Arkansas Medicaid worked as planned in pandemic, faces challenges in emergency

I’ve read a lot of columns recently that begin with the phrase, “If there’s one hard lesson we’ve learned from the pandemic…”. Well, this is not one of those columns, because I’m sure we’ve learned a lot of hard lessons that we should all reflect on and not repeat.

Instead, this column highlights a program designed to respond quickly to emergencies and act as a major cog in our social safety net – Medicaid. A program that was on the political heels of the more popular Medicare program to make its way into the Federal Social Security Act of 1965, Medicaid has played an integral and growing role in our nation’s health care system, covering approximately a American in five and serving as the primary source of long-term care coverage.

Even when the country is not in the midst of a pandemic, Medicaid is an essential part of the health care safety net. It ensures that people who do not have affordable access to health care coverage through an employer or individually purchased plan can access the care they need.

During natural disasters or public health emergencies, however, Medicaid plays a vital role in crisis response, although that role is not as visible as those played by the Centers for Disease Control and Prevention during COVID-19. or the Federal Emergency Management Agency in the aftermath of Hurricane Katrina. Medicaid’s ability to respond quickly is possible because of its design and funding structure, a state-federal partnership that ensures the federal government will match state spending for eligible individuals, without any limitations.

We may not experience another pandemic for a long time, but if we do, Medicaid was built to stand the test.

In Arkansas, enrollment in Medicaid and the Children’s Health Insurance Program, an add-on program, has grown from nearly 900,000 in early March 2020, just before COVID-19 arrived in Arkansas, to nearly 1.1 million. end of 2021. In other words, the source of healthcare coverage for more than one in three Arkansans is through these programs.

The substantial increase in enrollment is only partly due to pandemic-related demand for coverage. This is also due to congressional action early in the pandemic that protects enrollees from termination of Medicaid coverage during the public health emergency. Under normal circumstances, state Medicaid programs must assess whether a beneficiary is still eligible for coverage at least once a year, with beneficiaries’ coverage terminated if they are no longer eligible based on changes in income or other eligibility requirements.

As a result, Arkansas Medicaid officials will soon be faced with one of the most important administrative tasks in the program’s history: redetermining the eligibility of thousands of beneficiaries after years of delays due to COVID-19. The public health emergency is currently set to expire on April 22, 2022, although it could be extended as CMS has signaled it will give states 60 days notice before it ends.

Either way, states are now planning how they will handle this redetermination process and are trying to anticipate key challenges – and Arkansas Medicaid officials will have a particularly tight deadline: although federal guidelines give to states up to 14 months after the public health emergency to complete the eligibility reconsideration process, Arkansas lawmakers passed a bill in 2021 requiring the state to complete the eligibility reconsideration for Medicaid within six months of the end of the public health emergency.

Arkansas Medicaid officials have already announced the creation of a new call center to contact beneficiaries and help update key contact information. This effort is in anticipation of the upcoming redetermination process, which will require beneficiaries to complete renewal paperwork to continue receiving Medicaid coverage. Even so, state Medicaid officials have estimated at least a 30% drop-out rate.

Smooth transitions for those no longer eligible for Medicaid are essential to avoid unnecessary loss of coverage and ensure continuity of care during the redetermination process after the public health emergency, especially for those who are ongoing treatment for cancer or serious mental illness. , or substance use. Targeted outreach efforts for vulnerable populations should be a priority.

Medicaid has worked as intended during the COVID-19 pandemic providing needed care for those whose lives have been disrupted. As we emerge from the public health emergency, let us ensure that as a state we maximize the use of electronic data to renew coverage for those who remain eligible, commit sufficient resources to facilitate transitions from coverage and minimize administrative burdens for enrollees so that their health care safety net can remain intact.

Editor’s note: Craig Wilson, JD, MPA, is the director of health policy at the Arkansas Center for Health Improvement, an independent, nonpartisan health policy center in Little Rock. The opinions expressed are those of the author.

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