WASHINGTON — Days after surgery and with a young son undergoing chemotherapy, Kyle McHenry is scrambling to find out if his Florida family will still be covered by Medicaid next Monday.
A form on the state’s website said coverage for their ailing 5-year-old son, Ryder, had been denied. But another said the family will continue to use Medicaid until next year. However, a letter from the state said McHenry now earns too much for him, his wife and their eldest son to qualify after the end of the month.
Related: A State-by-State Assessment of the Impact of Medicaid Decisions
After three phone calls and a total of six hours of frustration with Florida’s Department of Children and Families, the McHenrys finally got the answer they’ve been dreading on Thursday: Most family members have died. Medicaid coverage, although Ryder is still eligible because of his illness.
“I’m trying not to panic,” McHenry’s wife, Allie McHenry, told The Associated Press earlier this week. The state agency did not respond to the AP’s request for comment.
McHenrys is one of the first victims in an unprecedented nationwide review of 84 million Medicaid enrollees next year that will require states to eliminate people whose incomes are currently too high for the state’s program. federal for the poorest Americans.
Millions of people are expected to go uninsured after being exempted for the past three years during the coronavirus pandemic, as the federal government barred states from removing anyone deemed ineligible.
Advocacy groups have warned for months that there will be a lot of confusion and error in the implementation, leaving some of the country’s poorest people suddenly without health insurance and unable to pay for services. necessary medical care.
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Medicaid enrollees have reported they were mistakenly kicked off in several states that have already started kicking people out, including Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire and South Dakota, according to data compiled by AP collect.
Trevor Hawkins is seeing the issues unfold first-hand in Arkansas, where officials told the AP the state is moving “as quickly as possible” to finish the review before the end of the year.
Hawkins spends his days driving twisty roads across the state, providing free legal services to people who have lost their insurance or need help filling out the form pages the state has mailed them. . Between drives, he gets about half a dozen phone calls daily from people looking for guidance on their Medicaid applications.
“The notices are confusing,” said Hawkins, who works for the Legal Aid Foundation of Arkansas. “No two people have the same experience of losing insurance. It’s hard to pinpoint what the real problem is.”
Some were mailed pre-filled forms that included incorrect household or income information but left Medicaid applicants with no room to correct the state’s error. Hawkins said others have received documents that say Medicaid recipients will lose coverage before they have a chance to reapply. A spokesperson for the Arkansas Department of Human Services said the forms instruct applicants to fill out their information.
Tonya Moore, 49, went weeks without Medicaid because the state used her 21-year-old daughter’s wages, including income from two part-time jobs she no longer worked, to determined that she was ineligible for the program. County officials told Moore she must get reports from businesses — about an hour’s drive from Moore’s country home in Highland, Arkansas — to prove her daughter is no longer working. there anymore. Moore said she was unable to receive the documents prior to her removal from Medicaid on April 1.
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Last week, Moore ran out of her blood pressure medication and insulin used to control her diabetes and was staring at a nearly empty box of blood glucose test strips.
“I was a little scared at the time,” she said at the time. “I don’t know how long it will take to get my insurance.”
Moore has been in Medicaid rehab since Monday with the help of Legal Aid.
The McHenry family, of Winter Park, Florida, also worries the state has mixed up their income while checking their Medicaid eligibility.
After their son Ryder was diagnosed with cancer in September 2021, Allie McHenry quit her job to care for the boy, leaving the family a single income from her job as a diesel mechanic. Kyle McHenry’s heavyweight. She then applied for the family to Medicaid but said they were initially denied because the state miscalculated Ryder’s cancer disability payments as income. She is concerned that the state has included those payments in its latest review but has not been able to get a clear answer, after calling the state three times and being disconnected twice after holding machine for hours.
“Calling them is always a nightmare,” says Allie McHenry of her efforts to contact the state helpline. “I don’t have the heart or the energy to try to call back.”
Notices sent to McHenrys and reviewed by the AP show they received warnings in less than two weeks that they would lose coverage by the end of April. The federal government requires states to notify people just 10 days in advance that they will be removed from Medicaid.
The family’s experience is not surprising. Last year, Congress, worried that some states weren’t equipped to properly handle the number of calls that would flood the lines during Medicaid, asked states to send data on call counts. , wait times and abandonment rates. The agency’s spokesperson said the federal Centers for Medicare and Medicaid Services will try to work with states where call wait times are particularly high.
Some doctors and their staff are letting their patients know about the complex process they will have to navigate over the next year.
Most of the pediatric patients that pediatrician Lisa Costello sees in Morgantown, West Virginia are covered by Medicaid, and she intends to talk to parents about what the process will be like. She is also encouraging her colleagues to do the same. West Virginia officials sent letters to nearly 20,000 people telling them they would lose coverage on Monday.
Some people may not realize that they no longer have Medicaid until they go to fill a prescription or see a doctor in the coming weeks, Costello said.
“Much of it is educating people, ‘You’re going to get this information; don’t throw it away,'” she said. “How many of us get scraps of mail and throw it in the trash because we think it’s not important?”
Every weekday, about a dozen employees at Adelante Healthcare, a small chain of community clinics in Phoenix, call families they believe are at risk of losing Medicaid. Colorful posters on the walls remind families in both English and Spanish to make sure their Medicaid coverage doesn’t lapse.
That’s how Alicia Celaya, a 37-year-old waitress in Phoenix, discovered that she and her children, ages 4, 10 and 16, would lose their insurance by the end of the year.
When she and her husband were laid off during the COVID-19 pandemic, they signed up for Medicaid. The two have gone back to work in the restaurant industry, but Celaya and her kids are still on Medicaid for free health care coverage because she can’t make hundreds of dollars to pay for insurance. Monthly coverage for employer-sponsored health insurance.
The clinic is helping her navigate the private health insurance plans available through the Affordable Care Act marketplace and trying to determine if her child is eligible for the Program. Federal Children’s Health Insurance or not, is called KidsCare in Arizona. Celaya said she will never be able to find a market where dozens of insurance plans for different doctors are offered at different prices.
“I am not an expert on health insurance,” she said.
