Tag: Medicaid

Biden to open up Medicaid, Obamacare plans to DACA recipients

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HHS Secretary Xavier Becerra said in a statement that the proposed rule would “improve health outcomes for DACA recipients and would in turn improve the economic and productive capacity of America.” He estimated that roughly a third of immigrants enrolled in the DACA program are uninsured.
The details: The proposed rule submitted by CMS amends the definition of “lawful presence” to include DACA recipients, also known as “Dreamers,” for eligibility for Medicaid and marketplace coverage. Medicaid and exchange applications will have their eligibility verified electronically when they apply for coverage, the administration said.
While finalization of new rules usually takes some time, the Biden administration expects to have the new policy in place by the end of the month.
Context: President Barack Obama created the DACA program in 2012, shielding immigrants brought to the U.S. as children from deportation and allowing them to work legally in the United States. But DACA recipients have continued to lack access to key federal programs and benefits, such as health care coverage, because they lack permanent legal status.
Biden has focused on using his executive powers to protect and extend benefits to DACA recipients. And the president said on Thursday that he will continue to press Congress to create a path to citizenship for DACA recipients.
The moves represent a sea change from the approach taken by the Trump administration, which attempted to dismantle the DACA program.
State perspective: Several states, including California, New York and Minnesota, already cover DACA recipients through Medicaid. However, they have been unable to receive federal matching dollars for the coverage and have had to pull from their own state coffers.
Other states have taken creative approaches to expand health insurance access for immigrants, such as Colorado’s new OmniSalud program, which allows people to purchase health insurance through the state marketplace without disclosing their immigration status and potentially receive state subsidies to help with premium costs.

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( With inputs from : www.politico.com )

April 14, 2023
Sex ed, birth control, Medicaid: Republicans’ ‘new pro-life agenda’

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In Iowa, Republican Gov. Kim Reynolds is pushing legislation to allow pharmacists to dispense hormonal contraceptives without a prescription. Indiana and Oklahoma are advancing similar GOP-sponsored bills.
In Indiana and South Carolina, Republican lawmakers proposed lawmakers proposed bills that would require comprehensive, medically accurate sex ed to be taught in the states’ schools starting in grade 5 or 6 — instead of their current abstinence-based approach.
And in Wyoming and Mississippi — two of the 10 states that have not expanded Medicaid — Republican Govs. Mark Gordon and Tate Reeves recently signed 12-month extensions of Medicaid postpartum benefits into law, in what Reeves referred to as a “philosophically uncomfortable” move that overcame fierce conservative opposition to boosting government welfare.
“What I can tell you is that the governor was more vocal in his support for [postpartum extension] and was much more outwardly supportive of this idea in the wake of the Dobbs decision,” said Gordon spokesperson Michael Pearlman. “He is a pro-life governor and supports life, but Governor Gordon wanted to emphasize that being pro-life, to him, goes beyond simply being pro-birth.”
Some GOP-controlled states embraced these policies before the fall of Roe v. Wade last summer, and Republicans argue there isn’t anything inherently liberal about them.
“The most important thing for people to realize is we need to be pro-life and not just pro-birth. That means investing in our families. That means taking a more meaningful approach to policy and forget about the politics. Let that go out the window and let’s actually do things that help people have successful families,” said Oklahoma state Sen. Jessica Garvin, a Republican who sponsored two birth control bills this year that passed the state Senate last week. “If we’re going to say we can’t have abortion for women in Oklahoma, what are we going to do to help support these women that can’t have an abortion?”
Some Democrats chafe at Republicans for taking credit for proposals they have long supported, particularly those aimed at underserved communities.
“This has been a long time effort specifically led by Black women in the legislature,” said Florida Democratic Rep. Anna Eskamani. “Republicans are trying to give off the impression that they’re championing issues for women and families while they strip away our bodily autonomy and rights.”

