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More Than 1.7 Million Consumers Still Wait For Medicaid Decisions

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Georgia Gets Applicant Data Only In May

For states that used the federal marketplace, www.healthcare.gov, a major complication was the technical issues that kept the federal site from sending complete applicant data to the states. 

Georgia’s Medicaid agency said it began to get applications from the federal marketplace only in May, and many of them were missing key information.

Trish Riley, a former Maine health official and a member of a commission that advises Congress on Medicaid, said the problems underscore the continued differences in state capabilities and cultures. Ramping up for a surge in Medicaid enrollment can be a big change for states that for decades focused on reducing fraud and abuse.

“It’s hard to change that culture, said Riley, an adjunct professor of health policy at University of Southern Maine.

California — which expanded eligibility--has experienced problems because of the sheer number of applicants and that enrollment is being handled by 58 counties using different computer systems, Riley said. About half of the 900,000 pending applications were made in the last 45 days, said California Medicaid spokesman Tony Cava. “Some [applicants] have not responded yet to our requests for …information [such as income].  Technology issues have also contributed,” he said.

State Eligibility Reviews

The process has been further complicated by state eligibility reviews that have found many people ineligible who applied through the federal marketplace.  States were always expected to make final eligibility decisions, but that has taken longer in some places than anticipated.

Of the 245,000 Ohioans who applied through healthcare.gov, for example, 93,000 were found ineligible, said state Medicaid spokesman Sam Rossi. Another 66,000 had already enrolled or are in process of enrolling directly through the state Medicaid program. Ohio, which expanded Medicaid eligibility, has more than 65,000 cases pending, he said. 

“States are digging out from huge numbers of applications they received,” said Rachel Klein, enrollment program director at consumer group, Families USA. She said some states did not increase staffing enough to be ready for the surge of applicants.

Fri, Jun 06 2014

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