This is a BFD:
CMS…… hello https://t.co/61lvjSEECh pic.twitter.com/v7wWHNk4Qr
— Adrianna McIntyre (@onceuponA) August 31, 2022
Signing up and maintaining eligibility for Medicaid and CHIP tends to be a pain in the ass. It frequently leads to significant enrollment churn. The current public health emergency has frozen redetermination and termination for non-eligibility. This has led to significant increases in enrollment and a lower proportion of the US population being uninsured. However, CMS estimates that the end of the public health emergency will lead to 15 million people leaving Medicaid with some becoming uninsured. Of that 15 million, just under half (6.8 million) are still eligible for Medicaid coverage. These eligible but terminated from coverage individuals will have fallen through cracks or aggressively pushed off of coverage by onerous redetermination requirements.
Steps taken to maintain accurate and low cost to the individual eligibility determinations is a big deal. This likely means enhanced data sharing between programs that already collect income information. It could plausibly mean that more people who qualify for WIC or free and reduced lunch would be automatically maintained in Medicaid because they will have hit the income guidelines. It could mean restrictions on form length or requirements that a typical beneficiary can readily explain what is needed as the forms would be written in plain English instead of either lawyer-ese OR 1947 Louisiana voting literacy test levels.
I’m not sure what will be in these regulations, but this is part of a quiet revolution in providing public services.
Ohio Mom
As is my tradition, a comment that is slightly off-topic.
Ohio Son, now 25, has had a Medicaid Waiver since his early elementary school years. When he was a minor, we had to resubmit paperwork every year to requalify.
I shouldn’t really say “we,” it was the county DD Services board that gave us a checklist of what documentation was needed, organized it, submitted it to Jobs and Family services, and argued with JFS when necessary. Some years the county DDS staff person working with us would warn us that the JFS staff assigned to us that go-round was particularly nitpicky.
I couldn’t have managed without DDS. It was too Byzantine a process for this college graduate who keeps records and documents obsessively. I can’t imagine how less privileged families would be able to manage. Many must not.
A side note: I was always amused that my taxes were paying one county worker from DDS to argue with another from JFS. The resources that go into preventing low-level fraud when the real pickings are on the Rick Scott-type level.
ETA for those who don’t know the acronym DDS: Developmental Disabilities Services, the agency formerly known as MR/DD.
dnfree
I am going to credit you and others of like mind who are focusing attention on and studying this problem blemish—people who actually want government to work efficiently and effectively.
dnfree
@Ohio Mom: I wouldn’t say that’s off-topic at all. And it’s always good to identify human services agencies by more than their acronyms because they vary so much in what they’re called in different places and different times.
Martin
Oh, here’s my on topic observation.
We’re currently enrolled in an exchange plan here in CA. And CA is doing something similar in that the exchange and Medicaid are increasingly being treated as opposite sides of the same coin. Your exchange information can trigger you to almost automatically be enrolled in Medicaid, and if you fall off Medicaid you are basically automatically enrolled in an exchange plan. Or, at least that’s what the state is trying to achieve – to make those two programs fairly seamless to move between.
I suspect it works pretty well for most people, but it doesn’t for us. See, being recently retired and coasting until it makes more sense to start my pension, we have very little income (our income is from investments, so it has a cost basis, so from a taxation point of view we earn very little because it’s basically just us returning our own money), so we look Medicaid eligible when you just look at the income part of the exchange paperwork. But we have a lot of assets, so we most certainly aren’t Medicaid eligible. That’s not the constituency the state is trying to address, so we keep getting caught out by a process that is trying really hard to put us on Medicaid.
It’s slightly frustrating but if you look at what the state is trying to do it’s going to help millions of people, so I don’t mind the frustration. Basically they’re trying to cobble together something that looks more like single payer out of a suite of disparate programs.
Sounds like HHS is taking a page from what CA is trying to do, and trying to make this process easier. Remember, if they can make it work in California, then the federal government has made it work for 12% of the US population. That’s a pretty good start on any program and why CA has a bit of a leg up in that laboratory of democracy thing.
Duane
Missouri’s Medicaid program is so poorly run, averaging a four- month wait period, that the federal government had to intervene and is basically in charge now.