With just a month left to meet their self-imposed deadline, state Department of Human Services officials told lawmakers Thursday that they still have a backlog of overdue Medicaid applications and other paperwork related to about 28,000 people.
Mary Franklin, director of the Human Services Department's County Operations Division, told members of the Legislative Joint Auditing Committee's Review Subcommittee that she still hopes to meet the department's goal of having the backlog cleared by the end of the year.
"We are throwing everything we've got at this," Franklin said.
Franklin spoke after a committee chairman, Sen. Bryan King, R-Green Forest, questioned other Human Services Department officials about the cost of the expansion that has extended Medicaid coverage to more than 324,000 low-income Arkansans.
Since the expansion took effect in 2014, the federal government has paid the full cost of covering the newly eligible adults, but Arkansas will be responsible for 5 percent of the cost next year.
Human Services Department spokesman Amy Webb said last week that the cost to the state in the fiscal year that begins July 1 is expected to total $125 million -- about $25 million more than the department projected earlier this year.
Noting that enrollment has surpassed expectations, King, who has opposed the expansion, said, "It was easily predictable to see from the figures that this was unsustainable, even two years ago."
The backlog resulted from the initial poor functioning of the department's new Medicaid enrollment system, which was needed to determine eligibility for several types of Medicaid benefits under new rules that took effect in 2014.
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Although the system's performance has improved, by June the department still had overdue paperwork related to about 100,000 Medicaid cases, including more than 34,000 applications that had been pending for more than 45 days.
To clear the backlog, the department has allocated about $8.4 million, including $7.5 million that it is paying to Reston, Va.-based Maximus to provide a "surge" of 250 temporary caseworkers who began processing paperwork in September.
As of Nov. 27, the backlog had been reduced to 27,882 overdue cases, Franklin said Thursday.
That included at least 17,782 applications that had been pending for more than 45 days, as well as at least 6,535 requests for changes in coverage that had been pending for more than 20 days.
The remaining 3,565 cases were applications or requests for changes in coverage that had errors or other problems that require extra attention from a caseworker or computer programmer.
She added that the department is up to date on processing applications for coverage for newborns and on conducting annual checks of Medicaid recipients' eligibility.
Gov. Asa Hutchinson has set a goal of reducing the growth of spending in the traditional Medicaid program, which covers low-income elderly people, children and the disabled, by about $835 million over five years to help pay for Arkansas' share of the expanded portion of the Medicaid program.
The expansion extended coverage to adults with incomes of up to 138 percent of the poverty level: $16,394 for an individual, for instance, or $33,534 for a family of four.
Under the so-called private option, most of the newly eligible adults receive coverage through commercial insurance plans, with the Medicaid program paying the premium and providing other subsidies that reduce or eliminate the enrollees' out-of-pocket costs for medical care.
Sen. Linda Collins-Smith, R-Pocahontas, who also has opposed the Medicaid expansion, asked Human Services Department officials if they had looked for ways to reduce the cost of that part of the program.
"To me it's just appalling that we would cut the most needy of Arkansans -- which I think is what Medicaid was intended for -- that we would cut the most needy to hand to someone that's very healthy," Collins-Smith said.
Kelley Linck, chief of legislative and governmental affairs for the department, said the planned changes to the traditional program are aimed at providing services more efficiently.
"We're not just decreasing spending," he said.
The Legislature has approved changes to the expanded portion of the program, including charging premiums of $13 a month to some enrollees, that Hutchinson has said would encourage enrollees to stay employed and take responsibility for their health care.
If approved by the federal government, the changes will take effect Jan. 1.
A Section on 12/02/2016