Thousands of people in Montana lost Medicaid coverage, not because they were ineligible, but because of “inaccessible and intractable” administrative barriers from the state health department.
This comes according to a letter signed by 66 national and state organizations sent to Gov. Greg Gianforte last week urging the governor to include spending on increased staffing for the Department of Public Health and Human Services, updating outdated software and other measures in his proposed 2027 biennium budget.
The Medicaid redetermination process comes after a freeze on disenrollment during the COVID-19 pandemic, with a total of 135,000 subscribers According to the Medicaid Redetermination Dashboard, the most common reason for withdrawal is a lack of communication with the department. Many former enrollees who may still be eligible must reapply for Medicaid, facing longer than usual wait times and health insurance. Medicaid Providers Lack of applications means we’re struggling to make ends meet Processed.
Ministry of Health preparing preliminary budget
The letter suggested conducting consumer advisory groups, focus groups, surveys and end-user testing to improve communication between the state and customers, and said health department officials should use plain language with customers to reduce delays.
The state health department previously told The Daily Montanan that it meets all federal standards for processing both reassessments and new applications. Department spokesman John Ebelt said Monday that the department is taking the letter’s request into consideration in its budget planning.
“This letter contains specific budget requests that DPHHS is currently working through as it prepares for the executive budget planning process for the next legislative session,” Ebert said in a statement. “DPHHS appreciates the feedback and suggestions made in the letter and will consider them.”
The letter was addressed to Gianforte, but the governor’s office on Monday referred questions to DPHHS. Copies of the letter were also sent to DPHHS Director Charlie Brereton, Department of Human Resources Services Director Jesse Counts, Medicaid Chief Financial Officer Jean Hermanson and Department of Budget and Program Planning Director Ryan Osmundson.
Jackie Semmens of the Montana Budget and Policy Center told lawmakers Thursday that the organizations that signed the letter include food pantries, health care providers, religious organizations and other places people turn to when they “are unable to receive the benefits they qualify for in a timely manner.”
“These organizations are seeing people coming into their food pantries because of delayed Medicaid decisions, forcing them to choose between paying for prescription drugs out of pocket or feeding their families,” Semmens said. “The 60-plus organizations have seen firsthand how cash-strapped the health care sector has been over the past year, which is why they’re banding together to ask the governor to improve access to public assistance.”
Organizations include the Montana Food Bank Network, Fort Peck Tribal Health Department, Montana Head Start Association and the American Heart Association.
The letter, sent June 17, said cuts made by the health department in 2017 led to the closure of 19 assisted living offices across the state, putting pressure on remaining staff.
The Medicaid cuts exacerbated these existing problems and “highlighted Montana’s safety net as outdated, inaccessible, and burdensome for those who need it most,” according to the letter. The groups called on the governor’s administration to invest in and modernize access to safety net services in Montana as it develops its 2027 biennium budget.
Before each Legislative session, the Governor releases a budget that includes proposed spending for the next two years. While the Legislature has the ultimate authority to allocate funds, the budget is a public statement of the investments the executive branch wants to make and approve. The Legislature meets again in January 2025.
Letter: State website difficult to navigate, more in-person support options needed
The groups want more in-person options for assistance, which could include reopening local public assistance offices. The letter says applying in person reduces the chance of mistakes and delays.
“Face-to-face support is a vital lifeline for seniors, people with disabilities and those living in rural areas,” the organisations said.
The state health department’s website for applying for safety net services like Medicaid and food assistance was difficult to navigate, and phone lines were jammed during the release process, resulting in people waiting for hours to speak to someone, the letter said. The groups believe the solution to the problem is to increase staffing at the health department, but the letter did not specify how many more employees they believe are needed.
“Because rural Montana relies on these application methods, Montana should make significant investments to improve their functionality,” the letter reads.
The letter blamed staffing shortages for delays during the Medicaid wind-down. Ebert has previously cited staffing shortages as reasons for Medicaid delays, as well as prioritizing currently uninsured people and reviewing previously unreported resources. He said the state pays 90 percent of “clean claims” (claims that don’t require additional review) within 30 days and meets federal standards of paying 99 percent of “clean claims” within 90 days.
Counts told lawmakers that about 9% of cases are still undergoing eligibility review, amounting to just under 20,000.
The Daily Montanan is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public benefit organization. The Daily Montanan maintains editorial independence. If you have questions, please contact Editor Darrell Ehrlick at 811-545-4411. [email protected]Follow The Daily Montanan Facebook and X.
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