Stories like this have proliferated in recent months. Nationwide, at least 3.8 million Americans have been expunged from Medicaid rolls since April, when pandemic-era coverage protections ended. In Arkansas alone, more than 200,000 residents had lost their coverage as of June 30, according to state data; nearly 12,000 of those purged Arkansans, like Avery, were listed as having “newborn” coverage.
Why is this happening all of a sudden? For three years, from March 2020 to April 2023, federal law prohibited states from kicking almost anyone off the program. Congress had given states enhanced Medicaid funding, and in exchange, they were required to err on the side of maintaining coverage.
This condition was partly intended to expand the universe of people eligible for care during a public health emergency. But it was also a Band-Aid for a problem that long predated covid and that any other rich country would consider embarrassing: dysfunctional, technologically incompetent governments dumping poor people off health coverage that they actually qualified for.
In fact, about three-quarters of those who have been terminated from Medicaid — both in Arkansas and nationally — lost coverage for “procedural” reasons, according to data from KFF. This means they lost coverage not because they’d been reevaluated and determined to no longer be eligible because they earn too much money, aged out of the program, moved out of the state, etc. Rather, they lost coverage because of dumb bureaucratic issues.
For example, maybe the state sent the renewal notice to the wrong address or never sent one at all (as seems to be the case for Penelope, a 5-year-old Florida girl with disabilities). Or maybe the beneficiary received conflicting information about what documentation is needed to re-prove eligibility (as happened to a 63-year-old woman in West Virginia).
Or maybe the local services office lost a file that had been hand-delivered, as happened to Kristina Lingar, another Arkansas mother I interviewed. Her 13-year-old daughter’s neurology appointment has been delayed while Lingar refiles the paperwork for what will be the fourth time.
In baby Avery’s case, it seems the state’s janky website cannot save or record her information correctly.
Avery’s mother received a phone call from the state in late May saying the 1-year-old’s Medicaid coverage would be canceled unless her information was updated online. After some rigmarole to recover her password, Quick logged in.
The system showed that Quick’s two older daughters, Mackenzie and Serena, were listed on her account as Medicaid enrollees and were squared away. But Avery was nowhere to be found. She did not seem to exist in the state’s public-facing records, even though she’d been receiving Medicaid-covered care since birth.
So Quick called back the state. And called. And called.
“I sat on hold four different times, until the hold line cut off after four hours each time,” Quick said. “I called the [Department of Human Services] number, the 1-800 numbers, all the different people and places they tell us to call into. I’m always stuck on hold, or put in an endless loop, and can’t get help.”
Last week, when Quick finally reached someone by phone, she was again instructed to log on to the online portal and update Avery’s profile. Which, again, doesn’t seem to exist.
Quick, a single mother to three kids and caregiver for her paralyzed stepfather, has had trouble carving out time to visit a social services office in person. She finally had an appointment Tuesday. There, she was told Avery could get coverage again — as soon as the state received yet more documentation of her household finances, which Quick scrambled to gather.
In the meantime, Quick remains terrified about what ailments or injuries might happen before she can get health coverage reinstated.
“I just have to hope that anything that comes up can be solved by Mommy doing ‘Mommy Magic,’” she says — referring to kisses and ice packs, rather than expensive doctor and hospital visits.
This is an old American story: Even those families whom Congress has deemed “deserving” of public insurance must navigate Kafkaesque red tape if they wish to receive or maintain coverage, especially in states unsympathetic to helping poor people. Arkansas’s own officials imply that there’s nothing to see here, that the state is merely “right-sizing” its Medicaid rolls — i.e., returning to its usual, pre-pandemic levels of government dysfunction. State officials allege that if lots of people are recorded as having not completed their paperwork, that’s probably because they wouldn’t qualify for or didn’t want Medicaid anymore.
In other words, the state somehow believes low-income families prefer “Mommy Magic” to actual medicine.