Children are losing Medicaid coverage in Missouri due to procedural reasons

COLUMBIA, Mo. (KMIZ)

Almost 40,000 Missouri children have lost Medicaid coverage since the renewal process began, with the majority of them losing it due to what's called "procedural reasons."

ABC 17 News has previously reported that procedural reasons can include anything from people not completing the necessary documentation, not having updated contact information to be reached by the state department or the state determining they are no longer eligible due to electronic data.

The renewal process began in June, and according to data from the Department of Social Services, 39,918 children have lost coverage. Of that, 11,543 have been deemed ineligible, while 28,375 have lost coverage due to procedural reasons.

Sheldon Weisgrau -- vice president of health policy and advocacy at Missouri Foundation for Health -- said it's concerning that most children are losing coverage not because they're ineligible, but because of procedural reasons.

"It is very concerning, because we obviously want to create a system where as many children as possible have health coverage," Weisgrau said.

Department of Social Services spokesperson Caitlin Whaley said children make up the majority of Missourians currently covered by Medicaid.

"While the numbers are definitely concerning and we're constantly evaluating ways that we can better reach families, it is roughly proportionate to the number of children that are enrolled in the program overall," Whaley said.

She said the income guidelines for children are much higher than adults, contributing to the large amount of children enrolled in Medicaid. She said it's not uncommon that children are on Medicaid while their parents are not.

In response to the high number of children due for renewal, she said the department has began targeting their messaging and advertising to better connect with parents who may have a child that's covered my Medicaid.

"Just make sure that they understand that it is essential that when they get mail from us, that they're paying attention, that they're returning those forms either through the mail or through our online portal," Whaley said.

To make sure no one loses coverage for procedural reasons, Weisgrau said people need to first make sure their contact information is updated with the state at my.dss.gov/renew. Then, people need to check their mail regularly and return any necessary forms promptly.

"Inevitably, some of these kids are going to turn up at doctor's offices or at pharmacies or in hospital emergency rooms and find out that they no longer have Medicaid coverage," Weisgrau said.

He said one resource that can help people navigate the renewal process is Cover Missouri.

According to the Kaiser Family Foundation, Missouri's disenrollments are split evenly at 50% adults and 50% children.

Whaley said people who lose coverage due to procedural reasons have 90 days after the due date to submit the necessary paperwork and regain coverage. After that, they will need to reapply.

Since renewals began in June, 63,434 people have lost Medicaid coverage because of procedural reasons, with 28,375 of them being children.

In August, 50,424 children were evaluated. Of that number, 26,889 youth were renewed for coverage, meaning a little less than half were either deemed ineligible or still have determinations pending.

2,813 children were deemed ineligible, 10,020 were closed for procedural reasons and 10,702 are still pending.

Whaley said people still receive coverage if their cases are pending.