COVID no-cut Medicaid policy comes to end

The official end of the COVID public health emergency means hundreds of thousands of Arkansans probably will no longer be covered by Medicaid. However, many can rejoin the program. On Monday, the Arkansas Department of Human Services announced it had disenrolled 44,667 Medicaid beneficiaries who no longer qualify for Medicaid, but whose coverage had been extended during the pandemic. Actually, the state removed 72,802 individuals total May 1, but 28,135 were removed as part of DHS’S normal operations. The department said that it removed 25,000 people monthly for a variety of reasons in 2018 and 2019 before the pandemic. (It also adds many people each month, too. There’s a lot of churn in the program.) More than a third of the total amount – 25,700 – were in the state’s Arkids First program. Medicaid provides government-funded health insurance for lower income individuals and others. Some are covered through traditional Medicaid. Others with incomes up to 138% of the federal poverty level can receive private insurance paid for by the government through the ARHOME program. The state, like others, had stopped removing most beneficiaries from both programs, regardless of whether or not they filled out the forms or started making too much money, for three years. This happened after former President Trump on March 18, 2020, signed the Families First Coronavirus Response Act. It increased federal Medicaid matching funds for states that kept all individual cases active during the public health emergency. Basically, no one was kicked out of Medicaid unless they died, moved out of state, were incarcerated or asked to be removed. That’s how things stood throughout the public health emergency. The Medicaid rolls, which stood at 921,066 on March 31, 2020, increased by 230,000 people during the pandemic. But with Congress’ passage of the Consolidated Appropriations Act last year, states could begin removing individuals again. Arkansas started doing so last month effective May 1, and it will continue doing so over the next five months. Keeping up with a million people, much less determining whether they are still eligible for a complicated government program after a pandemic, is a massive undertaking. DHS has tried to get in touch with the recipients. It said during a recent webinar that it had attempted more than 700,000 contacts and had been able to update or confirm correct addresses for 160,000 people. The policy change also means the state will stop receiving the extra federal funding that paid for most of that coverage, while insurance companies covering individuals through the state’s ARHOME program will lose funding, too. As for the 72,802 recipients removed from the rolls May 1, the reason cited by DHS for well over half (44,714) was, “failure to return the renewal form.” Why didn’t they? Some may have gotten a good job that offers health insurance and didn’t bother to tell the government. Some may have moved – it’s a highly transient population – and never received the form. Some no doubt didn’t take responsibility, for whatever reason, to send back the form. After all, they didn’t have to do anything for three years. If someone really needs care on a continuous basis, presumably they – and their medical providers who want to get paid – would not allow their coverage to lapse. If someone’s case has been closed, they do have a grace period to get reinstated. They can do so now by going to ar.gov/renew or calling 855-372-1084. Some generally healthy individuals who have lost coverage will go to the doctor or the hospital in the coming months and discover, along with their provider, that they don’t have government-funded healthcare anymore. Many of those people can just reapply and get retroactive coverage that will cover that visit. The individuals who are going to have the biggest problem are those who are being removed from the rolls and can’t reapply because they make too much money. They won’t be able to get retroactive Medicaid coverage when they go to the doctor or hospital. They’ll have their current medical situation to deal with, and they’ll have to get insurance, if they can. Ultimately we’re compacting what would have been done on a regular basis over three years into six months. If you’re on Medicaid and you don’t know for sure that you’ve been reapproved this year, you might want to contact DHS. Steve Brawner is a syndicated columnist published in 18 outlets in Arkansas. Email him at brawnersteve@mac. com. Follow him on Twitter at @stevebrawner.