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Missouri to keep kids enrolled in Medicaid for 12 months starting next year

In January 2024, those 18 and under who enroll in Missouri's insurance programs for low-income people will not be removed for 12 months.
Hanna Barczyk
Special to NPR
In January 2024, those 18 and under who enroll in Missouri's insurance programs for low-income people will not be removed for 12 months.

Missouri children who receive government health insurance will soon be able to keep their coverage for a year without worrying about being kicked off the state rolls.

A provision in the federal spending bill approved last year ensures all people 18 and under who receive insurance through Medicaid and the Children’s Health Insurance Program will be covered continuously starting Jan. 1.

Missouri is among the states that do not offer yearlong coverage.

“Having that 12 months of guaranteed coverage is going to provide more continuity for a family,” said Caitlin Whaley, a spokeswoman for the Department of Social Services, the state agency that administers the programs. “Making sure they have that continuous coverage really allows folks to plan and implement plans to keep their kids well, instead of just treating them when they're sick.”

Eligibility for Medicaid and CHIP is determined by household income and size and children's ages.

Medicaid eligibility and enrollment can sometimes fluctuate throughout the year, said Traci Gleason, vice president of external relations for the Missouri Budget Project, a nonprofit policy research institute that has advocated for expanded health coverage.

“You have people whose work hours might change, or seasonal workers, so this evens out coverage,” she said. “Minor changes in income are going to mean the kids won’t get kicked off. So they’re able to build relationships with physicians, they’re able to plan care in a way that hasn’t been possible when they’re being reassessed every month.”

The federal rule takes effect as tens of thousands of children are being removed from the state’s Medicaid program, MO HealthNet. Pandemic-era protections that kept Missouri and other states from removing anyone during the COVID-19 public health emergency expired earlier this year.

The state is systematically reviewing the state’s Medicaid recipients each month and removing those no longer eligible. Since the process started earlier this year, the state has removed nearly 110,000 people from the rolls, and close to half of those recipients were children, according to an analysis of state data by KFF, a nonpartisan health research nonprofit.

A large portion of those kicked off were disenrolled for “procedural reasons.” That means the state could not contact patients or otherwise prove their eligibility through data from WIC, SNAP (formerly known as food stamps) or other means.

While the continuous coverage requirement comes amid the state’s review of pandemic-era enrollees, the two are separate programs, Whaley said. The 12-month coverage will apply to those who enroll after Jan. 1, but those who are determined to be ineligible or who the state cannot reach during the Medicaid review process will still be taken off coverage.

“[The] restarts of those annual renewals, that is a return to normal business,” she said, “And even once we implement continuous eligibility, we will still be doing those annual renewals.”

Advocates for children’s health coverage were pleased about the change coming in January but are still concerned about the kids being removed during the state’s Medicaid reviews.

Keeping health insurance stable means kids can have more checkups, vaccinations and health screenings to keep them from getting sick, said Tim McBride, a health economics professor at Washington University.

“You know, we're worried about the number of kids we're losing now,” he said. “Going off and then going back on … the kids need coverage. I mean, their parents have sometimes difficult lives, and they may not sign them up again until they need coverage, which is not good.”

Joel Ferber, advocacy director of Legal Services of Eastern Missouri, pointed out that the new requirements don’t serve those affected by the latest Medicaid purge.

“If you’re not on Medicaid you don’t benefit from continuous eligibility,” he said. “It's important that the state keeps kids who are eligible on the program now.

Copyright 2023 St. Louis Public Radio. To see more, visit St. Louis Public Radio.

Sarah Fentem reports on sickness and health as part of St. Louis Public Radio’s news team. She previously spent five years reporting for different NPR stations in Indiana, immersing herself deep, deep into an insurance policy beat from which she may never fully recover. A longitme NPR listener, she grew up hearing WQUB in Quincy, Illinois, which is now owned by STLPR. She lives in the Kingshighway Hills neighborhood, and in her spare time likes to watch old sitcoms, meticulously clean and organize her home and go on outdoor adventures with her fiancé Elliot. She has a cat, Lil Rock, and a dog, Ginger.