more information about our programs and subprograms. To protect the identity of individuals in the data set, any values of 20 or less are suppressed and replaced with “<21”. In some cases, it’s necessary to also mask the denominator so that it is not possible to calculate a suppressed value.

Children enrolled in BadgerCare Plus are reflected in two areas of the Enrollment and renewals during Unwinding dashboard. First, by filtering using the dropdown for “Children” once one has selected the BadgerCare Plus button. Second, by filtering using the dropdown “Income Extensions.” Children typically comprise two-thirds of the total enrollment in this category.

Total Members

This is the number of enrolled members based on the combination of filter values selected.

Renewals Due

This is the number of members with a renewal due by the end of that month.

Coverage Retained in Different Program

This is the number of members who moved from one Medicaid program to another at the time of their renewal. For example, someone who has turned 19 may shift from BadgerCare Plus Children to BadgerCare Plus childless adult.

Coverage Retained in Same Program

This column shows the number of members who were found eligible at renewal in the same program they were previously enrolled in.

Coverage Ended - Procedural

This is the number of members who were found ineligible at renewal only because they did not take a required action such as not completing their renewal, not submitting information or verification, or not paying a premium (when required).

Coverage Ended - Eligibility

This is the number of members who were found ineligible at renewal because they did not meet eligibility requirements.

Pending Processing

This is the number of members whose renewal has been submitted but the agency is still processing the renewal.

Race and Ethnicity

Race and ethnicity categories are self-identified by members when they enroll. They can help users understand the demographic breakdown of members.

Social Vulnerability Index

The Social Vulnerability Index (SVI) is a tool developed by the Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry that uses U.S. Census data to determine the social vulnerability of a geographic area. An SVI ranking represents the proportion of counties in Wisconsin that are equal to or lower than the county being scored in terms of social vulnerability. For example, an SVI ranking of 0.85 signifies that 85% of counties in the state are less vulnerable than the county being ranked and that 15% of counties in the state are more vulnerable.

Total Members

This metric is a count of the number of individuals enrolled during the month specified. Some individuals may be enrolled in more than one benefit category or program. When filtering by a benefit category and/or program, the table will present an accurate count of the number of members enrolled in that benefit and/or program. When no filter is active, the table will present an accurate, unduplicated count of all enrolled members.

Enrollment data will continue to be updated for three months after it is first posted. This is because an individual may receive up to three months of retroactive coverage if they meet eligibility requirements during that time. For example, January enrollment numbers will first post in February. The January enrollment numbers will update again in March, April, and May to count those individuals who renewed or applied between February and April and received retroactive eligibility to January. When the data are updated in May, the January enrollment data will be final.

The total members count includes people who are:

• Already enrolled in a Medicaid program and who do not have a renewal due.
• Already enrolled in Medicaid and who were found eligible at their renewal.
• New applicants who were found eligible since the last update of this data.

The total members count also reflects disenrollments that occur outside of the renewal process, such as when individuals lose eligibility in a program that is not subject to renewals, voluntarily disenroll, move out of state, or pass away.

Renewals Due

This metric is a count of the number of members with a renewal due in the report month. The report month reflects the month of the members’ original renewal month, regardless of whether the member received a temporary extension of eligibility into the next month. Please note that members enrolled in Supplemental Security Income Medicaid (SSI MA) and members enrolled in Foster Care Medicaid do not have renewals, as their Medicaid coverage is automatically granted as long as they are getting SSI or are in out-of-home placement.

“Renewals due” is the base population from which “coverage retained in different program,” “coverage retained in same program,” “coverage ended – procedural,” “coverage ended – eligibility,” and “pending processing” are drawn.

Coverage Retained in Different Program

This metric is a count of the number of members who were enrolled in one program before their renewal but enrolled into a different program at the time of their renewal. It includes members who submit their renewal on time as well as those who do so within the three-month late renewal period. This number is a subset of the metric “renewals due.” The report month reflects the members’ original renewal month. This metric is retroactively updated until the value of “pending processing” equals zero.

Coverage Retained in Same Program

This metric is a count of the number of members who were found eligible at renewal in the same program they were previously enrolled in. It includes members who submit their renewal on time as well as those who do so within the three-month late renewal period. This number is a subset of the metric “renewals due.” The report month reflects the members’ original renewal month. This metric is retroactively updated until the value of “pending processing” equals zero.

Coverage Ended - Procedural

This metric is a count of the number of members who were found ineligible at renewal only because they did not take a required action such as not completing their renewal, not submitting information or verification, or not paying a premium (when required). This number is a subset of the metric “renewals due.” The report month reflects the members’ original renewal month. This metric is retroactively updated until the value of “pending processing” equals zero.

Coverage Ended - Eligibility

This metric is a count of the number of members who were found ineligible at renewal because they did not meet eligibility requirements. This number is a subset of the metric “renewals due.” The report month reflects the members’ original renewal month. This metric is retroactively updated until the value of “pending processing” equals zero.

Pending Processing

This metric is a count of the number of members whose renewal has been submitted but has not yet been processed. This number is a subset of the metric “renewals due.” This metric is retroactively updated until the value equals zero.

Race and Ethnicity

Members are asked their race and ethnicity at enrollment and when receiving certain services, but they do not have to report it in order to be eligible for Medicaid or to receive services.

