Arkansas Medicaid eligibility review expected to start in January – DHS officials

The Arkansas Department of Human Services is ready to “unwind” Medicaid coverage for thousands of Arkansans who gained access to the health insurance program when the federal government declared a public health emergency in 2020, officials said Friday.

The public health emergency (PHE) declared at the start of the COVID-19 pandemic will likely end in January, with an announcement expected in the next week,  DHS officials said during a media briefing.

DHS will then review the enrollment of 385,650 Medicaid clients who might no longer be eligible but had their coverage extended through an agreement written into Congress’ first coronavirus relief law in 2020.

This means all Medicaid clients need to be sure their contact information is up to date in the state’s system, either online, over the phone or at the DHS office in each county, department officials said. 

According to the department, “unwinding the PHE” will be DHS’ most complex undertaking since the Affordable Care Act was implemented about a decade ago.

“[We need] individuals engaging in that process and letting us know of any changes or any updates to their information,” state Medicaid Director Dawn Stehle said. “It’s going to be important to have that so we can determine whether or not they’re still eligible.”

In return for more Medicaid funds from the federal government, all 50 states agreed in March 2020 not to remove people from the program unless they had died, become incarcerated, moved out of state or asked to be removed from coverage.

Arkansas’ Medicaid enrollment has grown 22.8% since then, adding 209,883 people as of September, according to DHS data provided Friday.

Managing the review

DHS is required by a 2021 law to complete all 385,650 reevaluations within 180 days, or about six months, of the PHE ending.

“During that same time, we’ll still be doing our regular renewal business,” DHS Secretary Mark White said. “Medicaid clients typically come up every year, and we have to redetermine their eligibility. We’ll stick to that same schedule over the course of those six months and then in the remainder of the year.”

DHS plans to reestablish a Medicaid renewal schedule that is “sustainable moving forward,” since the Medicaid division will be processing more renewals than usual during those six months, said Mary Franklin, director of the department’s Division of County Operations.

Department officials estimated in January that 30% of Medicaid recipients, or roughly 335,500 people, could be disenrolled during the review process. Additionally, several groups estimated earlier this year that between 15-16 million Americans on Medicaid are now ineligible.

The department will help newly Medicaid-ineligible Arkansans find new sources of health coverage, Franklin said.

The 385,650 extended clients as of Oct. 17 make up 34% of the state’s total Medicaid population, according to DHS data. Clients might be ineligible for Medicaid now because of higher income, a change in their level of health care, aging out of the program or not responding to a DHS request for information in order to be renewed.

White said the last group is difficult to pin down.

“We don’t have any good way of knowing for these folks if they are no longer eligible or if they’ve just not responded to their renewals,” he said.

Clients can update their contact information by calling the Update Arkansas hotline at 1-844-872-2660 or visiting DHS’ benefits site.

So far 107,000 clients have confirmed or updated their addresses on the Update Arkansas website, Stehle said.

Getting the word out

The federal government is required to warn states at least 60 days in advance of the end of the PHE. If the PHE will not be extended past Jan. 11, 2023, the warning will be no later than Nov. 11.

DHS officials said Friday they expect the announcement next week but have not heard any confirmation that it will happen.

“Based on what I’ll call chatter nationally, both in the press and what we’ve heard from other states, they have not committed to anything, but at least in the things they are saying, it points this direction,” White said.

Even before the announcement, DHS is laying the groundwork for potentially ineligible Medicaid clients to know their enrollment will be reviewed, Stehle said. The department is conducting both a digital and in-person outreach campaign.

“We have teams of our nurses and other individuals who are reaching out to them, going out to those clients’ homes and where they live, making sure that they know that this is happening [so they can] go ahead and get their information updated,” she said.

Health care providers share some of the responsibility for reaching these clients, Stehle said, and they will receive lists of their clients who are at risk of losing coverage under certain adult Medicaid programs and the state’s childhood program, ARKids First.

Providers also need to ensure their Medicaid certification is up to date as the public health emergency winds down, Stehle said. They were not required to do this during the PHE, but they will be required to do so again after it ends, she said.

“Even though they didn’t have to do it, many of the providers have chosen to go ahead and get that done,” Stehle said.