Medicaid was expanded Jan. 1 to include an additional 170,000 New Mexicans but if any of them attempted to enroll in the insurance program through the federal government’s health care exchange website, their applications may be lost in a bureaucratic shuffle.
Healthcare.gov was designed to refer the accounts of Medicaid-eligible New Mexicans to state officials who administer the insurance program for low-income residents.
The website has not been transferring that information to state authorities, however, and officials at the Center for Medicare and Medicaid Services do not have any comment on the fate of the accounts involved.
The Human Services Department has not received any Medicaid-eligible applications from Healthcare.gov, a spokesperson for the state agency said Monday (Dec. 30). The department reportedly received some data from the federal website but the spokesperson added the information was of limited use.
New Mexico is not the only state to encounter technical difficulties in the account transfer process, according to the executive director of the National Association of Medicaid Directors.
“We knew fairly early on this was going to be a problem,” Matt Salo told The Taos News. There were challenges on both ends, he said, with some states unprepared for the federal website’s launch — New Mexico among them.
“They were having challenges receiving data,” Salo said.
Federal officials also expressed concern about the website’s capacity to transfer eligible accounts to state officials in the month preceding Healthcare.gov’s launch.
The goal, instead, was to ensure states were receiving those applications by Nov. 1 but it was not until mid-December that federal officials began testing account transfers to 10 states, including New Mexico.
The effectiveness of those tests was not immediately clear.
New Mexicans who are newly eligible for Medicaid should not despair, though, according to Salo. “The scenario with Medicaid, even if this process is not working perfectly, is better than on the exchange side,” he said, referring to the technical difficulties that have marred the efforts of consumers to enroll in health insurance from private companies through Healthcare.gov.
Medicaid coverage will be retroactive, Salo noted. New Mexicans who might have attempted to enroll in the state-run program through the federal website on Nov. 15, for example, would see any medical bills incurred since that time covered even if their application is not approved until January.
Unlike the health insurance exchange, he added, there is not an open enrollment period for Medicaid and no penalty if Medicaid-eligible New Mexicans are not enrolled in coverage. “But you’re probably better off going to apply directly through the state agency,” Salo said.
More than 29,000 New Mexicans enrolled in Medicaid during October and November, according to data from the Center for Medicare and Medicaid Services.
That interest has been apparent at local organizations that have been assisting residents with health care enrollment. Glitches on the federal website initially frustrated some and while applications are now being processed more smoothly, applicants are still encountering technical difficulties.
“We are receiving many calls from users who have come across issues when utilizing the website, and we then problem-solve with them depending on where the glitch has happened,” Denise Frank, a social worker at Holy Cross Hospital, told The Taos News in an email Dec. 16. “We have been able to help some consumers get through the entire process and purchase insurance on the exchange, and we have also talked to others who completed the whole process on their own, with a few questions for us along the way.”
The Taos Picuris Indian Health Center has also been enrolling newly eligible local residents in Medicaid. By late December, the clinic’s patients benefits coordinator reported submitting 35 such applications affecting 110 individuals.
Eligibility for Centennial Care, the state’s revamped Medicaid program that launched Jan. 1, was expanded to include any household earning 138 percent of the federal poverty level or less. Thus, a single person earning less than $15,420 annually is now eligible for coverage as is a family of four earning less than $31,812.