In a potentially disastrous turn of events, up to 30 million of the most economically vulnerable Americans face expulsion from the Medicaid program due to flawed state reviews. Health consulting firm Avalere warns that these flawed evaluations, marked by a series of systemic issues, could have devastating consequences for the nation’s neediest citizens. Despite these troubling projections, advocates argue that the Biden administration has been criminally slow in its response to stem this impending crisis.

Medicaid Meltdown

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States across the country are currently undergoing a comprehensive reassessment of the 94 million individuals enrolled in Medicaid. 

The Troubled Landscape of Medicaid Reviews

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However, this massive undertaking has been marred by a multitude of problems, ranging from excruciatingly long phone wait times in Florida to perplexing government forms in Arkansas and wrongful exclusions of children in Texas.

Legal Aid Frustrations

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Trevor Hawkins, an attorney for Legal Aid of Arkansas, expressed frustration at the lack of responsiveness from the Centers for Medicare and Medicaid Services (CMS) after raising concerns about Arkansas’ flawed process.

Hawkins emphasized the failure of CMS to provide clear information about the ongoing situation, leaving advocates in the dark.

Critics Say Not Enough Done

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Despite the challenges, according to experts, the Biden administration has not taken sufficient action to rectify the mounting issues.

Trevor Hawkins remarked, “They ask questions but they don’t tell us what is going on. Those should be major red flags. If there was a situation where CMS was to step in, it would have been Arkansas.”

Policy Shift Fallout

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In response to the challenges posed by the pandemic, the federal government had implemented a policy preventing states from removing individuals from Medicaid during this period.

However, with the conclusion of this policy, states are now obligated to review the eligibility of every enrollee over the next year. 

Becerra’s Power to Penalize States Faces Scrutiny

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The administration gave Health and Human Services (HHS) Secretary Xavier Becerra the authority to penalize states or put a stop to disenrollments in the event of identified improper removals.

Information Black Hole

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However, HHS has shared scant information about the problems it has uncovered. Earlier this year, HHS briefly halted disenrollments in 14 states without disclosing specific details. 

Children Wrongfully Removed

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In August, it was revealed that thousands of children had been wrongly removed in 29 states, prompting CMS to mandate the reinstatement of coverage for those affected.

Widespread Issues Persist for Disenrolled Medicaid Beneficiaries

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Despite these interventions, numerous advocates nationwide report widespread issues while assisting the estimated 10 million people who have already dropped out of Medicaid. 

Critics Accuse HHS of Withholding Findings

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Concerns persist that systemic problems are being overlooked, and critics argue that HHS has not been transparent about its findings.

Avalere’s Projection

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If current trends persist, Avalere projects that as many as 30 million people could lose Medicaid coverage.

This alarming figure far surpasses the Biden administration’s initial estimate of 15 million individuals facing disenrollment.

Systemic Problems in Medicaid Eligibility Determination

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The reasons behind these removals are largely procedural, with individuals failing to return renewal forms or provide necessary paperwork.

This highlights systemic issues in how states determine Medicaid eligibility, with notices often failing to reach recipients or conveying confusing information.

Arkansas Anomaly – 70% Disenrolled Due to Procedural Issues

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In Arkansas, over 70% of people were disenrolled due to procedural issues, raising serious concerns about the state’s notification process. 

Florida’s Frustrations

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Long phone wait times and unclear notices have plagued Florida’s Medicaid review, leading advocates to criticize CMS for its reluctance to address these issues.

Urgent Calls for Intervention as Systemic Issues Persist

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Despite the dire situation, CMS has not intervened to halt disenrollments in states like Arkansas, where procedural issues have resulted in significant removals.

Advocates argue that these problems go beyond anomalies and point to systemic issues that need immediate attention.

Americans on the Brink as Biden Administration Faces Medicaid Enrollments Crisis

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As states grapple with flawed reviews and individuals face the imminent loss of vital Medicaid coverage, the Biden administration finds itself under increasing scrutiny for its perceived inaction.

The health and well-being of millions of Americans hangs in the balance, emphasizing the urgency of addressing these systemic failures in the Medicaid enrollment process.

The post Medicaid Under Scrutiny – Efforts to Address Potential Disenrollment of Millions Amid State Review Processes first appeared on Thrifty Guardian.

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