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Enrollment ticking up in Missouri’s expanded Medicaid program, but rollout still rocky


MM Curator summary

[MM Curator Summary]: About 65% of the projected enrollment for expansion is in, but long application delays are still challenging.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Patient Stephen Leach (center) is brought into the in the emergency room by paramedic Joe Steltenpohl (right) at Christian Hospital on Wednesday, July 31, 2013. Christian Hospital has the busiest emergency department in the St. Louis area. The hospital is doubling the size of it’s emergency room and eliminating the need for the over flow rooms in the hallway with curtains for walls like the one Leach is being seen in. Photo By David Carson,

David Carson

Kurt Erickson

JEFFERSON CITY — Missouri has enrolled nearly 65% of the people it projected would qualify for an expanded Medicaid program, potentially putting the state on track to meet a goal set when voters approved the expansion two years ago.

According to the Department of Social Services, which oversees the MO HealthNet program, 178,000 people have signed up for the federally backed health insurance program for low-income Americans.

When voters approved the expansion, it was estimated that 275,000 would be eligible for the coverage.

But the rollout, which began in October, continues to be rocky.

Nearly 60,000 people are waiting for their applications to be approved and that wait time has stretched beyond the 100-day mark, said Kim Evans, director of family services at the Department of Social Services.

At a meeting of the state’s Medicaid oversight panel Wednesday, Evans said that processing times will drop to 45 days at the end of July and 30 days by the end of August. In March, waiting times were upward of 70 days.

Evans said giving workers raises and offering overtime pay and other incentives for employees who are tasked with the applications will help lower the time it takes to process an application.

“We have a lot of work ahead of us,” Evans said Wednesday.

The shorter waiting time also was good news to Sen. Jill Schupp, D-Creve Coeur, a committee member.

“I think that’s great,” Schupp said.

Before the voter approved expansion, the Medicaid program did not cover adults without children. Coverage through MO HealthNet is now available to all Missourians with incomes below 138% of the federal poverty level, or about $18,800 per year for an individual.

MO HealthNet Director Todd Richardson said the budget for the program is “positive” heading into a new fiscal year beginning July 1.

“Overall, we are very, very pleased,” Richardson told the committee. “This is certainly the best budget we’ve had since I’ve been director.”

The $10.1 billion plan, which has not yet been signed by Gov. Mike Parson, would boost nursing home reimbursement rates by $200 million, which could help boost the pay for front-line workers at the facilities.

Another $90 million was added to the budget for reimbursing medical providers.

Both of those adjustments are expected to go into effect on July 1, affecting the more than 974,000 people who are covered by the program.

The upcoming spending plan marks the first full year the state will operate under an expanded Medicaid program that was approved by voters after years of resistance from the Republican-led Legislature.

The expansion went online in October, but frustrations have mounted for applicants who are waiting to become eligible for the health care benefits.


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Health Plans Falter at Providing Medicaid Redetermination Info

[MM Curator Summary]: If we are counting on MCOs to get members to engage about the wind-down, we may be in for a disappointment.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Medicaid beneficiaries with higher incomes were more likely to report receiving Medicaid redetermination and re-enrollment information compared to lower-income beneficiaries.


Source: Getty Images


By Victoria Bailey

May 18, 2022 – Member engagement may be lacking for Medicaid plans, as only 56 percent of beneficiaries reported receiving helpful information about Medicaid redetermination or re-enrollment, according to a survey conducted by The Harris Poll on behalf of the health action company Icario.

Redetermination is when states must identify who is no longer eligible for Medicaid coverage and reach out to beneficiaries to gather the information that substantiates eligibility.

Millions of beneficiaries are expected to lose Medicaid coverage once the public health emergency (PHE) ends.

The Harris Poll conducted the survey online and gathered responses from more than 600 Medicaid beneficiaries in April 2022.

The results revealed disparities between high- and low-income beneficiaries. Nearly 80 percent of individuals who had an annual household income of $75,000 or more said they received information on Medicaid redetermination within the last year, compared to 69 percent of beneficiaries with a yearly income of less than $75,000 who said the same.

Almost 30 percent of beneficiaries said they did not receive any information or did not know if they received information about Medicaid redetermination or re-enrollment. Without the proper information about re-enrolling or confirming eligibility, beneficiaries may risk losing healthcare coverage.

