Governor says state's Medicaid rolls pared by 70,000 this year Advocates for poor contend state makes renewal more difficult than should be

JEFFERSON CITY, Mo. -- While Gov. Mike Parson's administration points to Missouri's improving economy as a reason up to 70,000 people dropped off the state's Medicaid rolls last year, advocates for recipients say problems with the new renewal system for applicants is causing part of the decline.

The system adopted last spring by the Department of Social Services automatically renews a low rate of recipients and has problems accessing data, the advocates say. That contributed to about 70,000 people dropping from the rolls last year, the St. Louis Post-Dispatch reported.

In the first three months of this year, the department said more than 12,000 more people, including 9,500 additional children, no longer have Medicaid coverage.

One problem with the system apparently violates a federal law requiring states to determine Medicaid recipients' eligibility by first checking several sources for patient income information, including the Supplemental Nutrition Assistance Program, formerly known as food stamps. Missouri's renewal system hasn't checked SNAP data since it was implemented last spring.

Joel Ferber, director of advocacy for the Legal Services of Eastern Missouri, said the situation creates a worst-case scenario where recipients never receive a Medicaid application and then find out they've been dropped despite already reporting their income to the state.

"Every child that has needed our help has been eligible for Medicaid or CHIP," Ferber said. "They only lost coverage because their parents were unable to get over the unnecessary bureaucratic hurdles."

St. Louis University law professor Sidney Watson said the likely outcome of violating federal Medicaid regulations would be the state receiving a letter from the Center for Medicare and Medicaid Services instructing the state to fix the problem by a certain time.

"The intent behind those regulations was to assure that when information was available to the state, and it is available to the state, they just have to make the computer system work," Watson said. "There are federal matching funds to create those computer systems to keep them up-to-date. It's a matter of will."

Missouri's renewal program also funnels patients with no income through the manual renewal process even though they clearly qualify for Medicaid. The renewal system for several months was not programmed to allow individuals to consent to the state accessing the recipients' federal income tax information.

Pat Luebbering, director of the Family Support Division of the Department of Social Services, told the MoHealthNet oversight committee last week the state also had mismatching personal identification information with what the federal system required.

The problems meant MoHealthNet had fewer ways to access patient income information, meaning it had less ability to automatically renew patients.

Department of Social Services said in a statement the agency plans to build a new tracking system integrating SNAP with Medicaid eligibility. It is also working with federal officials to find ways to automatically renew Medicaid eligibility reliably through federal data.

The agency said Missouri automatically renewed about 11 percent of Medicaid recipients in recent months. That state is among the bottom 10 states automatically renewing less than a quarter of Medicaid recipients, according to a nationwide report conducted by the Henry J. Kaiser Family Foundation.