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Missouri begins disenrolling Medicaid patients after three-year freeze

 Illustration of a man standing in front of a chasm. On the other side of the chasm is a marker indicating a hospital.
KFF Health News
Advocates for health coverage are worried eligible patients will incorrectly lose their insurance as states begin to redetermine Medicaid eligibility.

Medicaid recipients in Missouri are now at risk of losing their health insurance coverage for the first time in three years.

During the height of the coronavirus pandemic, the federal government issued emergency protections that barred states from removing people from the government-funded health insurance program for low-income people and families.

That changes this month. State workers from the Department of Social Services have been redeterminingpeople’s eligibility, but now Medicaid recipients could lose their coverage because they make too much money or did not fill out paperwork.

State officials and health insurance advocates are concerned that some people could lose their coverage because they didn’t know they needed to reapply this year, did not open mail that reminded them to send information to the state or incorrectly filled out forms.

“The key part this time is helping and getting the word out soon and educating the patients,” said Iva Eggert-Shepherd, a senior outreach program manager for the Missouri Primary Care Association who helps people apply. “They're confused, because they haven't had to do this for three years. They're wanting to know the process of ‘how do I report my address?’”

Missouri is taking more than a year to determine patient Medicaid eligibility month-by-month. The Social Services Department, which administers the program, began checking eligibility and sending out reenrollment reminders earlier this year.

The state will methodically review patients’ information, using SNAP records and other government data sources to see if their income qualifies them for the health insurance. State officials will then redetermine eligibility by the annual renewal month.

About 1.5 million Missourians, or nearly one-fourth of the state’s population, are enrolled in Medicaid, according to state figures.. Close to half of enrollees are children.

Missouri Foundation for Health Health Advocacy Director Nancy Kelley said she will be watching those figures in coming months to see if the state is kicking people off Medicaid because they forgot to mail in forms or made other procedural mistakes.

A key question, she said, will be: What can we learn about who is losing coverage?

“We can then turn around and work with our partners,” Kelley said. “A lot of people are looking at that in terms of community partners, the managed care organizations, the hospitals. They’re all hoping to not lose people when they're still eligible.”

Other states already have begun the renewal process. According to data from the health nonprofit KFF, more than 70% of patients disenrolled from Medicaid programs since the federal protections ended in spring have been kicked off due to “procedural reasons.” That means patients did not complete the renewal process or officials could not reach them.

Kelley said it’s difficult to predict if what happened in other states will happen in Missouri, because every state has a different plan for determining eligibility.

Those disenrolled from Medicaid by state officials can still get coverage through the healthcare.gov marketplace, Kelley said. If they lose coverage during the state’s Medicaid reenrollment process, they will be eligible for a special enrollment period for the marketplace and won’t need to wait for the annual open insurance enrollment window.

“They don’t have to go it alone,” she said, adding there are several organizationsthat will, for free, assist people in finding insurance.

Medicaid recipients in Missouri can go to mydss.mo.gov/renew to learn how to reenroll.

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