HealthCare.gov issues affect Medicaid enrollment

Share:

Here’s another HealthCare.gov problem – and a workaround – that haven’t gotten much attention.

People can apply for Medicaid (traditional or expanded) via the federal HealthCare.gov website. But the applications still have to get transferred to the states which have to process them to finalize enrollment in the actual state program. And it’s supposed to be done by Jan. 1.

Guess what? That was a problem. With all the website woes, the feds weren’t able to process that  information and had pushed back deadlines. Then, quietly, on the Friday of Thanksgiving weekend, CMS offered a transitional “administrative” fix through this federal policy guidance.

The states are allowed to use the minimal information on the so-called “flat files” to finalize the Medicaid status. The flat files had been pretty bare bones but CMS says expanded files will “include data elements such as: date of birth, Social Security number, eligibility category used for assessment or determination, and verification inconsistencies. The file will identify individuals who have been assessed or determined eligible for Medicaid and CHIP on the basis of modified adjusted gross income (MAGI).”

It would be good to check in with your state’s Medicaid director. Is this enough? Too little, too late? Will people be correctly enrolled in Medicaid by Jan. 1 – or will some be left uncovered, even if they did their part of the application process correctly?

Here’s a list of state Medicaid directors from the National Association of Medicaid Directors.

Joanne Kenen