Medicaid enrollment has grown significantly during the two-plus years of the pandemic, so redetermination and re-enrollment is new ground for many people,” Sara Ratner, senior vice president of government markets and strategic initiatives at Icario, stated in the press release.

There is a category of people who are new to Medicaid and are not eligible for auto-enrollment, and they will experience difficulties if they’re not familiar with how redetermination works.”

Beneficiary participants also indicated their preferences about Medicaid medical benefits communications and how they have received this information in the past. 

Forty-four percent of beneficiaries reported they prefer that Medicaid email them benefits communications, while 43 percent said they had received information this way. 

The second-most preferred form of communication was paper mail. Four out of ten beneficiaries preferred receiving communication by paper mail. Just over half (56 percent) reported receiving paper mail from their plan in the past.  

Preference for paper mail was higher among individuals aged 55 and up (59 percent), with 73 percent of older adults reporting having received paper mail communications before.

But paper mail may not be the best form of communication for all beneficiaries.

“The good news is, for people who are older and tend to have more stable housing, paper mail makes sense,” Ratner said. “Meanwhile, younger people and those with less stable employment not only don’t prefer it, but they also don’t remember getting it.”

After email and paper mail, individuals preferred live phone calls (19 percent), text messages (17 percent), in-person support (13 percent), automated phone calls (eight percent), social media (seven percent), and informational videos (six percent).

Successful communication between Medicaid programs and their beneficiaries can help ensure that individuals are aware of any changes with their coverage or action they need to take to maintain coverage.

A research brief from Adaptation Health highlighted some of the challenges Louisiana Medicaid beneficiaries experienced regarding communication from their plans.

Beneficiaries received communications too late and too close to re-enrollment deadlines and some individuals reported being overwhelmed by the volume of communication. Additionally, beneficiaries expressed various ways that they prefer to receive information, suggesting that Medicaid plans should expand their communication methods.

Medicaid communication is especially critical now as beneficiaries consider how their coverage may change when the PHE eventually ends.

Congress implemented flexibilities that expanded Medicaid eligibility and ensured continuous Medicaid coverage during the PHE. These flexibilities led to Medicaid gaining more than 12 million enrollees during the pandemic.

If policymakers do not make these flexibilities permanent, Medicaid beneficiaries could lose their eligibility a month after the PHE emergency ends, as states will begin the dis-enrollment process.


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Virginia poised to review eligibility of 2 million in Medicaid ‘safe haven’

[MM Curator Summary]: VA needs to review 400,000 members to see if they still belong in the Medicaid program once they begin efforts to return to normal operations.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



Michael Martz

Virginia is poised to begin an exhaustive 12-month review of more than 2 million people in its Medicaid program for the elderly, disabled and low-income families — it’s just a question of when.

The federal-state program, supercharged by Virginia’s expansion of eligibility in 2019 under the Affordable Care Act, has added more than a half-million people since the COVID-19 pandemic began, relying on more than $1 billion in additional federal funding to provide health care for people who can’t afford to pay .

“It’s been our honor for Medicaid to serve as a safe haven for folks with Medicaid coverage during the pandemic,” said Karen Kimsey, director of the Department of Medical Assistance Services, which runs the state’s Medicaid program.



But a reckoning is coming as the federal government prepares to end the public health emergency as early as mid-July, requiring states that received emergency aid during the pandemic to redetermine the eligibility of people on their Medicaid rolls.

It promises to be a long, painstaking process, which could result in up to 20% of Medicaid recipients losing their coverage because they are no longer eligible.

“That’s 400,000 people [in Virginia],” said Doug Gray, executive director of the Virginia Association of Public Health Plans, whose managed care companies provide most of the coverage. “That’s a lot of people.”

“The size and the significance of it is pretty daunting,” Gray said.

State agencies working with nonprofit health care advocates, medical providers and insurance companies are trying to make the process less daunting for people who rely on Medicaid for medical coverage.

The state has already begun running ads on social media and other digital outlets — in both English and Spanish — soon to be followed by radio and television to let recipients know about the process and ask them to make sure their contact information is up to date so they can stay well-informed.

The campaign is also sending information by mail to more than 1.1 million households.

“We want to let people know what’s coming,” Kimsey said.

They’re also trying to head off confusion and misinformation about what the so-called “unwinding” process means for Medicaid recipients, who tend to be among the most vulnerable people in communities across Virginia — and among the most misunderstood.

