Editorial: Missouri boots 11K kids from Medicaid because it can’t confirm they’re eligible

Aug 04, 2023

Missouri just kicked almost 11,000 of the state’s most vulnerable children out of the government’s health care system for the poor, even though they might still be eligible for the program. They were removed because state officials can’t figure out if they’re eligible.

The failure appears to have been caused at least in part by the state’s infamously inadequate technology. In other words, Missouri is, once again, proving itself to be one of the worst-run states in America. Recently, that official dysfunction cost poor kids participation in a federal food program. This time, it’s costing them medical coverage.

Normally, the Medicaid system — the joint federal-state program that provides medical coverage for the poor — updates its records annually to ensure that everyone in the program is still eligible. Those who aren’t are removed from it.

As dangerous as the pandemic was for Missouri families, it did indirectly provide protection for some of the poorest of them with a federal requirement that no one could be removed from Medicaid rolls until the health emergency was over. For those recipients, the annual renewal process was suspended starting in March 2020; everyone who was on the Medicaid rolls was just kept there (with enhanced federal funding covering the cost).

That reprieve ended in May. In June, Missouri officials, like those in other states, began the process of weeding out the eligible from the ineligible.

Anyone familiar with this state’s documented inability to competently carry out even some of its most basic responsibilities can guess what happened next.

As the Post-Dispatch’s Michele Munz recently reported, the state’s first round of reviewing Medicaid eligibility since the federal reprieve was lifted resulted, in June, in more than 32,000 Missourians losing their Medicaid coverage.

Half of those booted from the program were Missouri children — and more than 10,700 of them were children who might actually still be eligible. The state simply can’t confirm it, so they were removed for what are called “procedural” reasons that can include the state’s inability to reach the families.

Thousands more cases are still pending, in part, a state spokesperson told the Missouri Independent, because, “There was not a way for those to automatically process in the system,” so they are being processed by hand.

It’s unclear how much of the problem (which is also playing out in many other states) is caused by things like parents not filling out the right form and how much is what the state spokesperson called “system work” needed by the state.

What is clear is that Missouri has an especially lousy record when it comes to efficiently carrying out basic functions of government, especially those that involve technology. As this page pointed out last month, the state recently pulled out of a federal program that would have provided $42 million worth of food for low-income school kids because the state’s technology couldn’t navigate the program — even though at least 40 other states managed to.

The most ominous aspect of the Medicaid snafu is that the state’s review of families’ eligibility has just begun. It will be a long process that could ensnare tens of thousands more kids unless the state figures out how to correctly assess their eligibility. Gov. Mike Parson should intervene and ensure that, until the system is ironed out, the state is erring on the side of not kicking kids out of their doctors’ offices.

Views from the editorial board, opinions from guest and national columnists plus the latest letters from our readers.

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