Social Vulnerability Index

The social vulnerability index filter groups results by quartile based on members’ residential address. Q1 is the first quartile with SVI rankings up to 25%. Q2 is the second quartile, which includes SVI rankings between 26% and 50%, and so on. Find more information about SVI.

Data Source: InterChange, CARES, CDC/ATSDR

During the COVID-19 pandemic, DHS maintained eligibility for some members outside of CARES, the system used by income maintenance (IM) agencies to determine and manage eligibility for BadgerCare Plus and Medicaid for the Elderly, Blind, and Disabled. DHS established this process at the beginning of the pandemic as a “safety net” to ensure we were maintaining coverage for members who lost eligibility in CARES but needed continuous coverage under the provisions in the Families First Coronavirus Response Act. Due to this systems limitation, such members were asked to reapply rather than renew.

In May 2023, DHS asked 76,743 members to reapply to maintain their benefits. Of those, 7,664 reapplied and were found eligible. However, some members may have regained eligibility through a renewal if they were part of a household in which other members had a renewal date. Because of this dynamic, DHS is still analyzing how many of these members retained their eligibility and how many lost eligibility. DHS will share the results once available.

The four visuals below, “Medicaid Enrollment Trend,” “Percent of County Residents Enrolled in Medicaid,” “Medicaid Enrollment by Race,” and “Medicaid Enrollment by Ethnicity” provide additional data about Medicaid enrollment levels and demographic makeup. All of these visuals except for “Medicaid Enrollment Trend” display data for the most recent month.

Data in these visuals can be filtered by Medicaid benefit category and program. Just like with the table above, to filter by Medicaid benefit category:

1. Select the radio button of the benefit category you are interested in.
2. Click “Apply.” When you select a benefit category a second filter will appear with options for further filtering by programs within that benefit category. Selecting a program from the drop-down menu will filter the data for just that program. If you do not select a program, the table will display aggregate statistics for all programs within the benefit category.
3. To view data in a different benefit category, you must select the radio button next to that benefit category and again click “Apply.”

In addition to the filters, you can search the heat map for a specific county using the “Find County” search bar next to the map.

1. Begin typing the county name and if there is data for that county, based on the active filters, the county name will populate below the search bar.
2. Click on the county name and that county will appear on the map with a grey outline around it.
3. To see the exact number of enrolled members and percent of county residents enrolled in a county, hover the cursor over that county and a text box will appear.

Medicaid Enrollment Trend Chart

This chart shows the monthly count of individuals enrolled in Medicaid, BadgerCare Plus, and other state-funded programs that provide health care insurance coverage. Find more information about our programs and subprograms. This chart includes historical data going back to March 2019 in order to provide one year of data leading up to the public health emergency for context.

Percent of County Residents Enrolled in Medicaid Heat Map

This map displays the percentage of the county population that is enrolled in Medicaid, BadgerCare Plus, and other state-funded programs that provide health care insurance coverage for the most recent month. Hover over a county to see the count of enrolled residents as well as the percent of county residents enrolled. In order to protect the identity of individuals in the data set, any results where the count is less than 21 are suppressed and replaced with "<21" (or "<0.05%" if the result is a percentage).

"Medicaid Enrollment by Race" and "Medicaid Enrollment by Ethnicity" Bar Charts

These charts show the number of individuals enrolled in Medicaid, BadgerCare Plus, and other state-funded programs that provide health care insurance coverage by race and ethnicity categories. In order to protect the identity of individuals in the data set, if results for any category has a value of less than 21, the results will be suppressed.

Race and Ethnicity

Race and ethnicity categories are self-identified by members when they enroll. They can help users understand the demographic breakdown of Medicaid members.

Some individuals may be enrolled in more than one benefit category or program. When filtering by a benefit category and/or program, the visuals will present accurate statistics for the number of members enrolled in that benefit category and/or program. When no filter is active, the visuals will present accurate, unduplicated statistics for all enrolled members.

Medicaid Enrollment Trend Chart

This chart displays a count of the number of individuals enrolled during the month specified.

Enrollment data will continue to be updated for three months after it is first posted. This is because an individual may receive up to three months of retroactive coverage if they meet eligibility requirements during that time. For example, January enrollment numbers will first post in February. The January enrollment numbers will update again in March, April, and May to count those individuals who renewed or applied between February and April and received retroactive eligibility to January. When the data are updated in May, the January enrollment data will be final.

The total members count includes people who are:

• Already enrolled in a Medicaid program and who do not have a renewal due.
• Already enrolled in Medicaid and who were found eligible at their renewal.
• New applicants who were found eligible since the last update of this data.

The total members count also reflects disenrollments that occur outside of the renewal process, such as when individuals lose eligibility in a program that is not subject to renewals, voluntarily disenroll, move out of state, or pass away.

Percent of County Residents Enrolled in Medicaid Heat Map

Members’ residential address is used to map members to the county of residence. The numerator is the number of county residents enrolled in Medicaid. The denominator is the county population. County population data comes from the U.S. Census Bureau’s American Community Survey County Population Totals and Components of Change: 2020-2022.

"Medicaid Enrollment by Race" and "Medicaid Enrollment by Ethnicity" Bar Charts

Members are asked their race and ethnicity at enrollment and when receiving certain services, but they do not have to report it in order to be eligible for Medicaid or to receive services.

Data Source: InterChange, CARES, U.S. Census Bureau