Failure to reapply jeopardizes ARKids for 103,000

More than 100,000 children are at risk of losing their ARKids First health coverage because their parents or guardians haven't filled out new applications on their behalf, as the state Department of Human Services has requested, a department spokesman said Friday.

Information in the applications is needed to determine the children's eligibility under rules that went into effect Jan. 1, 2014, under the federal Patient Protection and Affordable Care Act.

Because of difficulties the Human Services Department encountered in installing a new eligibility determination and enrollment system, the department didn't begin trying to collect the information until last summer.

It has sent notices to 212,000 families with children who were enrolled in ARKids before the new rules went into effect but has received only 170,000 responses, department spokesman Amy Webb said.

On Friday, the department began sending to the remaining 42,000 families what it described as a third and final notice, giving the families an additional 30 days to fill out the applications.

The ARKids coverage for 103,000 children belonging to the families will be cut off unless the applications are submitted, Webb said.

In addition to sending the notices, the department has sent fliers about the renewals to school nurses, libraries and other organizations across the state, she said.

The department also advertised the renewals on Facebook, ran radio advertisements in about 60 counties and included information on the renewals in a newsletter to recipients.

Some families likely haven't responded because they are no longer eligible, Webb said. But, she said, "if there are eligible children in that number, we want to make sure they keep their coverage."

The Medicaid-funded ARKids program covers children from families with incomes of up to 216 percent of the federal poverty level: $34,409 for a two-person household, for instance, or $52,380 for a family of four.

About 390,000 children were covered by the program as of March 31.

The families that are being sent notices enrolled before 2014 through the department's old eligibility and enrollment system. The old applications don't contain enough information to determine eligibility under the new rules, Webb said.

Marquita Little, health care policy director for Arkansas Advocates for Children and Families, said it would be a "huge problem" if the children's coverage is terminated.

Although the parents could submit new applications to have the children's coverage restored, it could be weeks or months before the applications are approved, she said.

"Renewing coverage is much easier than re-enrolling," Little said.

The children covered by ARKids First are among about 600,000 Medicaid recipients in the state whose eligibility is governed by the new rules.

Those recipients include about 250,000 low-income adults who became eligible for coverage under the expansion of the program approved by the Legislature in 2013. Most of the adults are covered under the private option, in which the state uses Medicaid funds to buy insurance on the state's federally run health insurance exchange.

As of Dec. 10, the department had renewed coverage for 198,601 families or individuals under the new rules and had terminated the coverage for 61,702 recipients, in most cases because the recipients failed to respond to the Human Services Department's requests for income-related records.

Of those whose coverage was terminated, 17,316 had it reinstated after they provided the requested records.

The first notices to children of families covered by ARKids First went out in July and August, Webb said. Those notices directed the families to go to a state website, access.arkansas.gov, to fill out applications within 30 days.

Families that wanted a paper application were directed to get one from a Human Services Department county office, fill it out, write "renewal" across the top and mail it to a processing center in Pine Bluff.

The department also sent a second notice urging the families to submit an online or paper application "as soon as possible."

Webb said those first two notices did not include paper applications because using the state website is "the fastest and easiest way to respond."

The new notices do include paper applications.

"We thought families who failed to respond to the first two notices may be more inclined to respond if they had the paper application in hand," Webb said in an email.

Little said the department should consider calling families that haven't responded to the notices.

Webb said the department doesn't have the manpower to do that.

She said the department has hired extra workers to process renewals. The department will make sure it has processed all the applications that have been submitted before it begins cutting off the children's coverage, she said.

A Section on 01/16/2016

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