And The Great Fiasco Is Coming Soon!
Well, on paper things look great in Missouri!
The number of moms and kids needing Temporary Assistance continues to decline. The number of citizens getting Food Stamps dropped by more than 5,000 people from January to February. And, MO HealthNet (Medicaid) had its smallest increase in many, many months.
Too bad reports from about the state paint a less pretty picture. For example, callers still have issues connecting with the state’s Call Centers. Missouri still hasn’t issued the special SNAP benefits for school age kids for last summer. And, strangely, the number of low-income seniors in Medicaid paid nursing homes keeps dropping.
The Missouri Department of Social Services recently issued the Monthly Management Report for the Family Support Division and the MO HealthNet Division for February 2023. [ www.dss.mo/re ] It will not be a best seller.
The structural problems plaguing DSS have not been solved. They lack the staff to process even the current dampened flow of state citizens who qualify for help. Thousands of eligible families do not receive the assistance they should every month.
Plus, in a minute we’ll get to the Great Fiasco – a planned failure — which the state expects to cost 200,000 their access kato medical care.
First the numbers….
February Missouri Benefits
2023 2020
Temporary Assistance
Children 9,830 16,363
Adults 2,714 4,923
Total 12,544 21,286
Payments $1,234,584 $2,056,352
Per Family $ 228.67 $ 225.85
Per Day $ 8.17 $ 8.07
SNAP (Food Stamps)
Participants 664,349 657,317
Benefits $124,759,405 $79,932,343
Per Person $ 187.79 $ 121.80
Per Meal $ 2.24 $ 1.45
MO HealthNet
Enrolled 1,487,508 848,048
Covered 1,511,403 867,746
Cost $1,255,304,653 $761,096,766
Per Patient $ 830.56 $ 877.10
Managed Care 1,209,555 591,728
Premium $ 404.50 $ 276.55
Nursing Facilities 21,792 29,515
‣ The number of children covered by Temporary Assistance was once better than 120,000. The number of kids born to financially struggling moms has barely changed but eligibility for TA has.
‣ Remember what happened in March 2020? February 2020 represents the calm before the storm.
‣ Note that the cost per patient for Medicaid went down from 2/20 to 2/23 due to the addition of mostly healthy working folk through expansion. This February Managed Care covered four of five recipients, in back in 2020 it was just over two-thirds.
‣ Despite an aging population and the economic upheaval of the pandemic, the number of seniors needing help paying for nursing homes has dropped by a quarter?
The Great Fiasco: Missouri Reviews Medicaid Eligibility
During the pandemic Missouri and the other states were not required to do annual recertification processing of Medicaid participants. This Spring that onerous process – as required by Washington – comes back. State bureaucrats predict that 200,000 – or, one in seven – now covered will lose their benefits. [ https://missouriindependent.com/2023/02/02/200000-missourians-estimated-to-lose-medicaid-as-eligibility-renewals-resume/ ] I believe that will happen. It shouldn’t but it will…
- DSS limped along processing Medicaid applications prior to the pandemic. Now they have less staff and a lot more cases to struggle through.
- The state plans ‘innovative new ways ‘ for Medicaid participants to help with their recertification via electronic communication. Yes, those least likely to have good internet access and computer skills get to ‘populate’ critical data on a very complicated form.
- Missouri has stacked the deck.
The federal government published the 2023 Federal Poverty Guidelines – based on 2022 CPI data – in January 2023. But Missouri won’t start using that chart until October 2023. Most of those facing Medicaid recertification will fall under the 2022 guidelines, based on 2021 data.
Missouri Medicaid Expansion Annual Income Limit
Family of Four
2023 Limit 2022 Limit
$41,400 $38,925
Those stale numbers represent about $1.20 an hour in wages for a full time job.
Further, the default when DSS can’t process any part of a recertification is throwing the person, or family, off the rolls.
Remember, in the old days Missourians talked across a desk with a state employee who completed their request for Medicaid, food stamps and such. Now no one is responsible for any one family’s application. That’s history. Rejection can happen with no human intervention.
So, when bureaucrats project that one in seven Medicaid recipients will lose coverage it is, for the state, the happy result of doing a half-assed job. Remember, the ruling party in Jefferson City rejected Medicaid Expansion. Voters enacted it. In the end, Republicans figure out how to thwart the will of voters. That’s the Missouri Way.
Glenn