The Coming Medicaid Purge

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      eridani
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      https://www.dailyposter.com/the-coming-medicaid-purge/#comments

      In some states, there won’t be an opportunity for the legislature to increase funding or find other ways to address the coming wave of redeterminations before it happens, because many legislatures aren’t in session most of the time. In Oregon, lawmakers are frantically trying to pass a bill that would ease the transition, or provide a “bridge” of coverage for enrollees who no longer qualify, before their legislative session ends on May 27. The state has also applied for a federal waiver that would allow them to determine eligibility only once every two years, instead of annually, as currently required by law.

      The state’s Medicaid director told MACPAC in January that he wasn’t optimistic that the legislature would act in time: “I have one bite at the apple to get any budget issues resolved, any policy changes resolved, and I don’t think we are going to be able to because things are too fluid.”

      That fluidity is cutting into an already tight window for making the necessary changes to the program. “Even just reprogramming the computer system to do its renewals” can be a challenge, Brooks said in an interview last month. It can take four to six weeks to get a change to IT systems in a programming queue, she said, which is already over half of the 60-day window states will have before the extra funding runs out. Every state has its own system to update. A Commonwealth Fund blog post last year argued that states updating their electronic renewal processes to maximize automatic renewals without needing input from beneficiaries is “the most important single step states and CMS can take to avoid coverage losses.”

      States know this huge administrative task that will cost millions of dollars is looming, but they don’t know how soon, or how much notice they’ll get. They can’t easily get more money for staff from the legislature, and even if they could, training that staff to conduct redeterminations is time-consuming. And the longer it takes to do all this, the more it costs them.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

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