Arkansas Medicaid Mess: 50,000 people screwed, 25,000 screwed immediately
2019 OPEN ENROLLMENT ENDS (most states)
Time: D H M S
This is a huge story which I should have been following, but a) I was on vacation the past couple of weeks, b) I can't cover everything healthcare-related, and c) it's really not directly related to the Affordable Care Act. Fortunately, the Arkansas Times' David Ramsey has been all over it, so I'll let him lay it out for you:
...all three members of the household were among almost 36,000 Arkansans who were kicked off of their health coverage on July 31. Insurance for another 13,000 people across the state will terminate at the end of this month. The cancellations are the result of a statewide sweep of Medicaid performed by the Arkansas Department of Human Services in an attempt to weed out those beneficiaries whose incomes are too high.
Yet Classic's income clearly qualifies her for Medicaid. Like tens of thousands of other people who've recently lost coverage (or soon will), DHS terminated her insurance not because it actually determined she was ineligible, but simply because it flagged her account as needing additional information. The agency says it sent letters to each of these beneficiaries, giving them a 10-day deadline to provide documents verifying their income, and beneficiaries failed to respond in time. But the Times has spoken with many people who say they have repeatedly attempted to respond to DHS' request and have been unable to make contact. Some say they were told by a DHS worker over the phone that the letters were received in error and that they should do nothing. Others, like Classic, claim they never received the letter in the first place.
...On Monday, the polling organization Gallup announced that Arkansas had made greater gains in insuring its citizens than any other state over the past two years. In 2013, the rate of uninsured adults in the state was 22.5 percent. In 2015, that figure is now 9.1 percent.
The dramatic progress has been the direct result of the private option, a controversial policy compromise over Medicaid expansion struck between former Democratic Gov. Mike Beebe and Republicans in the legislature in 2013. Under the private option, Arkansas uses federal Medicaid money to purchase private insurance plans for adults whose household incomes fall below 138 percent of the federal poverty line. In Arkansas, that's a lot of families: Before DHS began removing people from its rolls, almost 250,000 individuals had gained private option coverage since enrollment first began in January 2014. Now, almost 50,000 Arkansans, most of them private option beneficiaries, have either lost coverage or are scheduled to lose it at the end of August.
That was a couple of weeks ago. Here's the latest, and it isn't pretty:
As the Arkansas Medicaid verification mess continues, it's important to remember the stakes: tens of thousands of Arkansans, many or most of them actually eligible for the program, are now facing gaps in access to care. That includes more than 25,000 who won't even have access to medication while things get sorted out, including the most vulnerable patients — kids in ARKids, very poor parents, and the "medically frail."
...Unfortunately, however, around 8,000 beneficiaries who had their coverage terminated were covered by QualChoice, and QualChoice chose not to participate in the pharmacy coverage deal with the state. If those folks try to get their medication this month, they will be turned away.
It gets worse. The bandaid fix by the insurance companies only covers beneficiaries on private plans. But there were tens of thousands more covered by the traditional Medicaid program, and they too will have no pharmacy coverage. Unfortunately, these are the state's most vulnerable beneficiaries:
Read the whole thing. It's an absolute disaster which is hurting real people for no reason other than gross bureaucratic incompetence.