Missourians who need expanded Medicaid coverage still have to wait far too long

Medicaid remains unexpanded in Missouri, nine months after voters ordered lawmakers to provide the service, and one month after the state Supreme Court affirmed that order.

The continuing delay is a failure of leadership that starts with Gov. Mike Parson and trickles all through the state bureaucracy. It ensures weeks of continued suffering for the working poor, who can’t get the coverage they need and are owed.

Missouri must do more to get them a Medicaid insurance card.

It isn’t clear why it’s taking so long. In early August, in a video provided to state employees (and later to The Star Editorial Board), Missouri Family Services Director Kim Evans said training and computer changes would delay Medicaid verification until Oct. 1.

“We need to be ready with all of our training, our policy, everything that we need for Oct. 1,” she said. “While people can start applying now, the applications will sit there until we have the eligibility piece in, which will be Oct. 1.”

Why will they “sit there?”

Her statement reflects the fine print on the application website operated by the Missouri Department of Social Services. “If you are applying for the new adult expansion coverage, applications will not be processed until after Oct. 1, 2021,” it says.

There are indications the state will make Medicaid benefits retroactive to a client’s application date — after the application is verified and approved. “We will take their coverage back … based on their application date,” Evans says in the video.

That echoes an Aug. 11 statement from Parson’s office. It said potential Medicaid clients “may be reimbursed” for health expenses incurred between the application date and verification.

But that will be small comfort to the hundreds of thousands of Missourians waiting for full access to expanded Medicaid. Who would incur thousands of dollars in health expenses hoping those costs “may” be repaid at a later date? Especially by Missouri, which continues to resist providing the health care the law requires?

Who would risk a denial of coverage, and huge hospital bills later? No one.

And what health care providers — hospitals, clinics, doctors’ offices — would accept patients who have applied for Medicaid, but who have not been verified and fully enrolled? Not many.

The outcome seems clear: Medicaid will not be fully expanded in Missouri until early October.

“They’re basically telling these folks to wait,” said Chuck Hatfield, the attorney for the plaintiffs who sued to force Missouri to honor Medicaid expansion.

We still encourage Missourians who believe they are eligible for expanded Medicaid coverage to begin the application process, if they have not already. There is preliminary work the state can do so the final verification can take place close to Oct. 1.

But we would also encourage plain speaking from Gov. Parson and his administration. The state needs an explicit promise from Parson that benefits will be paid retroactive to a client’s application date once the application is verified. Doctors and hospitals should take that promise at face value.

Then the governor could urge state employees to move as quickly as possible to finish the verification process. He might also explain to the state why it has taken so long for training and software improvements to be initiated, or why Missouri seems so unprepared to take these Medicaid applications.

“What were they doing?” Hatfield asked.

This is not a dispute over some trivial matter. It involves poor people who are sick and want the health insurance to which they are entitled. It involves a state government far too willing to ignore the law and the suffering from hundreds of thousands of people.

They’ve already had to wait too long.