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Insurers might lose millions of Medicaid members

States lag in verifying recipients' eligibility

Insurers operating Medicaid plans in states that expanded the state-federal program could end up losing thousands--if not millions--of members as officials start double-checking recipients' eligibility, reported Fox News.

Federal law requires that states verify each year whether Medicaid recipients remain eligible for the program, but many have failed to do so. So although the Affordable Care Act led to 15 million people gaining health insurance--many of whom found it through expanded Medicaid programs, millions of those new enrollees may no longer be eligible for continued coverage.

And as Medicaid expansion continues to help boost insurers' earnings, any drastic changes in enrollment could affect their bottom lines.

Arkansas, for example, hasn't started its redetermination process for Medicaid members. Arkansas Department of Human Services Director John Selig believes that up to 40,000 people could be ineligible for the state's Medicaid program, Fox News noted.

There's also been a delay in reviewing Medicaid members' eligibility in Massachusetts. Officials there said the ACA required changes to its Medicaid enrollment website, which then caused it to crash. Because of the glitches, the Obama administration allowed more than 320,000 Massachusetts residents to be added to the Medicaid expansion program without checking their eligibility.

Josh Archambault, senior fellow with Foundation for Government Accountability, estimates that as many as 1.2 million people in Massachusetts still need to have their Medicaid eligibility verified.

But the problem expands beyond Arkansas and Massachusetts. "In truth, we have yet to uncover how many other states the feds are allowing to sidestep the law, and these states may simply be the tip of the iceberg," Archambault told Fox News.

To learn more:
- read the Fox News article

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A look ahead at Medicaid expansion
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