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77,000 removed from Medicaid rolls in June

The office of the Arkansas Department of Human Service in Little Rock.
The office of the Arkansas Department of Human Service in Little Rock.

In the third month of activity, Arkansas posted its highest level of disenrollment figures since beginning its redetermination process mandated by state and federal law.

In June, Arkansas Department of Human Services officials disclosed that “approximately 77,000 beneficiaries were disenrolled because they are no longer eligible. As of July 1, total Medicaid enrollment was 971,364, including 414,722 children, 276,764 on ARHOME, and 279,878 other adults.” More than 50,000 cases were renewed, according to DHS.

In April and May – the first two months of a six-month disenrollment process – DHS reported 72,802 and 68,838 recipients respectively.

“There is a lot of fabricated outrage and incorrect reporting about Arkansas’ legally required efforts to redetermine eligibility for Medicaid recipients whose coverage was extended due to special rules during the COVID-19 Public Health Emergency that have since ended,” said DHS Secretary Kristi Putnam. “This outrage is misplaced, it’s coming from out-of-state media and special interest groups, and it distracts from the reality that Arkansas is following a detailed plan developed over more than a year that is both fair and helps protect Medicaid resources for those who truly need it.”

DHS says some Medicaid recipients have failed to return paperwork, but in the June report agency officials cited additional reasons for the high number of disenrolled. DHS noted:

  • There were two minimum wage increases in Arkansas during the pandemic, and unemployment has fallen from 4.9% in March 2020 to 2.7% as of May 2023. More Arkansans working for higher pay is a good thing, and it means that they are obtaining economic independence and cycling off Medicaid.
  • Arkansas is redetermining eligibility for beneficiaries whose coverage would have ended if not for the special rules during the emergency. These “extended” beneficiaries are more likely to be disenrolled because they have already been determined ineligible previously, even though they kept their coverage.
  • Arkansas continued eligibility operations for most of the pandemic. This means during the PHE [public health emergency], beneficiaries who confirmed their eligibility were transitioned off of the extended list and into categories of assistance for which they qualified. To date since the start of the emergency, more than 250,000 beneficiaries whose coverage was extended have transitioned to regular Medicaid coverage.
  • Historically, DHS disenrolled 20,000 to 30,000 people each month prior to the pandemic.

“Individuals in Arkansas are transitioning off of Medicaid, and the main reason is because they are working, making more money, and have access to health care through their employers or the federal marketplace,” said Deputy Secretary and Medicaid Director Janet Mann. “This should be celebrated, not criticized.”

Arkansas stopped disenrolling most Medicaid beneficiaries after former President Donald Trump on March 18, 2020, signed the Families First Coronavirus Response Act. It increased federal Medicaid matching funds for states that kept all individual cases active during the public health emergency. The state’s Medicaid rolls rose by 230,000 total during the pandemic.

The federal Consolidated Appropriations Act, signed into law last December by President Joe Biden, allowed states after March 31 to begin dropping Medicaid recipients who are no longer eligible. Normal eligibility rules, set by Congress and the Centers for Medicare and Medicaid Services, resumed April 1.

All beneficiaries who have not had a renewal in the last 12 months will be redetermined. State law requires that the work be completed in six months.

There is a grace period to help those who may fall through the cracks. Recipients who were disenrolled but still qualify usually can have their coverage reinstated without a gap if they provide their information within 30 or 90 days after their cases are closed. Individuals who later learn their coverage has ended can reapply and have retroactive coverage back to the date of reapplication.

For more than a year, DHS has conducted outreach to recipients, met with providers and stakeholders, and conducted an awareness campaign to encourage a return of renewal applications. It said beneficiaries are sent multiple notices by mail, with later ones advising them their case will be closed if they don’t respond or are found to be ineligible. The department said it also tries to reach recipients by text, email and/or phone if possible.

DHS said it has made a special effort to reach families with children covered by Medicaid, including by providing pediatricians lists of patients who could be disenrolled. DHS has distributed materials to families through school districts, school nurses, and libraries, and has contacted families directly.

Roby Brock is the Editor-in-Chief and Host of Talk Business & Politics.