Medicaid roll estimated to shed thousands

LITTLE ROCK — The latest estimate of Medicaid recipients who stand to lose their health coverage today is 26,500, about 6,500 fewer than state officials expected Monday.

The cancellations stem from an annual review of the incomes of private-option enrollees and other Medicaid recipients by the Arkansas Department of Human Services.

Human Services Department spokeswoman Amy Webb said the number of cancellations expected today was based on a July 21 estimate that was given to the insurance companies offering private- option plans, which the Medicaid program purchases on behalf of enrollees.

Since Wednesday, coverage for about 22,000 other Medicaid recipients — primarily private-option enrollees — is expected to end Sept. 1, Webb said.

The annual income checks began in mid-June, about eight months after they were scheduled to start, for Medicaid recipients who had been enrolled for at least a year and whose eligibility is governed by rules that went into effect Jan. 1, 2014, under the 2010 Patient Protection and Affordable Care Act.

By Oct. 1, the department expects to have checked the incomes of about 600,000 recipients, including children covered by ARKids First and about 200,000 low-income adults covered by the private option.

As of Wednesday, the department had begun checking the incomes of 327,405 recipients. Of those, 63,758 were found to be eligible, and 1,467 were found to be ineligible.

Coverage for 46,979 recipients was set to end because they had failed to respond to letters from the Human Services Department requesting more information about their incomes.

Such letters are sent to recipients whose incomes appear to have changed by at least 10 percent since the recipient was first approved for coverage.

The letters give recipients 10 days to provide pay stubs or other records related to their incomes. Those who fail to respond within 15 days are sent notices informing them their coverage will be canceled.

Coverage for those who were sent cancellation letters July 20 or earlier is scheduled to end today, Webb said. The coverage for those who were sent letters after July 20 will end Sept. 1.

Of the 48,446 Medicaid recipients whose coverage was set to end as of Wednesday, 44,279 were enrolled in the private option.

The state created the private option as a primary way of extending Medicaid coverage to adults with incomes of up to 138 percent of the federal poverty level: $16,105 for an individual, for instance, or $32,913 for a family of four.

The first annual income checks for the enrollees was delayed because of difficulties the Human Services Department encountered in replacing its 25- year- old electronic eligibility verification and enrollment system.

Those whose coverage is terminated can appeal the terminations. If the appeal is successful and filed within 90 days of the termination, the coverage can be reinstated retroactively to when it was canceled.

In the case of a private-option enrollee, the fee- for- service Medicaid program would cover medical expenses after the initial termination of coverage, Webb has said.

Max Greenwood , a spokesman for Arkansas Blue Cross and Blue Shield, said her company asked insurance agents who sell the companies’ policies to contact their customers and encourage them to respond to the Human Service Department’s notices.

The company also encouraged pharmacists to “communicate with their customers about the importance of responding promptly” to the notices, and it sent a notice giving doctors and other health care providers information about the annual income checks, Greenwood said.

She said the 10- day deadline for submitting information to the department “seems a bit rushed, but that’s a policy decision for policymakers to make.”

The company hasn’ t asked the department to extend the deadline, she said.

Matthew Glass, chief executive of a West Memphis insurance agency, said his firm helped more than 1,000 people enroll in the private option, but it had heard from about only 15 customers as of Wednesday who received letters from the Human Services Department.

One customer received a termination notice even though she said she had no income and had submitted the requested information, he said. He said he helped her resubmit the information.

Enroll the Ridge, a Jonesboro- based nonprofit organization that has received federal grant money to sign up people for coverage, has helped about 30 to 40 people submit the requested information to the Human Services Department in the past week, said Leonard Stern, an outreach worker with Wrightsville- based Future Builders, which works with Enroll the Ridge.

But Stern said he suspects many enrollees have changed addresses since they enrolled and didn’t receive the letters from the department.

“It will probably come up when a lot of people get sick and go to the hospital” and discover they don’t have coverage, he said.

Coverage for 46,979 recipients was set to end because they had failed to respond to letters from the Human Services Department requesting more information about their incomes.