COLUMBIA, S.C. - Some people shopping for insurance on the federal marketplace are being informed that they’re eligible for Medicaid and that their information is being sent to state officials to sign them up. However, states aren’t able enroll them because they’re not receiving usable data from President Barack Obama’s administration.
The Center for Medicare and Medicaid Services wrote a memorandum to the 36 states using the federal website last week acknowledging the information wasn’t being transferred automatically and saying another system was being developed to send it. More complete files could be sent as soon as next week.
Arkansas has not yet received data on applications made through the federal site healthcare.gov, but state officials have been told to expect the information soon, said Amy Webb, a spokesman for the Arkansas Department of Human Services.
Adults found eligible for the state’s expanded Medicaid program will receive notices directing them to visit a state website, insureark.org, where they can complete the enrollment, she said.
Most of those who enroll will receive coverage through private insurance plans, with their premiums paid by Medicaid, while those found to have exceptional health needs will be covered under the traditional Medicaid program.
In addition to using healthcare.gov, Arkansans can apply for Medicaid through a state website, access.arkansas.gov, by visiting a Human Services Department office or by calling (855) 372-1084.
People who already applied through healthcare.gov are not prohibited from filing a second application with the state, Webb said.
But she added, “We’d like to keep that at a minimum if at all possible.”
The problem with Medicaid coordination represents the latest issue to arise in the rollout of a website that’s been plagued with long waits for users and other glitches.
Some users in the 36 states who fill out applications on the federal site may believe that they’re already being enrolled in Medicaid or that state officials will contact them, even though the agencies aren’t receiving the information they need, said Matt Salo, executive director of the National Association of Medicaid Directors. The data-transfer problem is occurring in the 36 states where the federal site is deployed, regardless of whether they chose to expand Medicaid.
“Essentially, if you’re a consumer on healthcare.gov, it will tell you you’re eligible for Medicaid and the state agency will take care of it, but there’s no real way for the state Medicaid agency to know anything about it,” said Salo, who leads the nonpartisan membership group for state Medicaid chiefs.
The federal marketplace was designed to help people buy private insurance under Obama’s health overhaul. If shoppers qualified for Medicaid, the site was supposed to send their data to the Medicaid agency in their state.
As explained on healthcare. gov, “When you finish this application, we’ll tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid, we’ll let the Medicaid agency know so your coverage can start in 2014.”
The site also says: “If you or a member of your family qualify for Medicaid or CHIP, a representative will contact you to enroll.” CHIP stands for Children’s Health Insurance Program.
The federal Center for Medicare and Medicaid Services has devised an alternative way of sending files including the patient information to the states.
“CMS announced that we will be providing states with additional flexibility to use existing processes to enroll individuals in Medicaid and CHIP who applied through the federal marketplace. This process will ensure that coverage will begin on Jan. 1 for newly eligible enrollees,” spokesman Emma Sandoe said.
Salo said the federal government is currently sending states incomplete data files on people deemed eligible online - data called “flat files” - so that agencies can get a rough estimate of how many people they may need to enroll.
New files with more information could be sent as soon as Tuesday, Salo said. But states are unsure the new files will be complete or accurate enough for enrollments.
Tony Keck, director of South Carolina’s Department of Health and Human Services, said that so far his agency has been receiving garbled data that may include a name but no address or three digits from a Social Security number.
The administration notified state Medicaid directors in mid-September that the system wouldn’t work as planned when the site went live Oct. 1. It’s unclear when a final fix will be ready, Salo said.
It’s also not clear how many applicants could be affected nationwide. Salo said it’s too early to tell, and federal officials have not provided numbers.
Keck said South Carolina has received the incomplete data files on 8,700 Medicaid-eligible people who applied through the federal marketplace in October and November. However, he cautioned that he wasn’t able to verify whether all were truly eligible or if some already were enrolled in Medicaid.
As of Wednesday, Florida officials said they’re waiting for the federal government to transfer 35,056 applications, representing 48,664 individuals who are eligible for Medicaid and the children’s insurance program. But federal health officials warned the “the eligibility indicator field on the flat file is not accurate and we have no way to validate these numbers,” said Alexis Lambert, spokesman for the Department of Children and Families.
A spokesman for Ohio’s Medicaid agency said it’s having similar problems. The files are incomplete, and the information would have to be entered manually because of the format.
Information for this article was contributed by Seanna Adcox, Kelli Kennedy and Ann Sanner of The Associated Press and by Andy Davis of the Arkansas Democrat-Gazette.
Front Section, Pages 2 on 12/06/2013