A looming health care crisis could harm Missouri's poorest children.
Now is the time for state legislators and state health officials to develop a plan to avert or minimize the tragedy that could befall those children when the federal government's public health emergency ends.
In the three years leading up to the pandemic, Missouri's uninsured rate for children rose from 4.8 percent in 2016 to 6.5 percent in 2019. If there was bright spot in the pandemic, it was that the rate of uninsured children declined to 5.9 percent in 2021 due to the public health emergency, which barred states from removing Medicaid recipients from their Medicaid rolls during the public health emergency brought on by the COVID-19 pandemic.
But even then, the state's rate was higher than the national average.
Like Missouri, a majority of states saw a decline or some stability in the numbers of uninsured children during the public health emergency.
But the health emergency is expected to end within the next year. And it should; one would be hard pressed to suggest the nation should prolong the emergency designation. The federal government has not yet announced when the emergency will end, but it will give 60 days notice. Then, states will have up to 14 months to determine eligibility of all Medicaid enrollees.
That's where Missouri's health crisis could begin. The Show-Me State is one of six states where children are at the highest risk of losing health coverage when the emergency declaration ends, according to a story published this week by the Missouri Independent.
Nationally, an estimated 6.7 million children are at risk of losing coverage, according to a study by Georgetown University's Center for Children and Families.
Millions of eligible children will likely fall through the cracks and become uninsured in states that are inattentive or ill-intentioned when the federal continuous coverage protection expires, said Joan Alker, the director of Georgetown's Center for Children and families and the lead author of the study.
Unfortunately, Missouri has a "history of red tape losses for children," she said. The federal government's continuous coverage provision during the emergency overcame the bureaucratic hurdles that often create coverage gaps for eligible Missouri children, she said.
And there is a real health cost for these uninsured children.
They are more likely to face worsening chronic conditions, miss well-child checkups and their families could face overwhelming medical bills that adversely affect their quality of life, Alker said.
And to make matters worse, most adults in Medicaid-enrolled families nationally are not aware of the impending end of their services, an Urban Institute study found last month.
Thirty-five states have publicly provided plans for how to deal with winding down their services when the emergency ends. But Missouri is not one of those states.
And unfortunately, Missouri has a history of significant tech problems within its social services department that have adversely affected Medicaid recipients in the past and will likely do so again in the future. For instance, many of the department's processes are still manual, such as relying on paper forms. That creates undue burdens for staff and for those who would be served by the program.
And the ones who will likely be most hurt by those burdens are Missouri's children.
Children in states who "have not kept pace with modernizing their eligibility system" are at greater risk of inappropriately losing coverage, Alker said.
The public health emergency is going to end soon. Knowing that, state legislators and state officials need to escalate their planning as to how to handle the transition, implement plans to ensure the quality of care for the state's children does not suffer and then transparently communicate that plan to those who depend upon those vital services.
-- News Tribune