MN - Computer snag drops 22,463 from Medical Assistance rolls

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Computer snag drops 22,463 from Medical Assistance rolls Glenn Howatt Star Tribune Monday, October 9, 2000

About 22,500 Minnesotans on welfare were mistakenly dropped from the state's Medical Assistance health insurance program, a state audit has discovered.

State officials acknowledge that a computer system was not reprogrammed to account for welfare-to-work reforms that took effect in 1998, depriving some Minnesotans of the taxpayer-supported health insurance that they were entitled to after they left welfare because they became employed or because of other reasons.

The oversight affected 22,463 individuals in 9,359 households, or about 8 percent of all people who received cash assistance from the Minnesota Family Investment Plan, as the state welfare program is known, between 1998 and May of this year, when the error was found.

"The system was automatically shutting families down," said Kathy Henry, director of health care eligibility at the Department of Human Services.

"We have since fixed the system," Henry said. "We want to assure everybody who is eligible for health care programs that they can remain in health care programs as long as they need assistance."

It is unknown how many were unable to receive or pay for health care because of the mistake. But in a letter to be mailed this week to those families dropped from Medical Assistance, the state will offer to reimburse them for any medical expenses they incurred. Budget estimates on how much the error will reduce state coffers have not been completed.

The families also will be invited to reapply for Medical Assistance.

But some believe that Minnesota is not doing enough to make good on its mistake. They want everyone who was improperly dropped from Medical Assistance to be automatically reinstated to the program.

"The state is putting all of the burden on the clients when in reality the state made the mistake and they should correct it," said Maureen O'Connell, a policy analyst at the Legal Services Advocacy Project. "By establishing all of these hoops, they are guaranteeing that there are going to be very few people who are actually going to benefit."

O'Connell fears that some people who were terminated will be reluctant to go through the reapplication process, especially if they don't read or speak English and are uncomfortable with the bureaucratic welfare and Medical Assistance system.

"This is the outcome of a very complicated system for health care," said Jim Koppel, executive director of the Children's Defense Fund-Minnesota. "As long as the system remains complicated, people are going to have difficulty getting coverage or getting reinstated."

At least three other states -- Pennsylvania, Maryland and Washington -- automatically reenrolled all those who had lost Medicaid benefits under similar circumstances. Washington took action after the threat of a lawsuit.

Lawsuits for comparable errors are pending in New York and Florida.

"I would be surprised if we don't start hearing from a number of clients on this and we would certainly advise them of their rights," said Tim Thompson, litigation director for Mid-Minnesota Legal Assistance. "This could result in a lawsuit."

Minnesota will automatically reenroll some who were terminated from the program, namely 46 women who were pregnant and 1,174 children under the age 2. Under the state's Medical Assistance rules, most toddlers and recent mothers qualify for health care coverage.

But state officials defend their decision to not automatically reenroll the others because it is unclear whether they are eligible for health care support.

"As guardians of the taxpayers' money, we want to spend it wisely. We want to spend it on people who want assistance, need assistance and are eligible for assistance," Henry said. "Someone who is not eligible should not receive assistance."

Henry said it was likely that any family that needed health care support probably reapplied for Medical Assistance after being terminated. She said department records show that 30 percent of the 22,463 individuals who had been terminated are on Medical Assistance or MinnesotaCare, the state's health care assistance program for the working poor.

Before the welfare-to-work reforms were introduced, Medical Assistance was primarily available only to those on welfare. Even though Medical Assistance eligibility is now handled separately from welfare, many medical assistance recipients and even welfare case workers and other government workers don't understand that the changes have happened.

State officials and legal advocates therefore agree that they need to do a better job educating Medical Assistance recipients and welfare case workers that health care support is no longer linked to welfare support.

"Case workers really don't understand what these new rules are. Without training of case workers, there's a lot of room for error," said Rachel Kline, health policy analyst at the Families USA Foundation in Washington, D.C.

"Families don't understand either," she said. "Surveys have shown that they don't know they are still eligible for Medicaid, so they don't say anything when they get cut off."

Federal officials have visited Minnesota and most other states to examine the problem of Medicaid recipients losing insurance coverage as a result of losing welfare benefits. They will release a report, including results of what they discovered in Minnesota, within the next few months.

Anyone who has questions about the Medical Assistance changes and terminations should contact his or her local county welfare office.

http://www.startribune.com/viewers/qview/cgi/qview.cgi?template=metro_a_cache&slug=drop09

-- Doris (reaper@pacifier.com), October 09, 2000


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