State disenrolls 44,667 extended Medicaid beneficiaries; 72,802 total

The Arkansas Department of Human Services said it disenrolled 44,667 Medicaid beneficiaries whose coverage had been extended because of the COVID-19 public health emergency in the month of April – the first month Arkansas could do so under federal rules.

Another 28,135 cases were closed as part of DHS’s normal operations, bringing the total for the month to 72,802. The department said in a press release that it averaged 25,000 monthly disenrollments in 2018 and 2019 before the pandemic began. Among the cases due in April, coverage was renewed for 61,236 beneficiaries.

Arkansas stopped disenrolling most Medicaid beneficiaries after former President Donald Trump on March 18, 2020, signed the Families First Coronavirus Response Act. It increased federal Medicaid matching funds for states that kept all individual cases active during the public health emergency.

DHS this month started making the removals as a result of the federal Consolidated Appropriations Act, signed into law last December. It allowed states after March 31 to begin dropping Medicaid recipients who are no longer eligible. Normal eligibility rules, set by Congress and the Centers for Medicare and Medicaid Services, resumed April 1. All beneficiaries who have not had a renewal in the last 12 months will be redetermined. State law requires that the work be completed in six months.

A press release said the department expects enrollment to continue to decline in the coming months. Enrollment is still 145,475 beneficiaries higher than it was at the beginning of the pandemic. It was 921,066 on March 31, 2020. On May 1, it was 1,066,541. The state’s Medicaid numbers rose by 230,000 total during the pandemic.

Broken down by category of assistance, 18,561 of the disenrolled extended beneficiaries were part of the ARHOME program, the state’s Medicaid expansion program created under Obamacare. Another 9,662 ARHOME beneficiaries lost their coverage because of regular DHS operations. Coverage was removed from 14,242 extended beneficiaries in the ARKids First A program, the program that serves children. Another 9,595 cases were closed as part of regular operations. In the ARKids First B program, which serves children whose parents make too much money to qualify for regular Medicaid, there were 1,085 extended cases and 778 regular cases closed.

One of the two other categories of beneficiaries were those who were served by the Parents or Other Caretaker Relative program, which covers adults with related minor children in the home for whom they exercise care. In that category, 7,944 extended cases and 4,962 regular cases were closed.

Finally, the state’s newborn program provides full coverage to children up to age 1 whose mothers were eligible for services at the time of their birth. They are guaranteed coverage their first year of life regardless of income changes occurring in the home. In that category, 1,929 extended cases and 1,438 regular cases were closed.

By far the most common reason for closing a case was the failure of recipients to return the renewal form. That was 44,714 total cases and included 35,625 extended cases and 9,089 regular cases. The other reasons for closure were as follows.
• Failure to return requested information: 7,673 total; 1,596 extended; 6,077 regular
• Client requested closure: 5,791 total; 2,685 extended; 3,106 regular
• Household income is above limit for household size: 5,414 total; 1,485 extended; 3.929 regular
• Unable to locate – returned mail: 2,024 total; 739 extended; 1,285 regular

DHS began ramping up its preparations for the unwinding in January 2022. It has tested its systems through a variety of scenarios. Testing will continue throughout the process. More than a year ago, it contracted temporary workers to help with eligibility determinations. It has made phone calls, met with providers and others, and conducted awareness campaigns to try to inform beneficiaries of the change.

Last month, Mary Franklin, director of the DHS Division of County Operations, said at a webinar sponsored by Arkansas Advocates for Children and Families that the state continued to process applications and renewals throughout the three years of the public health emergency but kept individuals enrolled even when their incomes exceeded eligibility limits, when they didn’t respond to DHS communications, when their level of care for long-term supports changed, or when they aged out of eligibility. Cases were closed when individuals died, were incarcerated, moved out of state or asked to be removed.

The department said disenrolled beneficiaries can access insurance from other sources, including their employer or through the health insurance marketplace. The disenrolled can appeal the disenrollment and can get more information at this link.