DHS officials say redetermination numbers meeting estimates, work requirement waiver in ‘negotiation’ phase with feds

Nearly halfway through a six-month process to redetermine Medicaid eligibility for hundreds of thousands of Arkansans, Department of Human Services officials said they believe estimates of where the population would land are close to projections.

DHS Secretary Kristi Putnam and Arkansas Medicaid Director Janet Mann appeared on this week’s edition of Capitol View and Talk Business & Politics. According to figures released by the agency in June, nearly 140,000 Arkansans have been disenrolled from the Medicaid expansion program, now known as ARHOME, or had their cases closed through regular program operations. New figures are expected to be released in mid-July.

“We do feel that they are tracking. We chose to do our extended category first with our regular renewals, because we had worked through the three-year pandemic on redeterminations, and if we determined that they would most likely be ineligible, we put them in the extended category. So we started with that, those categories first, to really work on right-sizing our population,” Mann said.

During the COVID-19 pandemic then President Donald Trump stopped disenrolling most Medicaid beneficiaries as part of the public health emergency. Arkansas’ Medicaid rolls rose by 230,000 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 are slated to be redetermined. State law requires that the work be completed in six months.

“We have done a great deal of outreach,” Putnam said. “It is a lengthy process that starts either 90 days or 120 days with the notification going out initially, and then there’s a series of follow-ups… this also requires participation by the individuals who are receiving services.”

“So because we started with the category of individuals who’d had their Medicaid coverage extended, that’s going to have the higher number of people who are probably no longer eligible. Because they’ve been extended, many of them have been employed since then, they may have an increase in their income,” Putnam added.

Mann said that stakeholders and health groups that have raised issues with Arkansas’ disenrollment numbers have been made fully aware of DHS’ processes – which have undertaken over the last 15 months – and they are invited to attend a weekly conference call where concerns are addressed and new information is provided.

“We still hold a weekly provider/stakeholder call. Anyone is welcome to attend, to ask questions, and work with team members. But then we spent a great deal amount of time internally at DHS, working on our systems, working on our teams, making sure we had enough support. And not just with the caseworkers, but also with our program staff,” Mann said.

“I think that there’s a larger conversation behind the reaction, the anger, the outcry, so to speak, over the disenrollments, because there are many people who believe that we should have Medicaid for all,” Putnam  added. “The automatic conclusion that when someone moves off of Medicaid, that they are uninsured is one of the other misconceptions. Because there are eligibility [avenues] through employers, there’s eligibility through the federal marketplace. And part of our process has been to enhance the ways that we’re trying to connect individuals to their other coverages.”

Putnam and Mann also discussed the federal waiver Arkansas has requested to mandate a work requirement for Medicaid expansion eligibility. The waiver, which has been submitted to the federal Centers for Medicare and Medicaid Services (CMS), would require ARHOME recipients to work, go to school or volunteer in order to continue receiving expansion insurance benefits. Otherwise, they would be shifted to traditional Medicaid.

DHS says CMS will raise questions about their waiver application, which will begin a “negotiation” process for the state to show how it plans to address federal health officials’ concerns.

You can watch the full interview with Putnam and Mann in the video below.