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Advocates Decry Renewal Process At Unofficial Medicaid Hearing

Sebastián Martínez Valdivia
Bridget McCandless of the Health Forward Foundation testifies before a group of legislators as part of an unofficial hearing on Medicaid enrollment.

More than a dozen people testified at an unofficial hearing on decreasing Medicaid enrollment at the capitol Thursday, raising concerns, particularly about the rate of uninsured children in the state.

Legal advocates, activists and private citizens spoke on a range of issues, including the complexity of forms applicants for Medicaid have to fill out to re-enroll, and potential glitches in the renewal system.

The unofficial hearing was organized by House Minority Leader Crystal Quade and other Democrats who are looking for answers to why nearly 130,000 people are no longer covered, including some 90,000 children. Some Republican lawmakers also attended, including Rep. Mike Moon. 

Many witnesses said they want the state to stop automatically ending people’s coverage through the system, and make it a manual decision instead.

Quade said she was disappointed no representatives from the Department of Social Services, which oversees the state’s Medicaid programs showed up. But she did say she was heartened that some Republican representatives attended the hearing.

“We are being asked about it from folks on the other side of the aisle, but we’ve got to get the leadership to view this as a serious issue,” Quade said. 

State officials have in the past said they think the declines are due to economic improvement, and cite decreasing in caseloads in the Supplemental Nutrition Assistance Program. But many people at the hearing Thursday expressed skepticism, including Timothy McBride, who served as chair of the Healthnet Oversight Committee until this past summer.

McBride pointed to Missouri's economic growth, which has actually lagged behind the national average as a hole in the state's explanation. A professor at Washington University in St. Louis, McBride had questioned the steep declines after they first became evident last year until he was removed from his post.  

Other speakers included representatives from legal advocacy groups from eastern, western, central and southern Missouri, many of whom drew attention to the complexity of the renewal forms the state has sent applicants over the past few years. Legal advocates say those forms are a major factor in the decline in enrollment, arguing they often don't reach their intended destination, and even if they do, they're hard to fill out.

According to a recent report from the Georgetown University Health Policy Institute, Missouri's enrollment declined 12 percent between December of 2017 and April of 2019 - the most significant percentage drop in the country. That same report also put Missouri in the top five states for decline in children enrolled. 

Sebastián Martínez Valdivia is a health reporter and documentary filmmaker who focuses on access to care in rural and immigrant communities. A native Spanish speaker and lifelong Missouri resident, Sebastián is interested in the often overlooked and under-covered world of immigrant life in the rural midwest. He has a bachelor's degree in broadcast journalism from the University of Missouri and a master's degree in documentary journalism at the same institution. Aside from public health, his other interests include conservation, climate change and ecology.