And while some maternal health advocates welcome the growing number of conservatives backing these policies, they also argue that these broader maternal and reproductive health policies can’t undo the harm being caused by the lack of abortion access in these states.
“In my career — I’m in my mid-40s — I can probably count on one hand Republicans that have been out in front on access to contraception,” said Jamila Taylor, president and CEO of the National WIC Association and a longtime women’s health advocate. “So yes, we are pleased with some of the progress that we’re seeing even in red states, but that’s never going to replace the need or, quite frankly, our fight to ensure abortion rights in this country.”
‘A good thing’
Anti-abortion groups said they are happy to see lawmakers introduce legislation focused on helping families and have endorsed some of these policies, such as postpartum Medicaid extension, alongside the usual types of bills that accompany abortion bans, such as funding for crisis pregnancy centers.
“This kind of legislation that protects pregnant women and new moms, this is one of our key focuses of 2023, and it’s been awesome to see momentum in a lot of pro-life states this year,” said Kelsey Pritchard, director of state public affairs for Susan B. Anthony Pro-Life America. “We’ve been really happy to see states step up the plate and say, ‘Yeah, we need to do more to help pregnant women and to help our new moms in the state.’”
Several female Republican lawmakers told POLITICO that while they’ve long understood the need to increase access to contraception, Roe’s fall provided an opening for them to talk with their male colleagues about the importance of such policies.
“It’s not necessarily that they’ve been against it. They didn’t know they needed to be for it because they didn’t know it was a problem,” said Garvin, the Republican state senator from Oklahoma.
Garvin’s two birth control bills — one that allows pharmacists to dispense hormonal contraceptives without a prescription and another that makes clear the state’s abortion law does not restrict access to contraceptive drugs — cleared the GOP-supermajority state Senate with significant support.
“I think the overturn of Roe v. Wade has forced the issue to become more of a dinner table conversation, and people are more open about sex and family planning, and I think those are becoming more of conversation pieces within families, and it’s a good thing,” Garvin said.
In Iowa, lawmakers are taking another shot at expanding access to birth control, something the governor has wanted to do since 2019. While Reynolds’ bill to allow pharmacists to prescribe hormonal contraception cleared the Senate that year, it did not receive a vote in the House that year.
“There’s some very, very far right conservatives that just really didn’t believe in birth control, period,” said Iowa state Sen. Chris Cournoyer, a Republican. Since then, “we’ve had more conversations about why it’s important and why it factors in not just for maternal health but also for women’s health in general. I mean, there’s a lot of non-contraceptive reasons why you would get on birth control.”
A similar bill in Indiana also received enthusiastic support when it passed the House in late February.
“Allowing pharmacists to prescribe hormonal contraceptives is a simple, yet critical step to providing care to more Hoosier women, especially those who don’t have a primary care doctor, or can’t afford transportation to a different city or county,” said Indiana Republican state Rep. Elizabeth Rowray.
In two conservative states that have not passed Medicaid expansion, abortion helped Republicans who remain highly skeptical of anything that even vaguely resembles such a policy to pass legislation this year extending postpartum benefits from 60 days to a year after birth.
In Mississippi, Reeves, who is up for reelection this year, announced his support for the policy in February after months of opposition, calling it a part of the “new pro-life agenda” and saying that Republicans may have to do things that make them “philosophically uncomfortable” in the post-Roe era.
In Wyoming, legislation extending postpartum benefits passed by slim margins in the House and Senate — and legislative leaders in both houses attempted to kill the bill at multiple points during the session. Both GOP lawmakers supportive of the bill and the governor’s office pitched the proposal during hearings and debate on the bill as “pro-life.”
Exceptions to the rule
Not all of these proposals have reached a critical mass of Republican support. The two comprehensive sex ed bills introduced this year in Indiana and South Carolina — two states that have an abstinence-focused sex ed curriculum — have not received hearings.
But South Carolina Republican state Sen. Tom Davis said he is not giving up. He plans to bring his sex ed legislation forward as an amendment to another education-related bill.
“If we want to reduce unwanted pregnancies and, by that, reduce the number of abortions, we need to do a better job of providing factually correct scientific information that’s age appropriate,” he said.
And some Republicans are trying to separate maternal health from abortion. In Florida, for instance, the Department of Health requested more than $12.6 million in its budget this year for the Closing the Gap program, which became the centerpiece of a plan to expand telehealth postpartum services to people of color. The proposal received unanimous support from state lawmakers in 2021, and the department is now asking for a boost to its current $5.4 million budget to expand the pilot program.
But Joseph Ladapo, who oversees the state Department of Health, has emphasized that the increased postpartum funding predates the efforts pushed by Florida Republicans to tighten abortion controls. State lawmakers approved a ban on abortions after 15 weeks of pregnancy last year, and they are now poised to pass a six-week ban by the end of this year’s legislative session in May.
“For the last two decades, they’ve been taking it more seriously and the Department of Health has been involved in that area for years,” Ladapo said.
Maternal health advocates said they struggle with the fact that these advances come hand-in-hand with anti-abortion laws, which they believe threaten to worsen existing maternal health disparities.
“We’re glad that more states are starting to pay attention, but in light of the maternal health crisis, the point really is that Rome is burning, and states are not centering the full range of reproductive health needs,” said Ben Anderson, director of maternal and child health initiatives at Families USA, a consumer advocacy group.
But advocates also welcome the growing bipartisanship on these issues.
“What I do see as a pattern is reasonable conversations about some of these safety-net programs that should have long been part of the overarching public health dossier of programs, Medicaid expansion being one of them,” said Terrance Moore, CEO of the Association of Maternal and Child Health Programs. “I don’t want to go on a limb and say folks are all going in the right direction, but there’s been real education, deep education.”
Arek Sarkissian contributed to this report.

