In 2020, Missouri voters approved expanding the Medicaid program. But lawsuits and the COVID-19 pandemic have hampered enrollment efforts. The state officially began processing applications on October 1, 2021, three months after the expansion was slated to begin, according to the Constitutional amendment passed in 2020. By the end of 2021, data shows considerable growth in Medicaid applications.
Under the expansion, up to 275,000 people are expected to enroll in Medicaid. According to the Missouri Department of Social Services, as of February 18, 2022, enrollment in the adult expansion group (AEG) reached 66,489 persons. Reports indicate tens of thousands of applications are “pending.” The Center for Health Economics and Policy (CHEP) at the Institute for Public Health is offering a Missouri Medicaid Enrollment Dashboard, a tracking tool that shows applications to the program growing rapidly.
“The number of enrollment applications from September through December 2021, totaled 111,194 – that’s about 157% higher than the number of people who applied to the program (total 43,640) in the same four months in 2020,” said Professor Tim McBride, co-director of the CHEP and former chair of the state’s Medicaid oversight committee.
Historical patterns suggest that many people apply for Medicaid through the federally facilitated marketplace (FFM) during its open enrollment period, from November to mid-January. McBride said data from the dashboard indicates that 60.6% of the applications in December were through the FFM, while 27.4% were made online. Enrollment in the adult expansion group suggests that the number of people applying in the St. Louis region exceeds 20% of the projected enrollment in most counties. (see table).
As for the large number of pending applications, McBride says it’s likely due to several factors. As noted, most applications come in through the FFM, and Missouri Medicaid officials are choosing to evaluate each person’s eligibility, and that takes time. In addition, Missouri state agencies have faced staff shortages for many years, and this problem has been exacerbated during the COVID-19 pandemic. Missouri also faces significant challenges due to an antiquated computer system, and problems related to Call Centers.
The Center for Health Economics and Policy at the Institute for Public Health advances evidence-based research to improve health and works with policymakers and public health leaders to drive more equitable health policy.