Editorials

Why is Missouri dropping thousands of children from its Medicaid rolls?

Missouri’s health care challenges

Star readers said their biggest health care concerns are cost and lack of access, especially for those with pre-existing conditions. Missouri faces several challenges on those fronts.
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Star readers said their biggest health care concerns are cost and lack of access, especially for those with pre-existing conditions. Missouri faces several challenges on those fronts.

Amber Ozga knows one thing for sure about her 10-year-old son, Chase Henderson: He needs his meds.

He needs them every day. Otherwise, his school days can go south in a haze of misbehavior, academic struggles and lousy relations with other students.

“Chase doesn’t do well off his meds,” Ozga of Kansas City said.

But she can’t get all the medications that her son needs for a simple reason: He’s been booted off Medicaid, the health coverage program for the poor, even though Ozga’s financial situation hasn’t changed.

Ozga got a letter this month pointing out that Chase is one of her sons who “do not qualify.” That was a switch from December when he did qualify. But a month later, Chase was out. Like a lot of poor folks, Ozga had moved and hadn’t immediately received a letter from the Missouri Social Services Department asking for responses to eligibility questions.

Once she did get the letter, it was too late to get his coverage restored quickly. Now Ozga is on the hook for $268 for a month’s supply of an anti-depressants that will help Chase get through his days. She doesn’t have that kind of money.

Turns out that Chase is one of tens of thousands of children the state dropped from the program in recent months because of newly reinstituted eligibility reviews.

“The annual review process is lengthy and difficult for families to navigate, causing many eligible children to lose coverage,” says a fact sheet from Legal Services of Eastern Missouri, which helps families with the program.

Statistics show that nationally, Medicaid enrollment dropped 2.6 percent last year, but by 7.2 percent in Missouri. That’s 70,000 people, including more than 50,000 kids.

“This is the biggest drop in Missouri we’ve seen since 2005,” said Timothy McBride, chairman of Missouri’s MOHealthNET Oversight Committee, which advises the state Medicaid program.

Missouri officials cite several factors explaining the drop, including an improved economy. But Joel Ferber of Legal Services of Eastern Missouri is concerned that Missouri Medicaid “is programmed to cut folks off if they don’t respond to one of these letters.” Then, when they seek help through a call center, they wind up on hold for hours or sometimes cut off altogether.

Ozga has been there and has even taken time off work to call the center, a time-consuming task that sometimes includes a two-hour wait. At times, Ferber said, two-thirds of calls get deflected, meaning that callers have to start all over again.

“You can’t get the in-person assistance you need,” Ferber said. “That’s a glitch in the system.”

State Sen. Scott Sifton, an Affton Democrat, is seeking answers to his questions about the dramatic enrollment decline. “The reasons given by the state for taking health care away from 57,000 children do not add up,” he wrote to the state Medicaid director.

It makes sense to periodically check on Medicaid eligibility. But Missouri should hire more workers to reach out to those in jeopardy of losing coverage. Relying on the U.S. Postal Service to contact a highly transient population doesn’t appear to be an effective strategy. And the state’s Medicaid call center should be overhauled.

“The process,” McBride said, “is breaking down because we don’t understand the situations of low-income people.”

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