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( With inputs from : www.politico.com )

March 30, 2023
Democrats draw ‘red line’ around Medicaid as GOP mulls cuts

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“No one’s interested in doing anything other than saving it to make it more solvent for those that might need it down the road,” Sen. Mike Braun (R-Ind.) told POLITICO. “If you want to save [Medicaid] for future generations, it’s never too early to look at how to do that.”
Biden, who is expected to release his budget on Thursday, has spent much of the year castigating Republicans for proposals to cut Medicare, Social Security, Medicaid and the Affordable Care Act part of a broader effort to paint the GOP as a threat to popular health programs. Though Democrats, who control the Senate, will almost certainly reject big cuts to Medicaid, Republicans’ desire to rein in federal spending portends a drawn out political fight over a program that now insures more than one-in-four Americans.
Republican House and Senate leadership have been adamant that they will not cut those two entitlement programs, but have said less about Medicaid, which insures more than 90 million Americans. That number swelled during the Covid-19 pandemic, when states were barred from removing people who were no longer eligible.
Asked if assurances by GOP leaders that Medicare and Social Security are off the table have put more pressure on lawmakers to find savings in Medicaid, Rep. Michael Burgess (R-Texas) quipped: “It doesn’t take much imagination to figure that out.”
Some Republicans want to revive a 2017 plan to phase out the enhanced federal match for Medicaid and cap spending for the program — an approach the Congressional Budget Office estimated would save $880 billion over 10 years and increase the number of uninsured people by 21 million.
“If you remember back to the American Health Care Act, we proposed that we make some significant changes to Medicaid. I think you’re gonna find that some of those same ideas are going to be revisited,” said Rep. Buddy Carter (R-Ga.), a member of the House Budget Committee and the conservative Republican Study Committee, a group now working on its own budget proposal to pitch to GOP leadership.
Carter added that there is also interest in the caucus in abolishing Obamacare’s Medicaid expansion, arguing that the majority of states that have opted to expand the program over the last decade might have “buyer’s remorse.”
“Medicaid was always intended for the aged, blind and disabled — for the least in our society, who need help the most,” he said. “Trying to get back to that would probably be beneficial.”

