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State says it has no plan to track adults dropped from Medicaid

August 29, 2005
By: Leslie Yingling
State Capital Bureau

JEFFERSON CITY - As thousands of Missouri adults lose Medicaid coverage because of cutbacks effective Thursday, Sept. 1, Missouri's welfare agency says it does not have a plan to track the impact of the cuts on those who lose medical coverage.

Under legislation approved earlier this year, Medicaid coverage will be been eliminated for about 100,000 Missourians effective the first of September. Nearly 250,000 more will lose partial services under the state health care program.

The state will track Missouri adults who have lost eligibility because of changes to Medicaid only if they re-enter the system by meeting eligibility requirements in the future, said Deborah Scott, a spokesperson for state Social Services Department.

The department does not have a system in place to follow up on those who lose coverage permanently, but "we are going to do all we can to refer people," she said.

The absence of a tracking system triggered criticism from a Democratic leader.

House Minority Leader Jeff Harris, D-Columbia, said the state should track what happens to those who have lost Medicaid coverage.

"If we're going to craft and fund a health care vision for the state, part of that is to see what happens to the nearly 350,000 folks who have lost their Medicaid," he said. "There's nothing in statute to allow us to find out where they are and what will happen to them," he said.

The Social Services Department's Family Support Division will track children affected by changes to the State Children's Health Insurance Program guidelines, under which families who earn 100 percent of the poverty line or more will have to pay premiums, Scott said. Prior to the changes, families could earn up to 300 percent of the poverty line and not pay any premiums.

An official for one of the leading organizations that has criticized the cuts said the state should track the impact on former adult Medicaid recipients.

"There are lots of ways that they could," said Amy Blouin, executive director of the Missouri Budget Project. "They're the only ones that have the complete list of patients who will lose coverage because of the Medicaid cuts."

The Missouri Budget Project, which advocates for low-income Missourians, is doing the next best thing, Blouin said. In conjunction with other organizations, the group is distributing the Missouri Medicaid Survey to gauge the impact of the changes to Medicaid eligibility and coverage. They plan to produce a series of reports detailing the survey results and highlighting personal stories.

"It's essential to find out what's happening to people who are losing coverage, to determine the end result of the Medicaid cuts," she said. "It seems that when they've made such a significant change, the legislature would want to hear what the impact of that change is."

Several hundred survey forms have already come in from around the state, Blouin said.

Grass Roots Organizing, another welfare advocacy group, created the survey, which GRO members and volunteers are conducting door to door.

"We've expended lots of resources to visit low income communities all over Missouri," said Robin Acree, an executive director and organizer of GRO.

Scott said the Social Services Department may work with other organizations to consider tracking the adult population that has lost Medicaid coverage or services.

"The Division of Medical Services is in conversation with other organizations who are doing it," she said.

Scott said that the Medical Services Division director anticipates ongoing discussions about possible collaboration.

Neither the Missouri State Medical Association nor the Missouri Hospital Association will track adults who have lost Medicaid coverage, representatives of both organizations said.