The Arkansas Department of Human Services said it disenrolled 43,385 Medicaid beneficiaries whose coverage had been extended because of the COVID public health emergency in the month of May, the second month Arkansas could do so under federal rules.
Another 24,453 cases were closed as part of DHS’s normal operations, bringing the total closures for the month to 68,838. Among the cases due in May, coverage was renewed for 39,848 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. The state’s Medicaid rolls rose by 230,000 total during the pandemic.
The federal Consolidated Appropriations Act, signed into law last December by President Joe Biden, 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.
In April, DHS disenrolled 44,667 extended Medicaid beneficiaries and 72,802 total, with the rest occurring as part of normal operations.
The most common reason for closing a case in May was the failure of recipients to return the renewal form. That was 31,754 total cases and included 24,891 extended cases and 6,863 regular cases.
The other reasons for closure were as follows:
- Failure to return requested information: 9,900 total; 2,926 extended; 6,974 regular;
- Household income is above limit for household size: 8,287 total; 5,354 extended; 2,933 regular;
- Client requested closure: 6,412 total; 3,307 extended; 3,105 regular; and
- Unable to locate – returned mail: 3,093 total; 1,721 extended; 1,372 regular.
Broken down by category of assistance, 19,953 of the extended beneficiaries disenrolled in May were part of the ARHOME program, the state’s Medicaid expansion program created under Obamacare. Another 9,462 ARHOME beneficiaries lost coverage because of regular DHS operations, for a total of 29,415.
Coverage was removed from 12,108 extended beneficiaries in the ARKids First A program, the program that serves children. Another 8,404 cases were closed as part of regular operations, for a total of 20,512.
In the ARKids First B program, which serves children whose parents make too much money to qualify for regular Medicaid, there were 404 extended cases and 925 regular cases closed, for a total of 1,329.
Another category of beneficiaries are those 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, 7,435 extended cases and 3,378 regular cases were closed, for a total of 10,813.
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, 2,400 extended cases and 1,479 regular cases were closed, for a total of 3,879.
The department said last month that it averaged 25,000 monthly disenrollments in 2018 and 2019 before the pandemic began.
The department said in a press release that this month’s disenrollments follow more than a year of outreach when DHS called recipients, met with providers and stakeholders, and conducted an awareness campaign to encourage them to return their renewal applications. It said beneficiaries are sent multiple notices by mail, with later ones advising them their case will be closed if they don’t respond or are found to be ineligible. The department said it also tries to reach recipients by text, email and/or phone if possible.
DHS said it had made a special effort to reach families with children covered by Medicaid, including by providing pediatricians lists of patients who could be disenrolled. DHS has distributed materials to families through school districts, school nurses, and libraries, and has contacted families directly.
It said it believes that many individuals whose cases have been closed did not return their application packet because they knew they would no longer qualify.
There is a grace period to help those who may fall through the cracks. Recipients who were disenrolled but still qualify usually can have their coverage reinstated without a gap if they provide their information within 30 or 90 days after their cases are closed. Individuals who later learn their coverage has ended can reapply and have retroactive coverage back to the date of reapplication.
DHS in its press release said eligible beneficiaries when possible have had coverage renewed automatically through a process where data was checked against existing sources rather than requiring information to be submitted by beneficiaries. DHS is using that technique more than in the past and renewed more than 29,000 recipients that way in May.
Beneficiaries can get more information at ar.gov/renew.