Carter and many other Republicans are also pushing for Medicaid work requirements, though the one state that implemented them saw thousands of people who should have qualified lose coverage.
“For the people who are on traditional Medicaid — the pregnant, children and disabled — there’s no sense in talking about work requirements,” Burgess said. “But for the expansion population, able-bodied adults who were wrapped in under the Affordable Care Act, yeah, that has to be part of the discussion.”
Other Republicans want to make narrower reforms. Rep. Brett Guthrie (R-Ky.), who chairs the Energy and Commerce Committee’s Health Subcommittee, is looking at changes to value-based payments in Medicaid so that states aren’t “on the hook for treatments that don’t work.” Still others are weighing potential changes to areas within Medicaid, including provider taxes and how to handle coverage for people who are eligible for both Medicare and Medicaid.
The GOP members are spurred on by outside conservative groups like the Paragon Institute, which has been holding monthly briefings for Capitol Hill aides and backchanneling with members.
“If you look at what’s driving the debt, it’s federal health programs,” Brian Blase, the president of Paragon, who worked at the White House’s National Economic Council under the Trump administration, told POLITICO. “Either Congress will reform federal health programs or there will be a massive tax increase on the middle class.”
Democrats, for their part, are working to make any proposal to cut Medicaid as politically risky for Republicans as threats to Medicare.
“I worry that my Republican colleagues have, I guess, heard from the public about their desire to cut Social Security and Medicare [and] are looking elsewhere, and obviously poor people have very little representation in Congress, so that’s an easy target,” said Sen. Bernie Sanders (I-Vt.), who chairs the Health, Education, Labor and Pensions committee.
Democrats hoping to shield Medicaid in the upcoming budget negotiations are emphasizing how many red states have voted to expand the program since Republicans last took a run at it in 2017. They’re also stressing that the people covered by Medicaid aren’t solely low-income parents and children.
“Right now at least 50 percent of Medicaid goes to seniors, and a lot of that is for nursing home care,” Rep. Frank Pallone (D-N.J.), the top Democrat on the Energy and Commerce Committee, told reporters. “People don’t realize that Medicaid is the ultimate payer for nursing home care once you run out of money or once your Medicare runs out.”
In a speech in late February, President Joe Biden excoriated Republicans for pushing deep cuts to Medicaid, arguing that doing so would threaten the finances of rural hospitals that are barely able to keep their doors open today.
“Many places throughout the Midwest, you have to drive 30, 40 miles to get to a hospital. By that time, you’re dead,” he said. “Entire communities depend on these hospitals. Not getting Medicaid would shut many of them down.”
Two people familiar with White House plans tell POLITICO that Biden is expected to include a federal expansion of Medicaid in the remaining holdout states in the budget he will submit to Congress later this week.
Adam Cancryn contributed to this report.
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( With inputs from : www.politico.com )

March 9, 2023
Democrats draw ‘red line’ around Medicaid as GOP mulls cuts

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“No one’s interested in doing anything other than saving it to make it more solvent for those that might need it down the road,” Sen. Mike Braun (R-Ind.) told POLITICO. “If you want to save [Medicaid] for future generations, it’s never too early to look at how to do that.”
Biden, who is expected to release his budget on Thursday, has spent much of the year castigating Republicans for proposals to cut Medicare, Social Security, Medicaid and the Affordable Care Act part of a broader effort to paint the GOP as a threat to popular health programs. Though Democrats, who control the Senate, will almost certainly reject big cuts to Medicaid, Republicans’ desire to rein in federal spending portends a drawn out political fight over a program that now insures more than one-in-four Americans.
Republican House and Senate leadership have been adamant that they will not cut those two entitlement programs, but have said less about Medicaid, which insures more than 90 million Americans. That number swelled during the Covid-19 pandemic, when states were barred from removing people who were no longer eligible.
Asked if assurances by GOP leaders that Medicare and Social Security are off the table have put more pressure on lawmakers to find savings in Medicaid, Rep. Michael Burgess (R-Texas) quipped: “It doesn’t take much imagination to figure that out.”
Some Republicans want to revive a 2017 plan to phase out the enhanced federal match for Medicaid and cap spending for the program — an approach the Congressional Budget Office estimated would save $880 billion over 10 years and increase the number of uninsured people by 21 million.
“If you remember back to the American Health Care Act, we proposed that we make some significant changes to Medicaid. I think you’re gonna find that some of those same ideas are going to be revisited,” said Rep. Buddy Carter (R-Ga.), a member of the House Budget Committee and the conservative Republican Study Committee, a group now working on its own budget proposal to pitch to GOP leadership.
Carter added that there is also interest in the caucus in abolishing Obamacare’s Medicaid expansion, arguing that the majority of states that have opted to expand the program over the last decade might have “buyer’s remorse.”
“Medicaid was always intended for the aged, blind and disabled — for the least in our society, who need help the most,” he said. “Trying to get back to that would probably be beneficial.”

