It is estimated that the number of Alaskans who are covered by Medicaid has fallen by nearly 14,000 since the beginning of April, as federal protections to combat the COVID-19 epidemic ended. The number could increase when the state completes the procedure of determining who’s still eligible. This process was stopped during the declaration of an emergency in the nation.
These Alaskans are losing their coverage because their state’s Health Department continues work to get rid of a pile of new Medicaid applicants that have piled up within their Division of Public Assistance since the beginning of last year.
The federal government recently informed officials from the Department of Health that it is concerned by the rate, and that delays in processing new applications could hamper equal access to healthcare and may exceed the limit of the time it takes to determine whether those who apply to Medicaid have the right to apply. Medicaid is the most important health insurance for those with low incomes Americans. State officials claim they’re making progress but another issue — a slack of food stamp applicationsis a top priority.
In an official letter in which the Federal Centers for Medicare and Medicaid Services advised to the Department of Health it is not in compliance with federal requirements to process new Medicaid applications in a timely manner and is not performing well in making decisions about whether or not people are eligible to stay on the benefits.
The Centers for Medicare and Medicaid Services issued letters to states in all states that evaluated their performance on three measures — the performance of the call center, documentation problems, and slow processing times. A majority of states are behind by at least one of them. There are only Alaska, Florida, Montana, New Mexico and Rhode Island are in the back of all of them.
The regular checks to determine if individuals are still eligible for Medicaid, referred to in the field as “redeterminations” also known as “renewals” were suspended by federal authorities in the start of the pandemic, and resumed in May. Eligibility is based on income and other factors like pregnancy.
The state has processed more than 19,000 of the nearly 260,000 redeterminations that it will complete in the next year and one-half. Of the redeterminations that the state has announced, nearly 30% of Alaskans have lost coverage due to issues with their paperwork. The federal government has said that the rate is high because individuals aren’t receiving renewal notices, or that they aren’t able to comprehend them or are unable to submit the new forms.
It’s completed a tiny portion of a larger task and many Alaskans have been denied insurance. Medicaid enrollees in Alaska fell by 14,398 in the period from the 264,649 figure on April 30, up to 250,251 at the end of July according to the state’s figures.
It could be the result of revisions, said Deb Etheridge. She was named Director of the Division of Public Assistance early this year following news of a devastating food stamp backlog. Etheridge said that it could be due to the fact that Alaskans are now off the rolls while the state gets rid of its backlog.
The state started with the process of renewal in the spring. In June and May the state handled 4000 renewals every month. In the two months that followed approximately 3000 Alaskans dropped off the Medicaid rolls due to this either because they were considered ineligible, or because they had not completed their application. The state has increased their number of annual renewals from 11,000 in July. The state hasn’t yet announced the number of individuals who were denied coverage.
“It did appear that we saw more procedural closures than in the two previous weeks,” Etheridge said, in reference to instances where people were denied coverage due to the state didn’t receive the proper documentation.
Etheridge has been working closely with a consultant in data to gain a better understanding of the motivations of the paper-related issues.
Backlog slowdowns
The concerns from the federal government arise as The Division of Public Assistance also is working to eliminate an unfinished backlog of Medicaid applications. Additionally, the department is working on another application backlog for food stamps that has affected around 19,000 Alaskans. State officials say that the backlogs result of the constant understaffing of staff and massive cuts to the workforce and outdated computers. Due to the efforts to get out from the backlogs state is behind in processing 40% of all new Medicaid applications.
Etheridge believes that the warning letter from the federal government does not fully reflect the current situation in Alaska in the Medicaid renewals process because the system in Alaska is still in the process of recovering from problems. After the pandemic, Medicaid renewals are processing in a timely manner, Etheridge said. The delays only affect the new Medicaid application, Etheridge added.
“Until we’re able to clear of this backlog, they’ll always have be considered into our timetable” dealing with the new requests, she added.
Etheridge admitted that she does not know how many people are in the backlog as a result of computer system issues and she’d like to be able to fix by the close of the month.
Etheridge stated that the state has made significant progress in addressing the food stamp backlog with a mere 3,000 applications to be evaluated for eligibility. Etheridge hopes to have the applications processed by the end of October.
State solutions
The Department of Health got permission from the federal government to put the renewal of rural Medicaid to reduce the amount of people that lose insurance, Etheridge said. The division is focusing on those who are urban Medicaid renewals first, as rural residents are more likely to engage in subsistence fishermen, hunting and gathering during the summer months.
“We acknowledge the fact that, in remote Alaska there aren’t many people present during July.” She said.
It is essential for individuals to be at home, answering the phone, and checking their mail since it increases the likelihood that they’ll see the notice from the state and then send their renewal documents in time.
Alaska enjoys more time in processing renewals. The majority of states are given 12 months to process Medicaid renewals and to remove those who are no longer eligible to be covered. But Alaska’s rural population prompted an extension to federal law that grants the state an additional 18 months to examine the approximately quarter million people registered for Medicaid.
Despite the issues raised in the US government Etheridge claimed that his division will go through the motions to ensure that the removal of people due to procedural reasons is as minimal as it can be.
“This is a brand new method to conduct the business of today,” she said. “We are contacting people in the event that they don’t get their packages in the mail. We’re conducting outreach in order to get to individuals before we actually make the closings. It’s a third step of outreach that Division of Public Assistance hasn’t always performed previously.”
She explained that people typically have 90 days to submit late forms to the state when they are denied coverage. However, when renewals are occurring, the state has increased the deadline to 180 days.
In addition, Etheridge said the department is looking to hire more full-time employees to oversee Medicaid renewals. Etheridge said she’s eager for Medicaid officials to announce 15 jobs.
The Legislature provided the funds for those positions via the fast-track budget bill which was proposed by Governor. Mike Dunleavy in March. The program was praised as an alternative to the backlog of food stamps.
Alaskans who discover following three years’ protection against pandemics they do not qualify for Medicaid are still entitled to appeal, also known as an impartial hearing.
If the division is required to stop the benefits, Etheridge said it automatically transfer the information of the person in the Federal Marketplace, where they can get health insurance. “First most important, and what is most important is to ensure that Alaskans have access to health insurance in Alaska and Alaskans are able to access information on health coverage and eligibility” Etheridge said.
Medicaid information is able to be updated as the state goes through the state’s website .
This article first appeared in Alaska Beacon and is republished here with permission.