About 832,000 Medicaid recipients in Virginia are children and about 814,000 are working-age adults. More than 153,000 recipients are disabled or blind, and almost 85,000 are over 65 years old. Demographically, 54% are white and 35% are Black, with 5% Asian. About 55% are women and 4% are Hispanic.

Children and youths up to 19 years old account for 43% of the Medicaid population, followed by adults between 35 and 64 at 29%, and people from 20 to 34 at 22%.

The profile is a little different for the more than 650,000 Virginians who joined the program under new eligibility standards that took effect Jan. 1, 2019, to expand Medicaid under “Obamacare” to include childless adults for the first time. About 45% of those recipients are from 19 to 34 years old and 37% are from 35 to 54 years old.

The overwhelming majority of people in the expansion population — more than 485,000 — earn less than the federal poverty level, which is $12,140 a year for a single person and $20,780 for a family of three. About 169,000 earned between 100% and 138% of the poverty level, or up to $16,775 for a single person and $28,676 for a family of three.

Where do they live? More than 511,000 Medicaid recipients live in the state’s Central Region: including about 85,000 in Richmond, almost 81,000 each in Henrico and Chesterfield counties, and nearly 16,000 in Hanover County.

The largest number of recipients live in Virginia’s most populous locality Fairfax County, with more than 165,000, followed by Prince William County with almost 103,000.

Medicaid is an expensive program, more than $19 billion a year, divided between the federal and state governments. They split the cost roughly 50-50 for the base Medicaid population, but the federal government pays 90% of the cost for people enrolled under expansion, with a provider tax on hospitals covering the state’s share under the budget deal the General Assembly adopted in 2018.

Almost 49% of the cost provides coverage for the elderly, disabled and pregnant women, who account for just 18% of the Medicaid population.

So why does Virginia have to redetermine the eligibility of all 2 million people enrolled in the program?

After the pandemic began in March 2020, Congress passed the Families First Coronavirus Relief Act, the first of a series of emergency funding bills that provided a higher federal matching share to pay for state Medicaid programs. In Virginia, it was an additional 6.2%, or more than $1 billion through September.

In return, the state could not kick people off the Medicaid rolls, even if they no longer met eligibility requirements. Once the federal government ends the public health emergency, states must begin redetermining eligibility and, as early as Aug. 1, they can remove people from the program.

The U.S. Department of Health and Human Services is expected to decide by Monday whether to end the public health emergency or extend it another quarter of the fiscal year, through September. The government has promised to give states at least 60 days notice before ending the emergency.


Richmond and Henrico health districts to get new leader in July

Dr. Elaine Perry, most recently interim health director for the Virginia Department of Health’s Central Shenandoah Health District, in July wi…

Once Virginia begins to unwind the program by redetermining eligibility, the state and its partners will look for ways to ensure people continue to receive health care coverage.

“Our fear is that there are people who are eligible who will fall through the cracks,” said Debbie Oswalt, executive director of the Virginia Health Care Foundation, which works to expand health coverage and reduce the number of uninsured Virginians.

Many will reapply for Medicaid coverage if they remain eligible. Some will receive coverage through federally subsidized premiums for insurance on the marketplace that the federal government runs now — the state will take that over at the beginning of 2024. Others who have gotten jobs will gain private insurance through their employers. And some will become eligible for Medicare when they reach 65 years old.

The Virginia Poverty Law Center will be in the middle of those efforts to find health care coverage for people who may no longer qualify for Medicaid. The center, based in Richmond, employs 23 “navigators” across the state in the ENROLL Virginia! program, which helps guide people through the process of finding affordable health insurance.

“We’re expecting a lot of work in helping people to figure out where they belong,” said Sara Cariano, policy specialist and lead health insurance navigator at the law center.

The six managed care companies that provide health care coverage through Medicaid in Virginia also plan to help people find affordable insurance.

“This is a special initiative in which we want to keep people’s continuity of care,” said Gray at the association of health plans.


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Missouri struggles to process Medicaid applications

[MM Curator Summary]: Missouri Medicaid eligibility workers are struggling to keep up with the added strain of Medicaid expansion applications.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



Sebastián Martínez Valdivia



Filing an application for presumptive eligibility is the starting point in applying for Medicaid coverage.

Missourians who apply for Medicaid are now waiting nearly four months on average to get those applications processed.

