More than a million people have been excluded from Medicaid in recent months as some states took swift action to end health insurance after the end of the coronavirus pandemic.
Most were fired for not completing the paperwork.
Although the eligibility check is required by the federal government, President Joe Biden’s administration is not too pleased how efficiently some other states are doing the job.
“Forcing and rushing things will result in beneficiaries — children and families — losing coverage for some time,” Daniel Tsai, a senior Medicaid federal official, recently told reporters.
According to publicly available reports and data from The Associated Press, about 1.5 million people have already been disqualified from Medicaid in more than two dozen states that began the process in April or May.
Florida has lost several hundred thousand people, by far the most of any state. The drop rate was also particularly high in other states. Of those whose cases were decided in May, about half or more were dropped in Arkansas, Idaho, Kansas, Nevada, New Hampshire, Oklahoma, South Dakota, Utah and West Virginia.
According to Arkansas, more than 140,000 people have been excluded from Medicaid.
The eligibility reassessment puzzled 28-year-old Jennifer Mojica, who was told in April that she was no longer eligible for Medicaid because Arkansas incorrectly determined that her income was over the limit.
She got that sorted, but was then told her five-year-old son would be barred from Medicaid because she asked for his termination — which she said never happened. Her son’s insurance has been restored, but now Mojica says she was told her husband was no longer eligible. The uncertainty was frustrating, she said.
“It was like fixing one thing and then another problem came up and they fixed it and then something else came up,” Mojica said.
Arkansas officials said they were trying to automatically renew coverage for as many people as possible and were making a special effort to reach families with children. However, a 2021 state law requires post-pandemic eligibility redeterminations to be completed within six months, and the state will continue to “expeditiously deregister individuals who are no longer eligible,” the agency said in a statement Department of Social Services.
Arkansas Gov. Sarah Huckabee Sanders has dismissed criticism of the state’s process.
“Those who are not eligible for Medicaid are taking resources away from those who need them,” Sanders said on Twitter last month. “But the pandemic is over – and we are pointing the way back to normal.”
More than 93 million people Across the country, according to the latest available data, Medicaid members were enrolled in February — nearly a third more than in January 2020 before the pandemic increased funding to states.
Now that Eligibility checks have resumed, States have begun working through a backlog of cases to determine whether people’s income or circumstances have changed. States have one year to complete the process. However, it has proved difficult to find out everyone’s responses, as some people have moved, changed their contact information, or ignored mailings about the renewal process.
The Florida Department of Children and Families said it makes between five and 13 attempts at contact before barring people from Medicaid, including text messages, emails, and phone calls. Still, the department said 152,600 people didn’t respond.
Your coverage could be reinstated retrospectively if people submit information about their eligibility up to 90 days after the deadline.
Unlike some states, Idaho continued to review people’s Medicaid eligibility during the pandemic, even if it left no one disfellowshipped. When the enrollment freeze ended in April, Idaho began processing those cases — dropping nearly 67,000 of the 92,000 people whose cases have been decided so far.
“I think there’s still a lot of confusion among families about what’s happening,” said Hillarie Hagen, health policy officer at the nonprofit Idaho Voices for Children.
She added, “We’re likely to see people in the coming months show up at a doctor’s office not knowing they’ve lost Medicaid.”
Advocates worry that since Medicaid covers children whose incomes are higher than their parents’ or guardians’, many households that lose coverage could also include children who are still eligible. A report from last year The US Department of Health and Human Services predicted that children would be disproportionately affected and more than half of those who signed out would actually still be eligible.
However, this is difficult to confirm because the federal Centers for Medicare and Medicaid Services do not require states to report a demographic breakdown of those dropped. In fact, CMS hasn’t released data on each state yet. The AP received data directly from states and from other groups that collected it.
Medicaid recipients in numerous states have described the eligibility redetermination process as frustrating.
Julie Talamo, of Port Richey, Fla., said she called state officials every day for weeks and spent hours on hold trying to ensure her 19-year-old special-needs son Thomas would continue to receive Medicaid.
She knew her own insurance coverage would end, but was shocked to learn that Thomas’s coverage would be reduced to another program that could force her family to pay $2,000 a month. Eventually, an activist put Talamo in touch with a senior state health official, who confirmed that her son would continue to receive Medicaid.
“This system was designed to let people down,” Talamo said of the random process.
Some states have not been able to complete all monthly eligibility determinations. Pennsylvania reported more than 100,000 incomplete cases in both April and May. Tens of thousands of cases also remained incomplete in April or May in Arizona, Arkansas, Indiana, Iowa, New Mexico and Ohio.
“If states are already behind in processing renewals, that will only get worse over time,” said Tricia Brooks, research professor at the Georgetown University Center for Children and Families. “Once they start getting piles of stuff that hasn’t been worked on, I’ll… I can’t imagine how easily they can catch up.”
Among those still in limbo is 67-year-old Gary Rush, who said he was informed in April he was losing Medicaid insurance. The Pittsburgh resident said he was told he wasn’t eligible based on his retirement accounts, although he said he didn’t receive any of it. Rush appealed through an advocacy group, and at a hearing last week he was told he had until July to dump about $60,000 in life savings.
Still, Rush said he doesn’t know what he’ll do if he loses coverage for his diabetes medication, which costs about $700 a month. Rush said he gets $1,100 a month from Social Security.
In Indiana, 35-year-old Samantha Richards said she’s been on Medicaid her entire life and currently works two part-time jobs as an administrator. Richards recalled receiving a letter earlier in the year advising that pandemic-era Medicaid protections were ending. She said a local advocacy group helped her manage the renewal process. But she remains restless.
“Medicaid can be a little unpredictable,” Richards said. “There’s still a concern that out of nowhere I’ll either get a letter saying we have to reapply because we missed some paperwork, or that I missed a deadline, or that I’m at the doctor’s office or show up at the doctor’s office. I’ll go to the pharmacy and they’ll say, ‘Your insurance didn’t make it through.’”
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Lieb reported from Jefferson City, Missouri and DeMillo from Little Rock, Arkansas. Also involved were AP reporters Anthony Izaguirre of Tallahassee, Fla.; Marc Levy of Harrisburg, Pennsylvania; and Arleigh Rodgers of Bloomington, Indiana. Rodgers is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to cover undercover topics.
Copyright 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, transcribed, or redistributed without permission.
