By Jonathan Ingram, Nic Horton and Josh Archambault —Mr. Ingram is Research Director, Mr. Horton is Policy Impact Specialist, and Mr. Archambault is a Senior Fellow at the Foundation for Government Accountability.
Arkansas bureaucrats are wasting millions of dollars providing Medicaid benefits to people no longer eligible for the state’s Obamacare expansion. But is that just the tip of the iceberg?
Last month, internal e-mails from the Arkansas Department of Human Services surfaced, revealing that the state had never bothered to verify that individuals enrolled in Obamacare’s Medicaid expansion were still eligible for benefits. According to data provided by state officials, this is costing taxpayers up to $20 million each and every month.
We previously questioned why the state hadn’t started the redetermination process yet – which should have begun months ago. After all, federal law requires states to verify Medicaid enrollees’ eligibility at least once per year.
Department of Human Services Director John Selig (Photo: Log Cabin Democrat)
As we reported at the time, state officials contended that they had received a temporary waiver from the Obama administration, allowing them extra time to perform the eligibility checks. But it turns out that no formal waiver ever existed. Worse yet, a recent follow-up letter from the Obama administration may generate more questions than answers.
No Waiver Existed
After news broke that the state wasn’t performing the required eligibility checks, a number of reporters and lawmakers reached out for a copy of that waiver. Such a waiver would be pretty important – without it, Arkansas would be violating federal law.
But according to internal e-mails and other communications, no such waiver actually existed. Questions about the redetermination process sent state officials scrambling for cover.
That cover came on April 27, 2015, when the Obama administration retroactively approved Arkansas’ delay for all redeterminations that should have been conducted in 2014. The letter states:
[The Centers for Medicare and Medicaid Services] is now providing Arkansas with authority under section 1902(e)(14)(A) of the [Social Security Act] to delay eligibility renewals scheduled for January 1, 2014 through December 31, 2014 for 9 months, until October 1, 2014 through September 30, 2015. The state will continue to act on changes in circumstances, including changes in income.
Obama’s Letter Provides More Questions Than Answers
Unfortunately, this letter provides more questions than answers. First, it says that the Obama administration is now providing Arkansas the authority to delay its eligibility redeterminations. Does that mean that Arkansas was operating without that authority prior to April 27th? It certainly seems that way.
The Department of Human Services also contends that this letter allows them to delay all redeterminations until September 2015. But that is not, in fact, what the letter says. The letter allows them to delay redeterminations due in 2014 “for 9 months.” While a redetermination due on December 31, 2014 would not be due until September 2015 under this letter, one originally due on January 1, 2014 was actually due back in October 2014. This means that all redeterminations originally scheduled between January and August of last year should already have been conducted.
But even more worrisome is that the letter limits the delay exclusively to “eligibility renewals scheduled for January 1, 2014 through December 31, 2014.”It provides zero authority to delay redeterminations that should have been scheduled in 2015. So why hasn’t the state conducted the mandatory redeterminations that were due in January, February, March and April?
The Redetermination Process Should Have Begun Months Ago
Regardless of whether or not Arkansas’ actions are approved by Obama, they should be worrisome to taxpayers everywhere. The state has yet to redetermine eligibility for a single Medicaid expansion enrollee. By now, the state should have re-checked eligibility for more than 170,000 enrollees. Another 70,000 should be due for verification later this year or early next year.
To make matters worse, the Department of Human Services expects that up to 40,000 enrollees are still receiving benefits even though they’re no longer eligible. If those estimates are correct, taxpayers could be on the hook for up to $20 million per month to provide Medicaid expansion benefits to people no longer eligible.
Worst of all, state officials have facilitated this fraud by asking for waivers and continuing to kick the can further down the road. Meanwhile, nearly 3,000 children and adults with developmental disabilities are sitting on Medicaid waiting lists. Some of them have been waiting eight years or more for their needed home- and community-based services. They continue to wait, while Arkansas bureaucrats provide Obamacare welfare to 40,000 able-bodied adults who aren’t even eligible.
Welcome to Obamacare.
This article originally appeared at Forbes on May 11, 2015.