Carter and many other Republicans are also pushing for Medicaid work requirements, though the one state that implemented them saw thousands of people who should have qualified lose coverage.
“For the people who are on traditional Medicaid — the pregnant, children and disabled — there’s no sense in talking about work requirements,” Burgess said. “But for the expansion population, able-bodied adults who were wrapped in under the Affordable Care Act, yeah, that has to be part of the discussion.”
Other Republicans want to make narrower reforms. Rep. Brett Guthrie (R-Ky.), who chairs the Energy and Commerce Committee’s Health Subcommittee, is looking at changes to value-based payments in Medicaid so that states aren’t “on the hook for treatments that don’t work.” Still others are weighing potential changes to areas within Medicaid, including provider taxes and how to handle coverage for people who are eligible for both Medicare and Medicaid.
The GOP members are spurred on by outside conservative groups like the Paragon Institute, which has been holding monthly briefings for Capitol Hill aides and backchanneling with members.
“If you look at what’s driving the debt, it’s federal health programs,” Brian Blase, the president of Paragon, who worked at the White House’s National Economic Council under the Trump administration, told POLITICO. “Either Congress will reform federal health programs or there will be a massive tax increase on the middle class.”
Democrats, for their part, are working to make any proposal to cut Medicaid as politically risky for Republicans as threats to Medicare.
“I worry that my Republican colleagues have, I guess, heard from the public about their desire to cut Social Security and Medicare [and] are looking elsewhere, and obviously poor people have very little representation in Congress, so that’s an easy target,” said Sen. Bernie Sanders (I-Vt.), who chairs the Health, Education, Labor and Pensions committee.
Democrats hoping to shield Medicaid in the upcoming budget negotiations are emphasizing how many red states have voted to expand the program since Republicans last took a run at it in 2017. They’re also stressing that the people covered by Medicaid aren’t solely low-income parents and children.
“Right now at least 50 percent of Medicaid goes to seniors, and a lot of that is for nursing home care,” Rep. Frank Pallone (D-N.J.), the top Democrat on the Energy and Commerce Committee, told reporters. “People don’t realize that Medicaid is the ultimate payer for nursing home care once you run out of money or once your Medicare runs out.”
In a speech in late February, President Joe Biden excoriated Republicans for pushing deep cuts to Medicaid, arguing that doing so would threaten the finances of rural hospitals that are barely able to keep their doors open today.
“Many places throughout the Midwest, you have to drive 30, 40 miles to get to a hospital. By that time, you’re dead,” he said. “Entire communities depend on these hospitals. Not getting Medicaid would shut many of them down.”
Two people familiar with White House plans tell POLITICO that Biden is expected to include a federal expansion of Medicaid in the remaining holdout states in the budget he will submit to Congress later this week.
Adam Cancryn contributed to this report.
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( With inputs from : www.politico.com )

March 9, 2023
Why one state’s plan to unwind a Covid-era Medicaid rule is raising red flags

