Feds Want California to Clear Medi-Cal Backlog

State officials have until Monday to submit plan. (Justin Sullivan/Getty Images)

State officials must submit plan by Monday. (Justin Sullivan/Getty Images)

By Phil Galewitz, Kaiser Health News

Tired of waiting for states to reduce their backlogs of Medicaid applications, the Obama administration has given California and five other states until Monday to submit plans to resolve issues that have prevented more than 1 million low-income or disabled people from getting health coverage.

600,000 people signed up, but not yet enrolled, in Medi-Cal.

“CMS is asking several state Medicaid agencies to provide updated mitigation plans to address gaps that exist in their eligibility and enrollment systems to ensure timely processing of applications and access to coverage for eligible people,” said Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services. He said the agency will monitor states’ progress in solving the problems getting people enrolled in the state-federal insurance program for the poor.

In addition to California, the other states are Alaska, Kansas, Michigan, Missouri and Tennessee.

The agency sent letters June 27 requesting the plans, giving states 10 days to respond. It is unclear if any have submitted plans yet. The letters was first reported by InsideHealthPolicy, a trade publication.

California had a backlog of 900,000 applications pending applications in May — about half of them received within the previous 45 days. Although officials have not provided details on their plans for reducing the backlog, the largest in the nation, they recently said it has dropped to 600,000 cases. States typically have up to 45 days to complete the Medicaid enrollment process.

“We continue to make progress and will work with our county partners and Covered California to process the remaining applications and quickly deliver health coverage to all who are eligible,” health department spokesman Norman Williams said in an email Wednesday.

Tennessee Medicaid spokeswoman Kelly Gunderson denied the state has a backlog of applications saying, “There are numerous aspects of the letter with which we do not agree, and we are currently working on our response to CMS.”

All of the states relied on the federal online insurance marketplace that was established under the Affordable Care Act — with the exception of California, which set up its own marketplace known as Covered California. California and Michigan have expanded Medicaid under the health law, but the other four states did not.

About 6 million people have gained Medicaid coverage since September, mostly as a result of the Affordable Care Act.

A Kaiser Health News analysis of 15 large states in June found that more than 1.7 million more were still waiting for their applications to be processed—with some stuck in limbo for as long as eight months.

The reasons for the problems include technological glitches that prevented the federal insurance marketplace from transferring data on applicants to state Medicaid agencies. Also, many states were unable to handle an enrollment surge because of inadequate staffing, their own computer problems and other issues.

Kaiser Health News (KHN) is a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the Kaiser Family Foundation.

 

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