Centers for Medicare and Medicaid Services (CMS)

Since the federal public health emergency was declared in March 2020, states have been barred from removing enrollees from Medicaid, in exchange for enhanced federal funds. That pause on conducting eligibility redeterminations will end April 1.

Missouri on average took 41 days to process a Medicaid application in September for the eligibility group which includes low-income children, pregnant people, families and adults.

State officials declared the backlog of Medicaid applications "no more" and expressed optimism they would meet a federal deadline set for the end of the month. The state's processing time had grown to 115 days, far longer than allowed under law.

The federal government requires states to process Medicaid applications within 45 days. But in Missouri, roughly four in every five applications took longer to process than that, eight times the national average.

Missouri’s Medicaid program is now operating under a CMS-approved mitigation plan, which seeks to curb wait times that reached 115 days in late June — more than double what federal laws allow.

Federal rules give states a maximum turnaround time of 45 days to process Medicaid applications. In April, Missouri took an average of 101 days to process a signup.

Under the bill, facilities can still limit things like visitor movements and the number of visitors per patient, but cannot require patients be vaccinated against any disease to receive treatment or visitors. Experts warn it could cause a conflict between state and federal requirements.

During the pandemic, a federal mandate said states could not kick people off Medicaid, even if they were no longer eligible for the benefit. That will change if the public health emergency is lifted.

A federal mandate will soon require all U.S. nursing homes to vaccinate their workers or risk losing government funding. But some worry vaccine mandates will worsen staff shortages.

A little over a quarter of the more than 17,000 applications the state has received have received approval since August.

While the state is accepting applications for Medicaid coverage under expanded eligibility, it says it can't start processing those applications before October 1.

On average, about 62% of Johnson County employees who work in federally-licensed nursing homes and long-term care facilities are vaccinated.