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The high-speed effort in Arkansas, where more than a third of the state’s 3 million people are on Medicaid, offers an early glimpse at the potential disruption in store for the country as states comb through their Medicaid rolls for the first time in three years. These verifications, once routine, were suspended during the pandemic, and their resumption nationwide could lead to as many as 15 million people, including 5.3 million children, losing their health insurance.
While some states are taking pains to create a safety net to keep people insured, whether under Medicaid or a different health plan, other state Medicaid agencies are facing pressure from GOP governors and legislatures to work through the process as quickly as possible.
“It’s not surprising to me that we have a state like Arkansas — and now we’re beginning to hear from other states as well — where the pressure to move fast is going to be overwhelming,” said Sara Rosenbaum, professor of health law and policy at the Milken Institute School of Public Health at George Washington University. “The net result of all of this is that I expect — and look, the [federal] government expects — a lot of people to fall through the cracks. I think the government has seriously underestimated just how many people are going to fall through the cracks.”
Sanders, who also earlier this month introduced a new Medicaid work requirement, is focused “on implementing bold policies that move people from government dependency to a lifetime of prosperity,” a spokesperson said.
Arkansas’ truncated timeline — the shortest announced by any state — coupled with the fact that thousands lost Medicaid when the state briefly implemented a work requirement in 2018, has many fearing that tens of thousands of low-income Arkansans who are still eligible for Medicaid will lose access to their doctors and medications because they fail to fill out the requisite paperwork.
“This is so much bigger than the work requirements, so it could be much more devastating. Work requirements were … just a few thousand people. This is everybody,” said Loretta Alexander, health policy director of Arkansas Advocates for Children and Families. “You just know that there’s going to be some people that fall through the cracks.”
But Gavin Lesnick, a spokesperson for the Arkansas Department of Human Services, said the state has learned lessons from its past and is “confident” its plan will “properly protect benefits for eligible Medicaid recipients.”
“The Arkansas Department of Human Services has worked to develop a comprehensive unwinding plan that both protects taxpayer dollars and ensures that recipients who remain eligible for and need Medicaid benefits keep their coverage,” he said. “Our primary goal is to make sure Medicaid resources are being properly utilized.”