Since the state implemented Medicaid expansion in October — opening the door for most Missourians making less than 138% of the federal poverty level — wait times have ballooned.

As of February, Missourians were waiting more than two and a half times the 45 days the federal government says states should take to determine if someone is eligible.

Washington University Professor Timothy McBride spoke with KBIA reporter Sebastián Martínez Valdivia about state’s predicament. McBride studies health policy, and served as chair of the oversight committee for MO HealthNet — Missouri’s Medicaid program — from 2012 until 2019.

Sebastián Martínez Valdivia: How unusual are the wait times Medicaid applicants in Missouri are facing right now?

Timothy McBride: Very unusual. In fact, I’ve been tracking this for probably almost a decade and this is the highest number of days pending I’ve ever seen. There was a time when I was chair of the Medicaid oversight committee when the number of days pending was like 90, and we thought that was pretty high then.

Martínez Valdivia: And what are the biggest factors you think are contributing to the steep increase in wait times?

McBride: Multiple factors unfortunately. I think when I looked at it there were probably 150,000 applicants in about a four month period and a lot of those came from the federal marketplace.

So if people end up applying through the marketplace and then it tells them, ‘Well you actually are eligible for Medicaid.’ Then when the applicants come in there are probably three or four problems that we’re facing at the state level. They’re short-staffed because they have a lot of turnover in the staff, and that’s probably because of pay issues and other issues. Then actually some people have been out a lot because of COVID, so that’s another problem.

Martínez Valdivia: The state says staffing turnover is a big contributor to the difficulties they’re having. You chaired the MO HealthNet oversight committee for many years: is this a new problem for the Department of Social Services?

McBride: I think it’s more acute now than it’s ever been that I’ve seen — you know, I’m not there every day but from what I’ve heard. And I think we’ve historically paid our state employees about the lowest in the country and it just hasn’t grown very much and that problem is going to perpetuate itself. And obviously that was a discussion the legislature was having too after the governor proposed raising pay. So I think it’s always been an issue and I remember hearing about it but I think it’s become more problematic now especially as we come out of the pandemic.

Martínez Valdivia: Are there any immediate changes Missouri could make to speed up the process for applicants?

McBride: Well there are several things that I think people have been proposing for a while. And I think we actually saw this week— every week the state puts out a number of how many people are enrolled in the Medicaid expansion and it went up about 18,000 this week to over 100,000 enrolled now.

So what it appears is happening is that the state is now looking at people in a couple categories including the pregnant women category and the MO Healthnet for families category, and if they are eligible for the expansion, they’re moving them over. Frankly I think that could’ve been done a long time ago, closer to October, and I’m not exactly what took so long.

So in answer to your question, I think there are well-known ways of dealing with this that other states have used that I’m not sure our state is using.
This story was originally published by St. Louis Public Radio’s colleagues at KBIA in Columbia, Missouri.


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Renewal of De​​termination That A Public Health Emergency Exists

[MM Curator Summary]: The PHE has been renewed for the 9th time in 2 years, and the $40B additional spending on Medicaid per year will continue.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective April 16, 2022, the  January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, and January 14, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.


April 12, 2022


Xavier Becerra


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Louisiana Medicaid launches phone campaign to encourage members to update contact information

[MM Curator Summary]: LA joins the states launching member call campaigns in advance of the PHE end.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Louisiana Medicaid has launched a phone campaign to encourage its members to update their contact information. Automated calls will go out to members between the hours of 3 p.m. and 8 p.m. Monday through Saturday. The calls will remind members to update their phone number, mailing address and email address.

“When the federal COVID-19 public health emergency ends, we will be reaching out to our members through the mail to complete renewals and to verify eligibility. We don’t know when the public health emergency will end so we are preparing now. It’s critical that we have accurate information to be sure that members receive important notices related to their healthcare coverage,” said Patrick Gillies, Medicaid Executive Director. “We are sharing this information as we begin the phone calls campaign because we want our members to know these calls are legitimate and not a scam. These are recorded messages only. There will not be a Medicaid representative on the phone and we will not be asking for any personal information. The calls will be spread out over the next four to eight weeks.”

If you receive a call, the caller ID will show Louisiana Department of Health.

Members can update their contact information anytime by visiting or by emailing

It is very important for Medicaid beneficiaries to read and respond to all correspondence received from the Louisiana Department of Health during this critical time.


