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Missouri Lawmaker Wants State To Explain Purge Of Families From Medicaid

Missouri Speaker of the House Todd Richardson listens to representatives speak on the last day of the legislative session.
File photo | Carolina Hidalgo | St. Louis Public Radio
Sen. Scott Sifton (D-Affton) has sent Head of Missouri HealthNet Todd Richardson (pictured) a letter calling for reasons why nearly 73,000 people have disappeared from the state's Medicaid rolls.

A Missouri lawmaker is demanding that state health officials explain how 73,000 people dropped off Medicaid rolls last year.

The state debuted an automated system in 2018 to help identify people who were no longer eligible for Medicaid, the health-insurance program for low-income and disabled people. Among the system's critics is state Sen. Scott Sifton, D-Affton, who worries that its flaws led to the nearly 7 percent drop in Medicaid enrollment. Most of the people who lost coverage are children.

Department of Social Services officials have pointed to decreased unemployment as one reason for the drop, but Sifton thinks the numbers don’t add up.

“Any time you have a change in enrollment, and an enrollment drop that’s nine times the national average, according to one source, that raises questions,” Sifton said.

Missouri began to re-evaluate the HealthNet rolls last summer using an automated computer system to determine who remained qualified for benefits and who didn’t. Gov. Mike Parson, a Republican, took office in June and has made cutting Medicaid fraud a priority.

The state sent letters to some who it deemed made too much money or were otherwise not eligible and let them re-enroll or appeal the decision. Missouri has not expanded its Medicaid program, and it only applies to very poor people.

But nearly 8 in 10 who the state deemed ineligible are children, who are able to be covered if their families make up to 300 percent of the poverty rate, or close to $62,000 a year.


Sifton worries many didn’t receive the letters and were wrongfully unenrolled.

“Of these folks who were dropped, how many of these folks were dropped simply because they didn’t answer a letter that was sent to them within 10 days of when it was sent?” Sifton said

Sifton called on Richardson to provide information on how many enrollees were sent letters, how many weren’t deliverable, and the reasons why people were dropped.

The Missouri Department of Social Services, which administers Missouri HealthNet, is working on answers to the letter’s questions, department spokeswoman Rebecca Woelfel said. She declined to comment further.

Even for those who received a letter, enrolling in the system again has proven difficult.

Destinee Henderson of St. Louis is one of the former HealthNet enrollees who received a letter. She’s a mother of two who thinks the state wrongly decided her family shouldn’t be covered.

Henderson makes $46,000 a year. That means her children could potentially be eligible for benefits, even if she isn’t.

Henderson said she hasn’t been able to get in touch with state officials, even after she tried calling and submitting her application at the department’s St. Louis child support office.

“I filled out the forms to re-apply — they were some yellow documents — and I never got any notification or anything back that we weren’t approved, or if we were approved,” she said.

Henderson said now she can no longer afford the medicine her 2-year-old son, Benjamin, needs to prevent asthma attacks since the state dropped her family from the program. She’s had to take him to the emergency room four times since her family was unenrolled.

Henderson said she also has tried to leave voicemails for the department’s help line, but no one has called her back.

She doesn’t know what she’ll do if she can’t get her son back in the program.

“I don’t know at this point. I might have to take him to the hospital to get treatment,” she said.

“And I’ve started receiving all types of doctor’s bills now, saying I owe for medical expenses.”

The state needs to balance its mission to clean up the rolls with the possibility it could leave some people in limbo, said Tim McBride, a Washington University professor and the chair of the state’s Medicaid Oversight Committee.

For example, mailed forms are not likely to reach some people, especially low-income people who are on Medicaid, who may be homeless or have impermanent housing, McBride said.

The state’s effort to clean up the rolls “looks good in the budget,” McBride said. “But what I think is going to happen in four to five months is they’re going to be told, ‘We’re wrong: We need more money for Medicaid again.'”

Follow Sarah on Twitter: @petit_smudge

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Sarah is the health reporter at St. Louis Public Radio.

Send questions and comments about this story to feedback@stlpublicradio.org.