During the pandemic, enrollment in Medicaid and the Children’s Health Insurance Program swelled by more than 25 percent, surpassing 90 million, as a result of a congressionally created requirement that states keep people continuously covered in exchange for extra federal funding.
Unwinding that program represents one of the biggest reshufflings of the health care landscape since Obamacare began nearly a decade ago. And while Arkansas is moving the fastest to complete its unwinding work, GOP lawmakers in other states, such as Arizona, are eyeing whether there is anything they can do to expedite their work as well.
Still, national health care experts are warily eyeing Arkansas, in part, because of its history with work requirements, which many view as a cautionary tale of how Medicaid recipients can be tripped up by bureaucratic paperwork and lose coverage.
More than 18,000 low-income adults were thrown off Medicaid in 2018 for failing to show that they worked or participated in another job-related activity for at least 80 hours in a month. Many complained that a confusing system made it difficult to comply with the rules, and a 2019 study found that a lack of awareness and confusion about the new rule led to a wave of terminations, despite the fact that 95 percent of an estimated 140,000 affected people should have remained covered.
Similarly, a recent survey from the Urban Institute, funded by the Robert Wood Johnson Foundation, found that 64 percent of adults in Medicaid-enrolled families had heard nothing about the return to the regular renewal process.
“I don’t think [the state] set out to strip people of coverage they were entitled to receive back in 2018,” Rosenbaum said. “But if the process is subjected to very intense expectations about speed, a lot of the errors that we saw in the work requirements experiment — where people were not contacted or they couldn’t understand the contact and the information was incorrect or incomplete — we’re going to see it all over again.”
GOP lawmakers — who passed a bill creating the six-month timeline for completing redeterminations in 2021 — believe the state will be able to both complete its work in a timely fashion and prevent eligible people from accidentally losing coverage. They argue that moving through the process as quickly as possible will free Medicaid resources for the state’s most vulnerable.
“We want to take care of our Arkansans that really need help, but we also understand that we live in a budget neutral state and we have to have a balanced budget, so we have to be smart about our finances,” said Republican state Sen. Missy Irvin, chair of the state Senate Public Health, Welfare and Labor Committee. “We want to secure these programs so that they’re sustainable for the people that really really need them.”
Because Arkansas continued to conduct renewals and redeterminations during the pandemic — despite not being able to remove anyone from state rolls — it has identified more than 420,000 people who appear to be ineligible for Medicaid and need to go through the renewal process by the end of September to determine whether they qualify. An additional 240,000 people will go through the regular renewal process over the course of the year.
Organizations who work with Medicaid recipients say the state’s interim work — coupled with the fact the state started sending renewal letters to beneficiaries earlier this month, essentially giving itself a two month head start — is likely to make the process of conducting renewals an easier, though still daunting, task. It also means that the state is planning to meet CMS’s recommendation that states process no more than one-ninth of their caseload each month in all but two months of the renewal process.
“CMS has long communicated that states may have a large volume of pending redeterminations. That is why the agency has stressed that states and territories will need a reasonable period of time to complete this work effectively, efficiently, and according to the letter of the law,” a CMS spokesperson said.
Still, Arkansas hospitals — aware of the state’s past challenges — are fretting about potential coverage losses.
“Most of the hospital administrators out there remember what it was like before — the huge numbers of people who had no coverage. We were having to care for and take those losses,” Melanie Thomasson, vice president of financial policy and data analytics at the Arkansas Hospital Association. “Right now, taking those losses would be devastating.”
Groups such as Arkansas Advocates for Children and Families laud some of the steps Arkansas’ Medicaid agency has taken to smooth the unwinding process, such as improving communication between the state’s SNAP and Medicaid eligibility systems, translating documents for the state’s Marshallese community, and reaching out to organizations with whom they have previously had an adversarial relationship, such as Legal Aid, which has sued the state Medicaid agency at least five times in the last seven years.
The state has also brought on an additional 350 contract caseworkers to handle the increased work, made plans to hand-deliver renewal packets to its most vulnerable Medicaid recipients, and opened a telephone hotline so people can verify and update their contact information.
Arkansas Medicaid advocates also note that, unlike in 2018, redetermination is happening on a national scale under an administration that has put guardrails in place for the unwinding process and is acutely concerned about Medicaid recipients erroneously losing coverage. And they note that the state has had years, not months, to prepare.
“I think they’ve learned from past experiences. Even before the work requirements were over, you could see that they were starting to actually recognize the mistakes that had been made and trying to figure out how to get past the initial fumbling that they had done when they introduced it,” Alexander said. “They recognize what’s going on and how important this is and how many things can go wrong if they don’t get it right.”
Still, organizations on the ground say it’s not a matter of if but how many people who are still eligible for Medicaid lose their coverage, raising concerns about whether the state will have enough staff to conduct the renewals and is spending enough money on outreach to make sure people are on the lookout for their renewal letters and know they need to respond.
Arkansas’ renewal form asks for a litany of details, including proof of income and a full list of people’s financial resources, such as checking and savings accounts, property and cash on hand, vehicles owned, medical costs, costs to take care of others, a full list of household members, whether a child with an absent parent resides in their household and the absent parent’s Social Security number. Failing to answer the questions correctly could mean losing Medicaid coverage.
And observers of the Medicaid unwinding process also remain worried about the state’s ability to connect people who are no longer eligible for Medicaid coverage onto low- or no-cost plans on the federal health insurance exchange.
“We will have some individuals that are inappropriately disenrolled, but we’ll have many more individuals who will be appropriately disenrolled but may not find their way forward into a subsidized plan on the health insurance marketplace,” said Joe Thompson, president and CEO of the Arkansas Center for Health Improvement. “I think a great deal of focus has been on redetermining Medicaid eligibility. We have not made similar investments in terms of navigating people to health insurance exchange plans.”
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( With inputs from : www.politico.com )

February 27, 2023