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NM- About 85,000 residents to lose pandemic Medicaid coverage

[MM Curator Summary]: NM officials think about half the members will go to exchanges with zero premiums to pay.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


An estimated 85,000 New Mexicans will see their Medicaid coverage end when the federal government lifts the public health emergency that’s been in place during the coronavirus pandemic.

State officials are working to ensure nearly all of them are shifted to other medical plans, including subsidized policies offered through the state’s health insurance exchange.

“Our goal is to keep all the folks covered,” said Nicole Comeaux, New Mexico’s Medicaid director.

Like other states, New Mexico received extra federal dollars for Medicaid through a COVID-19 relief plan in return for keeping new patients enrolled until the declared health emergency was officially called off.

State health officials estimate 85,000 patients will be deemed ineligible for Medicaid when the health emergency ends, but they’re confident about half will move to employer-sponsored medical plans and half will enroll in plans offered through the health exchange, known as beWellnm.

About 5,000 pandemic enrollees will qualify for reduced Medicaid coverage.

Nationally, health authorities call the upcoming transition an unwinding. State officials refer to it as the Medicaid roll-off.

Before the pandemic, the state received $3.50 in federal money for every dollar it invested in Medicaid; the federal match increased to about $4.70 under the emergency declaration, Comeaux said.

The two largest groups who joined the rolls during the pandemic are families with “very low” incomes and adults whose earnings are 138 percent or less of the federal poverty level, she said.

The Biden administration is signaling it will make one final 90-day extension of the health emergency in mid-April, so the transition of ineligible Medicaid members must be underway by summer, Comeaux said.

At a beWellnm board meeting Friday, Jeffery Bustamante, the health exchange’s CEO, said the goal is to get all patients who lose Medicaid coverage and qualify for plans through the exchange enrolled in insurance policies. The exchange largely serves self-employed workers and their families and others who don’t receive medical coverage through their employer. It also offers group coverage for workers at some small businesses.

“This is without a doubt an aggressive goal,” Bustamante said. “But this is a once-in-a-lifetime moment for the exchange, where we have people who are eligible and willing to sign up for a public program.”

The exchange, which offers plans from six carriers, has more than 40,000 patients enrolled this year.

Many patients who signed up for policies are now benefiting from subsidies through the federal American Rescue Plan Act, which has drastically reduced premiums. BeWellnm officials said in December that 4 in 5 New Mexicans eligible for the exchange could enroll for less than $10 a month.

A few board members on Friday expressed skepticism about trying to hit the 100 percent target in enrollment, however.

“I’d really like to see a more realistic goal … and not ‘let’s hope we get there’ goal,” board member Teresa Gomez said. “I think 100 percent is completely unrealistic.”

Bustamante said no one offered membership should refuse, given most who are dropped from Medicaid will qualify for plans with zero premiums. It’s simply a matter of meeting with the people and ensuring they know what’s available to them, he said.

States’ Medicaid enrollment swelled by 22 percent to about 78 million people by September, the highest participation since the program was created as a cornerstone of President Lyndon B. Johnson’s War on Poverty, according to a Washington Post story, which noted New Mexico has the highest proportion of residents on Medicaid in the country.

States face a deadline for moving ineligible members off Medicaid. Federal subsidies will continue for only three months after the emergency ends, and afterward a state must pay the full costs of the rolls containing unqualified enrollees.

In effort to create a buffer to give states more time, some proposed funding was added to the Build Back Better bill for that purpose, but the legislation has stalled in the U.S. Senate.

Comeaux said the overall roll-off will go 14 months and will require vetting all of the state’s Medicaid recipients to determine who’s eligible to receive benefits.

The plan is to identify those who no longer qualify for Medicaid by Aug. 1 and transfer as many as possible to the health exchange, she said.

People won’t be without a lifeline if they fall off the rolls before beWellnm’s official enrollment period begins in the fall, officials say.

They can sign up for a health exchange plan in a special enrollment period designed for those who lose Medicaid coverage, and many can receive financial aid for their insurance premiums from the state’s Health Care Affordability Fund, said Colin Baillio, project manager for the state insurance superintendent.

At the meeting, Bustamante said in-person meetings with Medicaid recipients and a clear message about what is happening and what they need to do will help ensure no one is left without coverage.

Comeaux said it also will be imperative that Medicaid recipients update their personal information, such as addresses, to ensure a smooth transition to the health exchange if they are removed from the rolls.

