Localize It: Medicaid coverage restored for thousands after computer errors in many states
FILE - The U.S. Department of Health and Human Services building is seen, April 5, 2009, in Washington. About 500,000 people who recently lost Medicaid coverage are regaining their health insurance while states scramble to fix computer systems that didn't properly evaluate people's eligibility after the end of the coronavirus pandemic, federal officials said Thursday, Sept. 21, 2023. (AP Photo/Alex Brandon, File)
By DAVID A. LIEB Associated Press
EDITORS/NEWS DIRECTORS:
Federal officials say about 500,000 Medicaid recipients who recently lost coverage are having their health insurance restored after state computer systems failed to appropriately handle their eligibility reviews.
All states are undertaking a massive examination of Medicaid rolls — the first such review since the federal government lifted a pandemic-era moratorium on removing people from the program.
In many states, the first step involves using computer programs to determine whether people can be automatically re-enrolled in Medicaid. If their eligibility is unclear, then people are sent renewal notices asking for further information before being dropped from the rolls.
Federal officials say eligibility is supposed to be reviewed for each individual in a household, because children often have higher income eligibility thresholds than adults.
The federal Centers for Medicare and Medicaid Services sent a letter to all states last month asking them to verify compliance with this federal rule.
CMS officials said Thursday that 29 states and the District of Columbia had conducted automated eligibility reviews for entire households instead for individuals. That means some people — primarily children — may have been inappropriately dropped from Medicaid.
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READ AP’s STORY
Medicaid coverage restored to about a half-million people after computer errors in many states
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STATES WITH RENEWAL PROBLEMS
According to CMS, the following jurisdictions reported problematic automated systems, with an estimate of the number of people affected:
Alaska, fewer than 10,000
Colorado, between 10,000 and 49,999
Connecticut, between 10,000 and 49,999
Delaware, still assessing the number affected
District of Columbia, fewer than 10,000
Georgia, still assessing the number affected
Hawaii, between 10,000 and 49,999
Idaho, fewer than 10,000
Illinois, fewer than 10,000
Iowa, between 10,000 and 49,999
Kansas, between 10,000 and 49,999
Kentucky, fewer than 10,000
Maine, problem exists but none affected
Maryland, fewer than 10,000
Massachusetts, fewer than 10,000
Minnesota, still assessing the number affected
Nebraska, still assessing the number affected
Nevada, greater than 100,000
New Jersey, fewer than 10,000
New Mexico, fewer than 10,000
New York, between 50,000 and 99,999
North Dakota, fewer than 10,000
Ohio, between 10,000 and 49,999
Oregon, still assessing the number affected
Pennsylvania, greater than 100,000
Vermont, fewer than 10,000
Virginia, between 10,000 and 49,999
West Virginia, fewer than 10,000
Wisconsin, fewer than 10,000
Wyoming, between 10,000 and 49,999
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PUBLISHABLE CONTEXT
Medicaid is a joint federal and state health care program for lower-income residents. The federal government provides much of the money, but states manage their own programs. During the coronavirus pandemic, the federal government provided states with extra Medicaid money but barred them from removing people from the rolls.
The Medicaid enrollment freeze ended in April, and states have been reexamining the eligibility of participants since then. Federal Medicaid officials said some states’ computer systems wrongly looked only at household information — not information for each individual — when making automated determinations about eligibility.
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CONSIDER THESE REPORTING THREADS
— If your state had problems with its automated Medicaid eligibility reviews, contact your state Medicaid agency for the best estimate of how many people were affected, and how many of those were children. The CMS figures are reported only in broad ranges. For example, CMS reported that between 50,000 and 99,999 people were affected in New York. That state’s Medicaid director put the figure at 70,000 people, including 41,000 children.
— If your state had eligibility renewal problems, ask your state Medicaid agency how long it expects to take to update its computer systems. CMS officials say some states expect to complete changes in September but others could take months. What are your state’s work-arounds in the meantime? How much are the changes costing?
— Are Medicaid recipients aware they may have lost coverage inappropriately and having their health insurance restored? What’s being done to let people know about this? Talk to nonprofit groups that help people apply for health care coverage to put you in touch with affected people.
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FIND YOUR STATE: NUMBER OF MEDICAID ENROLLEES
The federal government keeps data on how many people rely on Medicaid in each state, though the data lags behind by several months. Scroll down on this page to view an interactive map with that info, or click the “complete dataset” link at the top of the page to access all the data.
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MORE STATE DATA SOURCES
— Several entities keep tabs on the number of people retained and dropped from Medicaid during post-pandemic eligibility reviews. The nonprofit health policy organization KFF maintains an online Medicaid enrollment and unwinding tracker. The Georgetown University Center for Children and Families also maintains a Medicaid unwinding tracker.
— States are required to report monthly data about the number of people renewed and removed from Medicaid to the Centers for Medicare and Medicaid Services. Those reports are due by the 8th of each month. The data is not cumulative, so the figures in each month’s report must be added to come up with totals for those kept on Medicaid or removed. Ask state agency officials for the monthly “Medicaid unwinding” report due to CMS.
— The federal government releases data from states’ monthly Medicaid reports. However, it runs several months behind. The May data was released in August and can be downloaded at the bottom of this federal website.
— Some states post their Medicaid enrollment and removal data on their own websites. The format and timeliness will vary. This Ohio website, for example, includes links to the monthly data in the same format as submitted to the federal government. This Missouri website uses similar terminology as the federal reports but displays the data in bar charts. This Virginia website uses slightly different terminology than the federal reports.
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READ PREVIOUS AP COVERAGE:
Children getting wrongly dropped from Medicaid because of automation `glitch’
Feds raise concerns about long call center wait times as millions dropped from Medicaid
Paperwork problems drive surge in people losing Medicaid coverage health coverage
More than 1 million dropped from Medicaid as states start post-pandemic purge of rolls
Biden administration urges states to slow down on dropping people from Medicaid
Kicked off Medicaid: Millions at risk as states trim rolls
An explanation of the Medicaid eligibility determination process
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Localize It is an occasional feature produced by The Associated Press for its customers’ use. Questions can be directed to Katie Oyan at koyan@ap.org.