Thousands of Alaskans lose Medicaid as state reviews eligibility
August 30, 2023
The number of Alaskans covered by Medicaid has dropped by more than 14,000 since April, after federal protections for the health care benefits ended with expiration of the COVID-19 emergency declaration.
The number losing their benefits may increase as the state continues the process of determining who still meets eligibility requirements — the reviews were halted during the national emergency declaration.
And while many Alaskans are losing their coverage or waiting to hear if they will, the state’s Health Department continues working to clear a backlog of new Medicaid applicants that has piled up at the Division of Public Assistance since last year.
The federal government recently told the Department of Health that it is concerned about the lost-coverage rate and also how delays in processing new applications may impede equitable access to care and exceed time limits for determining whether applicants for Medicaid are eligible.
Medicaid is the primary health coverage for low-income Americans. As of the end of the state’s 2022 fiscal year last June, almost 500 Wrangell households were receiving Medicaid benefits — close to half the households in the community.
State officials say they’re making progress on processing Medicaid applications, but another issue – a simultaneous backlog in food stamp applications — has been a priority.
The Centers for Medicare and Medicaid Services sent letters to all states that assessed their performance on three measurements — call center performance, paperwork issues and slow processing times. Most are behind on at least one. Only Alaska, Florida, Montana, New Mexico and Rhode Island are behind on all three.
The periodic checks on whether people remain Medicaid-eligible, known as “redeterminations” or “renewals” were halted by the federal government at the beginning of the pandemic in 2020 and restarted in May. Eligibility depends on income and other factors, such as pregnancy.
The state has processed nearly 19,000 of the roughly 260,000 redeterminations it must make in the next year and a half. Of the redeterminations the state has reported, nearly 30% of Alaskans lost coverage because of problems with their paperwork. The federal government said the high rate indicates that people aren’t getting notices to renew, that they cannot understand them or that they are unable to submit their new forms.
Workers have completed a small part of a large task of redeterminations and already many Alaskans have lost coverage. Medicaid enrollment in Alaska dropped by 14,398, from 264,649 on April 30 to 250,251 by the end of July, according to state statistics.
The state began the renewal process in spring. In May and June, it looked at 4,000 renewals each month. In each of those months, roughly 3,000 Alaskans came off the Medicaid rolls as a result, whether because they were found ineligible or had not completed their paperwork.
Deb Etheridge, who became the director of the Division of Public Assistance earlier this year, said she is working with a data consultant to better understand the reasons behind the paperwork issues.
The backlog of food stamp applications affects roughly 19,000 Alaskans. State workers say the backlogs are a result of chronic understaffing and deep workforce cuts as well as outdated computer systems. As a result of the efforts to dig out from under the two backlogs, the state is late in processing 40% of new Medicaid applications.
“Until we’re sort of cleared of that backlog, they’re always going to be factored into our timeliness” handling new applications, Etheridge said.
She said the state has already made progress on the food stamp backlog, with only 3,000 applications left to determine their eligibility. Etheridge aims to have those processed by October.
Alaska has more time than other states to finish processing Medicaid renewals. Most states have 12 months to process Medicaid renewals and remove people who no longer qualify for coverage. However, Alaska’s high rural population contributed to a federal extension that gives the state 18 months to review the roughly quarter-million residents who are enrolled in Medicaid.
Etheridge said people usually have 90 days to get late paperwork to the state after they lose Medicaid coverage, but while these renewals are happening the state has doubled that to 180 days.
The Legislature in March approved a fast-track spending bill to hire more staff for the Division of Public Assistance. Five months after the funding was appropriated, Etheridge is waiting for the state to post 15 new job openings.
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