More than 118,000 Missouri children and parents lost Medicaid coverage between January 2018 and June 2019, a drop of over 16% of those who had been enrolled. This includes nearly 95,000 children and almost 24,000 parents who were previously enrolled. This decline was the second largest in the country and nearly four times higher than the national average. 

While part of the drop in coverage may be attributable to the state’s improving economy, the vast majority of the decline in enrollment appears to be directly correlated with new renewal procedures and information systems enacted by the state in July 2018.

87% of patients who lost Medicaid coverage still met income eligibility requirements.

A survey of health care providers conducted by Kids Win Missouri, Missouri Budget Project and the Missouri Coalition of Children’s Agencies indicated that 87% of patients who lost Medicaid coverage still met income eligibility requirements. Their patients reported they did not receive the renewal paperwork, the submitted paperwork was lost or not processed, families did not submit paperwork or did not understand the renewal process, or the renewal notices were received too late. Renewal problems were aggravated by staffing issues and high volume at the call center and local resource centers.

What Can Be Done?

There are several administrative tasks the state can undertake to address the immediate challenges of the new renewal procedures and ensure that every income-eligible child and parent is enrolled in Medicaid.

The state can place a moratorium on quarterly Medicaid eligibility reviews until the backlog of renewals is completed and systems issues contributing to the decline can be addressed. Longer-term, Missouri can make Medicaid stronger by implementing a range of policy options that would streamline enrollment and renewal, including twelve-month continuous eligibility, which would allow children to maintain their Medicaid health coverage for a full year, stabilizing coverage and ensuring consistent care without the state needing to process additional paperwork. 

How Can I Help?

We strongly urge Missouri residents to contact their state senators and representatives to express their concerns about the drop in Medicaid enrollment as well as support for administrative and policy actions the state should take to stabilize the system and ensure children have health coverage.

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