Child advocacy group presses KDHE for details of application impediments
TOPEKA — A Kansas advocacy organization said state records indicated children comprised two-thirds of the 45,000 people who have lost Medicaid coverage for procedural reasons since the restart in April of eligibility assessments halted during the COVID-19 emergency.
Kansas Action for Children, a nonprofit and nonpartisan organization in Topeka, said Kansas Department of Health and Environment statistics showed 62.3% of Kansans dropped from KanCare because of application issues were children.
“As children’s coverage has been discontinued until their caregivers submit the renewal form or reapply, this will cause a significant disruption to kids receiving time-sensitive health services,” said Heather Braum, health policy Advisor of Kansas Action for Children. “Sadly, their caregivers might not even know coverage has been discontinued until trying to access services for their children.”
KAC said the exodus of children from Medicaid appeared most significant in the counties of Chautauqua, Clark, Decatur, Finney, Ford, Grant, Gray, Greeley, Hamilton, Rawlins, Seward, Stanton, Stevens, Thomas and Wyandotte.
In response to the COVID-19 pandemic, the federal government suspended eligibility reviews to allow families across the United States to remain on Medicaid. Nationally, Medicaid enrollment surged from 71 million in February 2020 to 93 million in February 2023.
In Kansas, nearly 130,000 Kansans were added to KanCare during the three-year suspension. That hiatus in annual eligibility evaluations was lifted in April, which launched a 12-month review cycle in the states and territories. That meant about one-fourth of 530,000 Kansans in KanCare would be drawn into the eligibility process. Magnitude of the assessment bottleneck in Kansas and other states has proven difficult for program administrators.
KFF News, formerly known as Kaiser Health News, reported 3.8 million Medicaid enrollees in 39 states and the District of Columbia had been disenrolled from Medicaid as of Monday. Across all states with available data, KFF said, 74% of people disenrolled had coverage terminated for procedural reasons.
The federal Centers for Medicare and Medicaid Services previously said four of five people dropped from Medicaid lost those benefits due to procedural complications.
The great unwinding
April Holman, executive director of Alliance for Healthy Kansans, said the inability of Kansas to approve eligibility expansion of Medicaid created a coverage gap for low-wage parents and their children who didn’t have alternatives for affordable health care coverage.
She said the ongoing Medicaid redetermination process, also referred to as “unwinding,” placed Kansas children at a disadvantage compared to youth in neighboring states.
“Though the data available for each state in the unwinding process varies, it is clear that Kansans are in a more precarious position with the Medicaid unwinding than working families in states that have moved forward to ensure access to affordable health care,” Holman said. “Unlike Kansans, individuals in Missouri, Oklahoma, Nebraska and Colorado, along with 36 other expansion states, don’t need to worry about falling in the coverage gap.”
She said the quickest and most effective way to protect Kansans from losing health coverage under Medicaid was to expand KanCare — the name of Kansas’ Medicaid program. She said the reform could lower rates of infant mortality and raise high school graduation rates. It would narrow racial disparities in health coverage and outcomes while enhancing services for mental and behavioral care, Holman said.
“By providing affordable health coverage to low-wage parents, we can protect Kansas children and ensure they have access to the health care they deserve.
Braum said information released by KDHE didn’t reveal precisely why individuals were dropped from Medicaid by the agency and placed in a pool of people given 90 days to reapply or otherwise complete applications. While families have the option of continuing the application process, concerns have been raised about individuals not fully understanding their responsibilities in the process.
“One thing is clear, though, greater outreach is needed for all KanCare members, especially to families whose children are likely still eligible for coverage even if adults in the household are not,” she said.
Inside the numbers
According to KDHE, at the end of June the agency had sent 275,647 Kansans renewal letters for KanCare. Overall, 29,012 individuals had been renewed and 7,432 were notified they weren’t eligible. At the same time, 45,837 individuals had their Medicaid coverage discontinued for procedural reasons. It’s unclear how many people had submitted renewal forms that had yet to be processed.
Kansas officials began by sending renewal notices 30 days before they were due from applicants, but other states granted applicants weeks longer to respond.
KDHE didn’t respond to a request Monday for comment about what steps might be taken by the agency to address the large number of discontinuations involving children. KDHE spokesperson Philip Harris said KDHE did temporarily pause procedural disenrollments until June 18 due to mail-service disruptions.
That grace period was designed to give the agency an opportunity to find the “permanent solution” to application challenges, said Christine Osterlund, deputy operations chief for the state’s Medicaid office.
Kelly said at that time the complexity of the Medicaid unwinding process affirmed the need to expand eligibility for the program in Kansas. The Kansas Legislature, which is led by Republicans in the House and Senate, has fought off attempts by Kelly to gain legislative approval of KanCare expansion.
“It will boost our economy, bring hard-earned tax dollars back to our state and, most importantly, save lives,” Kelly said.
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