The Alaska Division of Public Assistance has temporarily paused a practice of dropping people from Medicaid for paperwork-related reasons after thousands of low-income Alaskans — including families with kids — lost health coverage that they may still be eligible for.
At the same time, some health care providers say they’re seeing more uninsured patients, and a possible increase in the number of patients who appear to be delaying important health care due to a recent loss in coverage.
Earlier this summer, the state resumed annual eligibility reviews, which had been paused during the COVID-19 pandemic. Since then, only a third of Alaskans on Medicaid whose eligibility has been checked so far have been found eligible and renewed in the program, according to state data.
Over the last two months, close to 40% of people previously on Medicaid who were up for review — nearly 14,000 people — were dropped from the program for procedural reasons, which often means that a family didn’t receive or respond to mail from the Division of Public Assistance requiring them to verify their eligibility for the program.
That can often happen because the state doesn’t have an updated address on file for a family, or a letter from the division gets mistaken for junk mail. But the state doesn’t know exactly why so many people were getting dropped for this reason, said Deb Etheridge, the department’s director.
“We were seeing a lot of kids being disenrolled,” said Etheridge. “So we paused procedural disenrollments for (October) benefits so that we can do a review of all individuals who haven’t sent their information back to see if we can make an eligibility determination, and if we can get to the bottom of why this is happening.”
Etheridge said that in order to decrease the number of people who are dropped for procedural reasons, families will have at least an extra 30 days to respond to requests for income verification and other information, and the state will do its best to verify eligibility even without that paperwork.
She said that as part of that review, applications are being reopened in an effort to increase the number of people who can keep their health coverage. The state is also working on setting up a system to send text messages to people who are missing information.
“It’s definitely a learning curve. But our staff are out there doing the best they can with the tools they have,” Etheridge said.
She also noted that Alaskans who think they’re eligible for Medicaid but are dropped anyway have the right to a fair hearing, which is a review of a decision made by the state. Fair hearing requests can be made in person, by phone or in writing to any employee of the Division of Public Assistance, and must be made within 30 days from the date of the notice.
Before eligibility reviews resumed, approximately one in three Alaskans were enrolled in the state’s Medicaid programs, which are sometimes referred to as DenaliCare and Denali KidCare, and thousands more could lose their coverage in the coming months.
Under a provision in the federal health emergency that began in March 2020, Alaskans who might otherwise have lost Medicaid coverage due to a new job or other change in status were able to keep their coverage for the last two years without needing to submit annual paperwork — even if their income rose high enough that they were no longer eligible for the program.
Medicaid recipients include eligible low-income adults, children, pregnant women, older adults and people with disabilities. States administer the program, which is funded jointly by states and the federal government.
At the Anchorage Neighborhood Health Center, a federally qualified health center where half of all patients are enrolled in Medicaid, clinic chief executive officer Lisa Aquino said staff have seen a recent increase in the number of patients who’ve been affected by the change.
“We’re definitely seeing an increase of patients with questions, looking for help with health insurance, and our health insurance team is getting like, booked out farther in the future than it normally does,” she said.
Aquino said she’s also hearing from patients who are forced to wait hours on hold with the state’s Medicaid helpline, which she said has become backed up in recent months.
Her clinic has a sliding-scale fee for Alaskans who are uninsured or underinsured, which can reduce the cost of care significantly. But Aquino thinks many patients who’ve lost their Medicaid coverage in recent months may not know about the sliding-scale fee, and may be avoiding seeking care instead.
“We are seeing a reduction in patients on Medicaid, but we haven’t seen that increase in the people on the sliding scale, which makes me think that perhaps some of those people are just avoiding medical care at this point,” she said.
• To check on the status of an application or ask an eligibility technician with the state any other questions, the Virtual Call Center number is 1-800-478-7778. Wait times have been long due to the backlog, but callers have the option to leave their number for a same-day callback.
• To update your contact information with the state, you can visit its online form or call the Medicaid Information Update Hotline, 1-833-441-1870, which is staffed by a team dedicated to process contact information changes and was established to reduce wait times through the virtual call center.
• For a free appointment with a health care navigator who can help you determine if you’re still eligible for Medicaid — and what your options are if you’re not — dial 211, or 800-478-2221, or visit the Alaska 211 website at alaska211.org. Those appointments can happen in person in Anchorage, Mat-Su, Fairbanks and Soldotna, and virtually for the rest of the state.
• Alaskans who think they’re eligible for Medicaid but are dropped anyway have the right to a fair hearing, which is a review of a decision made by the state. Fair hearing requests can be made in person, by phone or in writing to any employee of the Alaska Division of Public Assistance, and must be made within 30 days from the date of the notice.