Thousands lose Medicaid in Arkansas: Is this America’s future?

Susan Caplener, outreach and patient services coordinator for Mid-Delta Health Systems, a Federally Qualified Health Center in Clarendon, 30 miles east of Marvell, said about 50 or 60 of the clinic’s patients have lost coverage in the last two months. Some days, she said, it’s been too much to handle.

“In the beginning, when all of this was unraveling and we were hearing all of this, I kept telling my boss, ‘I got it. Don’t worry. I got it. I got it,’” Caplener said. “Then a couple of weeks ago, I had a day that, all of a sudden, I was like, ‘I don’t have it. What am I going to do?’ … My phone never stopped ringing.”

For Boose, the coverage loss means she’s been unable to see a doctor for chronic headaches that routinely wake her at night or get relief from prescription medication. For others, it means rationing medications for long-term illnesses, skipping autism therapy or shaving their child’s head for lice because they can’t afford to go to the doctor.

“Being a mother with young children, it’s frustrating,” said Shakina Gates, a 38-year-old mother of three who lives just outside of Marvell in Poplar Grove. “When we have issues, we don’t receive the cards, or we’re trying to get information about our case, we have problems with no one answering the phone, or no one wants to really talk to you.”

CMS officials were in Arkansas last week meeting with patient advocates. Tsai told POLITICO the agency anticipates having similar meetings across the country.

“People should be concerned. This is not a good way to run a system. I say that across the country and for any state,” Tsai said in an interview. “Should we create a system that’s complicated and difficult to follow? No. That should be an uncaveated answer.”

But that’s exactly what appears to be happening as data trickles in from states that began culling their Medicaid rolls in April and May. More than 1 million people have lost their health insurance, according to data KFF has compiled from 20 states. Procedural terminations account for at least 80 percent of people who’ve lost Medicaid in seven states.

What’s happening in Arkansas is unique in its speed but the state’s early efforts are a cautionary tale for the roughly 93 million Americans on Medicaid who are expected to go through the renewal process during the next year.

It will never be perfect

Arkansas Rep. Brandon Achor, a Republican, knows what happens when people lose their Medicaid. Before pharmacy school, he worked as a pharmacy technician in North Little Rock.

“For me, Medicaid is Mrs. Daisy counting out dollar bills three feet from me deciding whether she gets insulin this week or her kid gets an inhaler,” Achor said.

Still, Achor, who now co-owns a pharmacy with his wife, said he has faith in Arkansas’ renewal process and supports the compressed time frame. He said the state isn’t trying to “catch people sleeping.”

“I am worried that people will fall through the cracks, yes. But I have faith that the system honors the need, and that if their need is there and they recognize they have been dropped, that they recognize the resources they have to be re-enrolled,” Achor said in an interview at his pharmacy just outside of Little Rock.


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