Cumbersome paperwork, state computer systems that don’t communicate with one other, call center troubles and language barriers are causing some children in Missouri to fall through the cracks and get kicked off of Medicaid benefits.
MO HealthNet, Missouri’s Medicaid program, helps pay for medical costs for children and certain eligible adults from families with low income. Even more troubling, families may not realize it until they take their sick child for treatment.
“Families contact us after they go to the doctor or pharmacy and learn they no longer have coverage,” said Joel Ferber, director of Advocacy for Legal Services of Eastern Missouri (LSEM).
Data analysis by LSEM points to a number of systems failures that resulted in a 9 percent decline in children enrolled in the Missouri Medicaid program in 2018, which is nine times the national average. LSEM said that affects 56,716 children – and represents an historic drop in child Medicaid and CHIP enrollment.
“We have regular discussions with the state agency, so we talked with them about what was happening,” Ferber said about the huge drop in coverage revealed in annual renewals. “They have dual computer systems. One of the many problems is, when they were all on the same computer system, if the family renewed for SNAP or food stamps that would automatically extend the Medicaid. Now, families could have just been renewed in SNAP, but the two systems don’t talk to each other, so if they renew Medicaid, it wouldn’t automatically renew SNAP. And they also don’t necessarily record an address change.”
Tim McBride, a health economist who heads the Missouri MO HealthNet Oversight Advisory Committee, told The American the system broke down after the state decided to do “redeterminations” of eligibility of mostly women and children – and to do so through the mail, giving recipients only 10 days to respond. He said letters were sent to families who could not be verified through cross-checking federal or state data.
“I think the breakdown is when people get these letters, they don’t respond; they don’t know that they need to respond or understand the letters,” McBride said. “Sometimes they don’t speak English as their first language, and I’m not sure if the letters are written the way they should be.”
Additionally, he said there are big problems with the call center – staffing and work that is outsourced to a private call center.
“We’ve heard stories of people waiting 45 minutes or an hour or more, then getting cut off or their paperwork getting lost in the system, and so I think that’s a big part of the problem too,” McBride said.
The Missouri Department of Social Services has not responded to requests for comment from The American.
Ferber said thus far, LSEM has been able to help at least 40 children get back on Medicaid.
“Every single case that we’ve handled, the kid has still been eligible,” Ferber said. “It’s not that the family got jobs that made them so much income that they didn’t need Medicaid anymore. They all qualified.”
Ferber said the evidence of error is clear; now the state needs to really want to fix the problem it created.
“Missouri’s drop-off rate for Medicaid for kids is nine times the national average, and Missouri’s economy isn’t nine times better than the national economy, and this is the only benefit that shows deviation,” Ferber said.
“So, it’s not the economy, it’s systems issues – whether it’s complicated paperwork, or problems with all these systems breaking down, or it’s the phone center, or dueling computer systems that don’t talk to each other.”
To find out if you or your child is still enrolled in MO HealthNet Medicaid services, contact the MO HealthNet Service Center at 1-855-373-4636 or at www.myDSS.MO.gov.
Legal Services of Eastern Missouri assists families in getting their eligible children back on Medicaid who may have been kicked out of the system in error. Reach LSEM at 314-534-4200, 800-444-0514 or at www.lsem.org.