© 2024 Kansas City Public Radio
NPR in Kansas City
Play Live Radio
Next Up:
0:00 0:00
Available On Air Stations

Missouri resumes annual vetting of Medicaid patients in April, as COVID-era protections end

Nia Sumpter holds her son Zacheriah at the Lewis and Clark Branch of the St. Louis County Library in early February 2022.
Sarah Fentem
St. Louis Public Radio
Patient advocate Nia Sumpter, shown with her son Zacheriah, was one of more than 250,000 people who became eligible for Medicaid when Missouri expanded the program to low-income adults. Starting April 1, Sumpter and other Medicaid recipients will need to submit annual re-enrollment forms for the first time since the start of the pandemic.

Missouri health officials will soon begin examining who is eligible for the state’s Medicaid program after a three-year pandemic pause, a development that’s expected to lead to close to 200,000 people losing coverage.

During the pandemic, the federal government prevented states from kicking people off Medicaid insurance. That provision ends April 1. Starting next week, Missouri will resume reviewing enrollees' income and other data to see if they still qualify for MO HealthNet, the state’s Medicaid health insurance program.

“We know there will be individuals who will not be eligible,” said Kim Evans, director of the state’s Family Support Services Division. “There are cases we have not touched in three years.”

Medicaid is the government-sponsored health insurance program for adults and children who have disabilities or who fall below a certain income threshold. To receive benefits, enrollees need to report how much money they make to the state.

Around one in four Missourians — or 1.5 million people — are enrolled in Medicaid, the most in the state’s history. Department of Social Services officials said during a press conference Tuesday that the record number of enrollees is partly due to the federal pause and partly because a 2020 voter-backed initiative in Missouri expanded the program to more low-income people.

While the moratorium on kicking people off the program was tied to the public health emergency, the expansion of Medicaid to more of the state’s poor people was not pandemic-related, said Todd Richardson, the state’s Medicaid director. After the state’s vetting of residents begins, people who qualify because of the expansion will still be able to receive benefits.

Richardson said he’s sure some people will drop off the rolls once the state once again begins renewing eligibility.

“As we start to get into June and July and the start of the upcoming fiscal year, we do think enrollment will come down from this historic time,” Richardson said. “We built our budget around that expectation.”

People may lose their coverage because they now make too much money to qualify. But some benefit-eligible people could also lose coverage if the state is unable to find information that proves their income level, said Evans, of the Family Support Services Division.

State workers are encouraging enrollees to update their information on the DSS website so the department can contact them if more information is needed to prove eligibility.

Missouri this year has also begun using data from the U.S. Postal Service and the state’s Supplemental Nutrition Assistance Program to look up information about people. It’s possible that the state could determine whether someone qualifies for Medicaid without soliciting any information at all.

“Our hopes are that we can complete most of these without having to have additional contact with the individual, and they’ll just get a letter from us telling them of the final decision,” Evans said.

The state’s vetting process won’t happen all at once. Instead, the state will review batches of enrollees month by month, based on when enrollees would normally renew their coverage for the next year.

People should be on the lookout for mail in the two months before their annual renewal month, Evans said.

Evans and Richardson said the yearslong project of determining eligibility is an unprecedented challenge for the state’s Medicaid program.

Family Support Services has 200 employee vacancies it’s trying to fill, officials said. Even so, Evans is optimistic the state can handle the load.

“I feel like we’re little elves running around,” she said. “But I feel very confident we’re moving forward with this.”

The state is deploying video tutorials, live chat functions and in-person help centers in every Missouri county to help walk Medicaid patients through the renewal process, Evans said.

Sarah Fentem is the health reporter at St. Louis Public Radio.
KCUR serves the Kansas City region with breaking news and award-winning podcasts.
Your donation helps keep nonprofit journalism free and available for everyone.