As of Monday, Arkansas Insurance Department officials were still awaiting word from a federal agency on what steps will be taken to prevent a gap in coverage for nearly 4,800 Arkansans whose Medicaid coverage ended Sunday.
Those individuals were notified in late May that their Medicaid coverage would be terminated at the end of that month because they incorrectly had been ruled eligible for the program.
A spokesman for the state Department of Human Services said last week that officials at the federal Centers for Medicare and Medicaid Services had pledged that affected enrollees who signed up for plans on the state insurance exchange would have coverage as soon as they paid their first month's premium.
Normally, coverage for someone who signs up in late May or early June would not start until July 1.
The 4,798 affected enrollees had applied for Arkansas' expanded Medicaid program through the Centers for Medicare and Medicaid Services, a division of the U.S. Department of Health and Human Services.
The federal agency sent information on the applicants to Arkansas in a data file with code indicating that their eligibility had not yet been verified, but state Human Services Department employees didn't know about the code and thought the applications already had been approved.
Insurance Department spokesman Heather Haywood said Monday that her department had not received information on the issue from the federal agency.
"We are awaiting guidance on when health-insurance coverage could take effect for those who lost their private-option coverage plans and are eligible to purchase health insurance through the marketplace," Haywood said.
Centers for Medicare and Medicaid Services spokesman Aaron Albright said last week that the agency was working to ensure the enrollees would receive "the correct coverage as soon as possible" but didn't give further details about when the coverage would start. He didn't respond to a request for additional information Monday.
Those who received the notices were among more than 170,000 Arkansans who had been approved for coverage as of April 30 under the state's expanded Medicaid program since sign-ups began Oct. 1.
The affected enrollees likely include people being covered by Medicaid-funded private plans under the state's so-called private option as well as people assigned to the traditional Medicaid program because their health needs are considered exceptional, Human Services Department spokesman Amy Webb has said.
Many of the enrollees may be eligible for Medicaid but must supply additional information by visiting a federal enrollment portal, healthcare.gov, or calling a federal call center at (800) 318-2596.
If they are found eligible for Medicaid, the enrollees would not face a gap in coverage because the program will pay for up to three months of past medical expenses after an applicant is approved.
Those who are ineligible for Medicaid can apply for coverage -- along with tax-credit subsidies to help pay their premiums -- through the state's federally operated insurance exchange.
Among those who received the notices was Cheryl Cohen, 58, who owns Village Nutrition, a health-food store in Hot Springs Village, with her husband, David.
After she was told she qualified for Medicaid, her husband dropped her from his insurance policy with his job at a sales and marketing company.
After she received the notice, she called the federal call center and was told her income is too high to qualify for Medicaid.
She said her husband had applied to put her back on his policy, but she hadn't received word on the application as of Monday.
"I'm in limbo right now," Cohen said.
Under the federal health-care overhaul law, people with access to employer-sponsored insurance are generally not eligible for subsidized coverage on the exchange.
Haywood said the state Insurance Department received about 20 calls last week from people who had received the notices, but it hadn't received any calls since then.
An outreach worker at the Living Affected Corp. in North Little Rock spoke to an enrollee last week who received one of the notices, said Diedra Levi, the organization's director.
She said the woman's income was too high to qualify for Medicaid, so she signed up for a plan through healthcare.gov with a monthly premium of about $100, "which she really can't afford."
Levi said she didn't know whether the woman had paid her first month's premium or when the coverage was scheduled to start.
Dale Ramsey, chief executive of the Arkansas Guide Organization in Huntsville, said the two people who have called his group for help were both surprised to receive the notices because they hadn't realized they were enrolled at the time.
One person was paying a monthly premium for a non-Medicaid plan on the exchange, and the other thought she had canceled her private-option coverage after finding a job that offered insurance.
It's possible that the cancellation of the coverage for the person who found a job had not yet been processed when the notices went out, Webb said.
Someone could have been enrolled mistakenly in both the private option and a non-Medicaid plan if they submitted multiple applications with slightly different information, Webb added.
Metro on 06/03/2014