Missouri Legislators on Tuesday held one of the only official hearings on Medicaid enrollment since a major drop left more than 90,000 children without coverage.
Initially, officials attributed the low numbers to a strong economy. Department of Social Services officials now argue the dip in Medicaid enrollment is largely due to improved eligibility verification.
Republican state Rep. David Wood chaired the hearing. He said too many people who didn’t qualify enrolled in Medicaid after the Affordable Care Act was implemented, and the state didn’t have the resources to check.
In 2018, the state implemented a new system to manage enrollment called the Missouri Eligibility Determination and Enrollment System, or MEDES. That system relies in large part on mailed forms requesting information from Medicaid recipients.
Legal advocates and social workers have complained that those letters aren't reaching clients, and even when they do, they're not given enough explanation or time to fill them out. According to numbers provided by the state last February, 60 percent of people who lost coverage failed to return the requested information.
Jennifer Tidball, acting director of the Department of Social Services agreed with Wood's assessment, saying she and her colleagues anticipated a shift once the new system of eligibility determination was implemented. "And at that point, we would see, I believe, we call that I think at that point a correction of the caseload to where it needed to be," Tidball said.
Democratic Rep. Deb Lavender questioned why the state’s initial explanation was that economic growth meant fewer people needed the service. She also criticized the state’s practice of kicking children who still qualified off Medicaid when their parents lost eligibility.
"We're placing the blame on parents on not resigning their kids up," Lavender said.
Wood conceded the system needs to be improved. "I think that there is a complicated process that makes it very cumbersome for those that are needing the services to fill out all the applications," Wood said. "I think we do need to streamline our processes."
Advocates for Medicaid recipients have called attention to a number of cases where children have lost coverage without their parents realizing. In many cases, they've blamed mailed forms not reaching clients, and — even when information is returned correctly — that bugs in the state's system have lost the data.