Missouri Medicaid expansion: Less than a quarter of applicants now covered


JEFFERSON CITY, Mo. – It’s been almost a week since the state started processing applications for Medicaid expansion and a top official for MO HealthNet says thousands are now covered.

Last August, Missouri voters approved to expand Medicaid to anyone 19 years and older making less than $18,000. Lawmakers chose not to fund it during the legislative session, but the Missouri Supreme Court ruled the state must move forward with it. The state estimates roughly 275,000 Missourians are eligible under expansion.

Starting Oct. 1, the Department of Social Services (DSS) started processing applications. According to the Centers for Medicare and Medicaid Services (CMS), the state has received around 17,000 requests to join Medicaid. Less than a week later, only 4,300 Missourians have coverage.

“There are still pending applications in the queue that are being evaluated for their eligibility,” the chief transformation officer of the MO HealthNet Division told Senate members Thursday. “As of two days ago, we had enrolled about 4,300 members in the expansion population. What the next few months look like, senator, is unknown.”

After a special session over the summer to renew the Federal Reimbursement Allowance (FRA), the tax from health care providers that funds Missouri’s Medicaid program, Senate leaders formed a committee to address some members’ concerns over Medicaid funds going to abortion providers, such as Planned Parenthood and transparency issues.

The Senate Interim Committee on Medicaid Accountability and Taxpayer Protection met for a fourth time Thursday since July. Top Medicaid officials testified in front of the committee, fielding questions about the state’s program.

“I have concerns how well MO HealthNet is able to analyze the data they get in,” committee chairman Sen. Bill White (R-Joplin) said. “We need to have our Medicaid system work properly, we need to have the proper tools and we need to not be running on an archaic system.”

Roughly a sixth of the Show Me State’s population is on Medicaid.

Currently, the state’s application process to participate in all benefits, such as food stamps, childcare, and medical is 60-plus pages long but the department plans to streamline that process.

“We’re able to trim our 63-page application down to about 9 or 10 pages,” Mathews said.

Mathews said implementation was delayed but hopes the state will start using the new system the first of the year.

“We intentionally delayed that implementation because of the confluence of expansion,” Matthews said.

Lawmakers like White are still asking for more transparency from the department about the state’s program.

“That data, as the state is paying for that service, is data that is entitled that us as legislators and you as the department, definitely, should be able to analyze if the system is working,” White said. “I’m frustrated that the data isn’t out there for me as a legislator to know if we need to look at things differently.”

Mathews also explained to the committee how the division is working to create a new revenue source for rural hospitals. It would be called the “hospital health hub.” The initiative would be centered around the area’s population, meaning if a hospital helped a patient make the right health choices by referring them to a food bank if needed.

Last month the committee met to discuss changes that could be made to the program, giving DSS the ability to block abortion providers from Medicaid finding for unethical behavior.

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