Clara Bates, Missouri Independent
The proportion of uninsured children in Missouri stabilized during the COVID-19 pandemic, reversing a long-standing trend of an increase in the number of children without insurance, according to a report released Wednesday by Georgetown University. Did.
But the researchers say children will be denied health insurance due to the end of a federal public health emergency that will likely occur next year and will require states to redetermine the eligibility of all Medicaid recipients. It warns that you will be exposed to the risk of losing it properly.
Missouri was previously identified as one of the six states where children are most at risk of losing their insurance once the public health emergency ends.
A report Wednesday, carried out by the Center for Health Policy Research for Children and Families in Georgetown, found that the uninsured child population declined or stabilized in most states from 2019 to 2021. I was. This is largely due to federal regulations that prohibit states from excluding Medicaid recipients. From Medicaid rolls during public health emergencies.
According to U.S. Census data, the percentage of uninsured children in Missouri was 6.5% in 2019, dropping to 5.9% in 2021. The Georgetown University report said 2020 data was not available, so he analyzed federal data for 2019 and 2021.
Missouri had a higher proportion of uninsured children than the national average in both years. In 2021, approximately 86,000 Missouri children were uninsured.
In the three years leading up to the pandemic, the proportion of uninsured children rose nationally “for the first time in recent memory,” notes a Georgetown press release. This was also the case in Missouri. According to federal data, the percentage of uninsured children in Missouri rose from 4.8% in 2016 to 6.5% in 2019.
“Procedural Expulsion”
Missouri’s Department of Social Services came under fire for a significant drop in Medicaid enrollment in 2019 after adopting new renewal processes and information systems.
The Missouri Budget Project that year was eligible for compensation due to problems in the renewal process, such as not receiving proper documentation or submitting documentation only to be lost or not processed. I discovered that family members were often excluded from Medicaid.
At the time, Medicaid call centers had hours of wait times.
Proponents worry that once the public health emergency is over, administrative barriers could return Missouri to a situation where eligible Medicaid recipients are stripped of their renewal process. .
In a study earlier this year, Georgetown researchers estimated that 6.7 million children nationwide are at risk of losing coverage when the public health emergency ends. The federal government predicted that her nearly three-quarters of the children removed from Medicaid roles after the public health emergency ended would remain eligible but would be removed due to procedural issues. .
“We often hear that procedural deregistrations occur when registrants ‘fail’ to renew,” said an August Center for Children and Family post.
When children are uninsured, they are more likely to experience exacerbations of chronic illnesses, are unable to get health check-ups for healthy children, and families receive high medical bills and may even be in medical debt. says Joan Alker, director of the Center for Children and Families in Georgetown. the study’s lead author said at a news conference on Wednesday.
Children in Missouri are particularly at risk, an earlier report from Georgetown noted. Because the state does not have a policy to provide the child with her 12 months of continued Medicaid coverage and is managing the Children’s Health Insurance Program (CHIP) in ways that could lead to coverage gaps. This includes billing family members for her CHIP.
In an email, Alker noted that Missouri has a “history of bureaucratic loss of children” and bureaucratic hurdles that create a coverage gap for eligible children. We believe that the continued provision of compensation during the period has helped contain it.
At a news conference Wednesday, Alker said the report’s findings that the proportion of uninsured children declined slightly nationally during the pandemic were “welcome news for America’s children.” However, “it may be short-lived.”
Nationwide, “millions of eligible children are likely to be overlooked and uninsured in careless or malicious states when their continued federal coverage protection expires.” Arker continued.
The federal government has not yet announced when PHE will end, but will give 60 days’ notice, and after it ends, states will have up to 14 months to determine the eligibility of all Medicaid participants.
The Missouri Department of Social Services told the MO HealthNet Oversight Board that it will take a year to complete all updates.
The Missouri Department of Social Services did not immediately respond to a request for comment.
In July, the state released several federal grants designed to reduce the backlog of Medicaid applications after the public health emergency ended and before the full caseload of Medicaid participants had to be updated. Adopted flexibility.
These flexibilities will apply until the end of the public health emergency rollback period and may ease the verification hurdles. One of his measures, which focuses on applications received through the federal marketplace, allows states to accept federal information without having to double-check it.
Missouri social services officials also said they are working to update attendees’ address information so they can be contacted when the public health emergency ends and updates resume. increase.
At the MO HealthNet conference in August, Kim Evans, director of family support, said the state is working with managed care providers to update patient information in the eligibility system if a patient moves. I was. It also encourages attendees to update their contact information and is working to transition to an electronic notification system, Evans said.
Most adults in families enrolled in Medicaid nationally are unaware that services will be renewed again soon, an Urban Institute survey found last month, making sure to tell the state about the next shift. poses a challenge for
Unlike the other 35 states, Missouri has yet to publicly provide an outline of plans or plans for the rollback of the public health emergency, according to Georgetown’s rollback tracker.
Registration challenges
Missouri is working to replace outdated technology, Social Services Director Robert Nodell explained at a news conference in August.
Missouri’s Department of Social Services has had technical problems for years, with many processes relying on paper forms being manual and taxing on participants.
The Missouri Department of Social Services and the nonprofit Sibylla created a 2020 report on benefits program enrollment challenges, and participants concluded that “the system feels like a secret and no one has the answers.” attached. As for staff, the report concludes that they “feel more like an assembly line than connected to the people they serve” and that their work is “siloed.”
Children in states “lagging behind modernizing entitlement systems” are at higher risk of improperly losing coverage, Alker said Wednesday.
Deborah Greenhouse, a pediatrician in South Carolina and a member of the American Academy of Pediatrics’ Federal Affairs Committee, said at a press conference Wednesday that the continued surge in childhood respiratory illnesses and the mental health crisis in children has led to said there was a particular need for continued compensation for children.
“The media turmoil will add another layer of crisis to an already dire situation,” Greenhouse said.
