PROVIDENCE, R.I. (WPRI) – With more than 350,000 Rhode Islanders undergoing Medicaid recertification beginning this month, state leaders are adamant wait times won’t get longer but acknowledge the number of people getting kicked off the program could be far more than initially estimated.
The Medicaid re-enrollment process, which was put on hold for three years during the pandemic, officially kicked off beginning April 1. State leaders have been scrambling to prepare, and the R.I. Department of Human Services is already reporting wait times at its call center that are more than double the state’s target of 30 minutes.
The dynamic is causing concern among some lawmakers and state union workers, who argue the influx of so many people seeking re-enrollment into Medicaid – estimated at 16,000 to 20,000 per month – will likely exacerbate existing wait times and staffing challenges at the department.
“The facts and data say we should have our hair on fire,” Senate Finance Chairman Louis DiPalma told Target 12.
The McKee administration has pushed back on the idea that wait times will worsen. Call wait times averaged one hour and seven minutes in March, according to the most recently available data. DHS Director Kim Brito said they are in the process of trying to add more staff to help speed up the process, which has topped one hour since at least July.
“It’s not something that we are proud of, but we’re going through a lot of different process changes to tackle that,” Brito told Target 12. “We expect the wait times to stay around the same number — we don’t expect each person will call.”
State leaders’ goal is to try and keep as many people insured as possible, either by recertifying them for Medicaid or finding them some other type of plan, such as those provided through the state’s health insurance exchange, HealthSource RI.
“We think that several thousand, maybe more, may be able to come through the exchange,” said HealthSource RI director Lindsay Lang.
Lang estimates 30% of HealthSource customers currently pay less than $20 per month thanks to federal subsidies.
Early estimates provided by state leaders last month suggested only about 25,000 to 30,000 Rhode Islanders would lose Medicaid coverage during recertification, about 8% of the 350,000 people currently enrolled. The share, however, is less than half of what federal health and human resource officials last year estimated would be coming off the rolls.
Asked about the discrepancy, state leaders acknowledged their number used financial information available to them at a single point of time earlier this year. But they don’t have comprehensive insight into all enrollees’ financial situations, and ultimately the rate could end up being closer to the federal estimate of 17%.
If that happens, the number of Rhode Islanders losing Medicaid coverage would be closer to 60,000, pushing the state’s uninsured rate up from its current 2.9% to somewhere closer to its pre-pandemic level of about 4%.
“It is a massive process that no one in the nation has done in three years, and yes, there is anxiety that comes along with that,” said state Medicaid director Kristin Souza. “Our goal is to keep everyone insured, whether it’s through Medicaid or other options.”
The state agencies will be trying to connect with enrollees in multiple ways, including online, through DHS field offices and through the state’s 15 “navigator” agencies based in community partner organizations across the state.
About half of the 350,000 enrollees could be automatically re-enrolled, assuming the state has the accurate financial information tied to each of those people. The other half will have to take action to remain covered, and the state has already started sending out notifications to people.
One of the most important things people can do to prepare, according to the state leaders, is to start getting their paperwork in order and their contact information up-to-date. They acknowledged that many people have moved over the past three years, which could complicate getting in touch. The state is posting information on a dedicated website, staycovered.ri.gov.
For people getting kicked off the program who think they still qualify for the public health program, Lang said there’s a formal appeal process they can go through. Those who are appealing will remain covered during that period.
“Additionally, if you come off of Medicaid there is a special enrollment period for 60 days that enables you to come through HealthSource RI and pick a plan,” she added.
How smooth the 12-month process goes could ultimately come down to how well the state responds to unexpected issues, and the local union for months has been raising the alarm around staffing shortages. According to a report submitted to legislative leaders in March, DHS still had 117 positions that still needed to be filled.
Matthew Gunnip of SEIU Local 580, which represents DHS workers, told Target 12 the agency has been hiring, but they’re losing people at similar clip, meaning there hasn’t been much of a net gain. Through the first four days of recertification, he said no major issues had come up.
But he expects that will change as the process heats up and people realize their coverage could be in jeopardy.
“They understand a tsunami is coming and they’ve know that for a year,” Gunnip said. “They’re not all hands on deck in terms of getting people hired.”