Unprocessed Medicaid applications may create backlog, Illinois officials warned

SHARE Unprocessed Medicaid applications may create backlog, Illinois officials warned

In what it calls “a gargantuan task ahead of us,” state officials said Thursday that Illinois is awaiting more than 70,000 Medicaid applications from the federal government for residents — at least some of which may have been incorrectly referred to apply for Medicaid by the federal website instead of buying a plan.

People who make less than 133 percent of the poverty level would qualify for Medicaid. Those who make between 133 and 400 percent of the poverty level are supposed to be eligible for tax credit, which would allow them to buy health insurance on the Illinois Health Insurance Marketplace.

But state officials have warned that at least some of the Medicaid applications they get from HealthCare.gov may actually be applicants who, based on their income, should have been sent to the online marketplace instead where they could shop for a plan under the Affordable Care Act.

People with higher incomes who lack health insurance have until March 31 deadline to get private insurance plan on the marketplace — and may get government tax credits to help them pay for it. Tax penalties result if they are uninsured after that date.

But in order to know who may or may not have wrongly been sent to Medicaid, they need to go through all the applications. And doing that quickly is what concerns state officials, Chicago Sun-Times’ Tina Sfondeles reports.

Michael Koetting, deputy director of planning and reform, told council members of the Health Care Reform Implementation at a meeting Thursday that the number they are expecting from HealthCare.gov is 70,000, and that will be a daunting undertaking for state caseworkers, he said.

Illinois Department of Human Services Secretary Michelle Saddler agreed, saying the incoming applications will “create major problems” and that her agency had “a gargantuan task ahead of us.”

“According to our schedule, it will take more than two weeks to get through the transfers. We don’t know how many applications they have to send to us, but their last count as of Dec. 31 was 70,000 applications, covering more than 100,000 individals,” Koetting said. “That amount will completely swamp us.”

Koetting said caseworkers will be prioritizing the transfers over those who applied for insurance through the federal marketplace. He said 5,000 applications had been transferred to Ilinois from the federal government as of Thursday.

Michelle Sadler, secretary of the Illinois Department of Human Services called the issue a major problem.

“We’re saying this calmly but we are looking at having to take caseworkers off other assignments to focus on this. We’ll be getting this all, but we are really looking at a gargantuan task ahead,” Sadler said.

State officials say prioritizing the federal transfers will ensure that those people will be able to apply for the federal marketplace plans by the March 31 enrollment deadline.

On Monday, enrollment numbers released by the federal government showed that 61,111 Illinois residents had chosen an insurance plan through the Affordable Care Act, Obama’s health care law, by the end of December.

Koetting told the council that more than 250,000 Illinois residents are expected to be enrolled for coverage by spring.

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