COLUMBIA (AP) — South Carolina’s Medicaid agency is working to process thousands of applications backlogged through the federal online marketplace.
As of Aug. 1, the state Department of Health and Human Services had reviewed more than 60 percent of the 38,000 applications the federal government began transferring in mid-February. Of those, 13,000 await more information from the applicant.
The agency should be caught up within a couple of weeks, meeting a self-imposed goal it gave federal officials last month, said deputy director John Supra.
“We believe we’re on track,” he told The Associated Press.
Six temporary employees hired since July 1 are helping with the paperwork, and employees are working overtime to determine applicants’ eligibility. Of the decisions made so far, 56 percent are approvals — compared with a normal approval rate of 70 percent. Many others who filled out a form through HealthCare.gov were already enrolled in Medicaid.
The applications date to Oct. 1, when the problem-riddled federal website went live. South Carolina is among the 36 states that chose not to run its own online exchange, leaving that responsibility to the federal government.
The website was designed to help people buy private, government-subsidized insurance under President Barack Obama’s health care overhaul. If shoppers made too little to qualify for subsidies but likely qualified for Medicaid, the site was supposed to send their data to the Medicaid agency in their state. But Medicaid directors were notified in mid-September those transfers wouldn’t immediately work as planned.
South Carolina didn’t start receiving transfers until Feb. 12; most of the backlog had transferred by early April. The state agency has yet to receive an estimated 5,000 to 6,000 applications filled out through the federal site, according to the agency.
Even with the glitches, the agency could have been better prepared for applications it knew were coming, said Sue Berkowitz of Appleseed Legal Justice Center.
“It’s a huge problem,” she said Monday of the state backlog. “I’m a little surprised they weren’t ramped up to begin with.”
Normally, the state takes a median of six days to process Medicaid applications.
The state’s delay in determining eligibility is partly due to unusually high numbers — 40 percent, or about 15,000 of the transferred applications — seeking coverage due to a disability or for long-term care. That’s double the 20 percent of applicants who sought such coverage through state applications submitted over the 2013-14 fiscal year, according to the agency.
Determining eligibility for those applicants is “much more intensive,” said deputy director Beth Hutto.
State officials attribute the increase to a single, possibly confusing question on the federal application. Applicants were asked if they have a disability that interferes with their daily activities. But people can have a chronic condition, such as diabetes and asthma, that impacts daily living without fitting the Social Security Administration definition of a disability, agency officials said.
Officials stress that, for those eventually deemed eligible, their coverage will be retroactive to the date of their application.
Berkowitz said the concern is that, until they get their Medicaid card, “they’ll wait and get sicker and get more expensive and possibly harder to treat.”
In South Carolina, parents generally qualify for Medicaid if their take-home pay is up to 50 percent of federal poverty guidelines. The federal law intended for states to increase coverage for non-disabled adults to 138 percent of poverty and include childless adults, but the U.S. Supreme Court’s decision made that an option, not a mandate. Income limits are already higher for pregnant women, the disabled and elderly in long-term care.
South Carolina is among states not expanding Medicaid eligibility. The state’s Republican leaders have repeatedly refused, leaving a gap between non-disabled adults who qualify for Medicaid and those who qualify for subsidies.
However, as expected, the state has seen a rise in the number of people seeking Medicaid coverage.
As of April, nearly 1.1 million South Carolinians received health care coverage through Medicaid, or more than 20 percent of the state’s population. That’s 169,000 more than Medicaid covered in 2012, according to the agency.