“That only works if people have kept us updated about where they are,” Comeaux said. “Get us your information. It gets you to a different source of coverage.”


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Arizona to resume disenrolling people from Medicaid program

MM Curator summary

[MM Curator Summary]: AZ has announced its plans to begin efforts to determine whether 500,000 Medicaid members are still eligible once the PHE is declared over.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



Arizona’s Medicaid program says it and a health care program for children will soon resume disenrolling state residents no longer eligible for coverage and that an estimated 500,000 people currently enrolled will need to go through a process to see if they remain eligible.

Arizona Health Care Cost Containment System officials said the state generally hasn’t disenrolled beneficiaries since the pandemic began in March 2020 unless they moved out of state, voluntarily disenrolled, aged out of the children’s program or died.

But an agency statement said some people with Medicaid or KidsCare coverage now could be disenrolled from those programs because they no longer meet financial or medical eligibility requirements.


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Call center to reach out to Medicaid clients to update contact information

MM Curator summary

[MM Curator Summary]: Arkansas will launch an effort to confirm member contact information as a pre-cursor to its post-PHE eligibility redetermination effort.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.


Many Medicaid clients across Arkansas will soon receive phone calls from Arkansas Department of Human Services (DHS) representatives working to update clients’ contact information so they will not miss important renewal letters in the coming months.

DHS announced today that it has set up a new call center that will reach out to clients to help them quickly and easily update their information. The representatives will be able to update a client’s mailing address, phone number, and email address on file.

DHS has not had to complete renewals during the COVID-19 pandemic, but that will soon change. Clients who have not updated their address since the pandemic began could miss these letters and may then lose coverage.

“We want everyone who is eligible for Medicaid to have the option to continue getting coverage,” said Mary Franklin, Director of the Division of County Operations. “If you get a call, please answer and make sure your information is correct. Spending just a few minutes on the phone can make a big difference and can help you keep your Medicaid coverage.”

These representatives will call from 844-872-2660, and that number will show up on the caller ID. Representatives will be reaching out between 8 a.m. and 4:30 p.m. Monday through Friday.

This call will only cover address, email, and phone number changes. If you have questions about your coverage, please call 855-372-1084 or check your case online at

During the federal Public Health Emergency, Arkansas Medicaid is required to delay ending coverage for clients whose cases would have normally had to be closed for reasons including being over the income limit, not returning information DHS asked for, or not completing renewal paperwork.

Once the Public Health Emergency ends, DHS will be required to use the normal rules for determining when a case should be closed and a client’s coverage should end. All clients who have had their closures delayed during the pandemic will need to complete renewal paperwork, if they want to keep their coverage.

Clients also can apply for coverage or manage their benefits online at


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Oregon takes step toward covering thousands set to lose Medicaid

MM Curator summary

[MM Curator Summary]: The Oregon legislature is working on a bill to require the HHS agency to have a plan for Medicaid eligibility redetermination efforts that do not push people back into uninsured status.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.




PORTLAND, Ore. — Oregon is a step closer to creating a bridge plan for those who stand to lose their Medicaid coverage once the Covid-19 public health emergency ends.

House Bill 4035, which passed the Oregon Senate on Thursday, requires the Oregon Health Authority to develop plans for redetermining Medicaid eligibility and maintaining members’ access to insurance coverage.

During the pandemic, Oregon and other states hit the pause on doing regular redeterminations of Medicaid eligibility to ensure that no one lost access to care. The state’s Medicaid rolls grew by more than 300,000 to 1.4 million members, increasing Oregon’s insured rate to an all-time high of nearly 96%.

“Underinsurance has fallen precipitously for people of color,” said Sen. Elizabeth Steiner Hayward, a Portland Democrat and chair of the Joint Committee on Ways and Means, who carried HB 4035 on the Senate floor. 

Those earning between 138% and 200% of the federal poverty level, she noted, “are the most likely to churn on and off Medicaid, costing their own health and everyone money and our state (is) the poorer for it. It’s an important bill to allow Oregon to stay at the forefront of health system transformation.”

The state has a year to complete the eligibility redeterminations after the public health emergency ends, which is expected to happen in April. About 55,000 people could likely be disqualified from Medicaid but may not be able to afford to buy their own insurance through the Oregon Marketplace. The bill establishes goals, including maintaining access and minimizing disruptions by phasing in redeterminations for vulnerable populations.

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