At least 2,000 Gallatin County kids lose Medicaid coverage

More than 24,000 children in Montana have lost vital health care coverage since pandemic-era provisions for enrolling in Medicaid have ended and the " great unwinding" begins.

Newly-released data from the Montana Department of Public Health and Human Services helps illustrate the impact that the federally-mandated reprocessing of millions of Medicaid enrollees is having locally.

In Gallatin County, at least 2,000 children have lost coverage — behind only Flathead and Yellowstone counties.

"We are seeing a trend at probably every community health center across the state where the percent of patients that we are serving that have Medicaid coverage is declining,” said Lander Cooney, chief executive officer of Community Health Partners. "Some of those folks [are] able to transition to [other] health insurance coverage… but the harder number to capture is the patients that have lost coverage and therefore are no longer seeking services.”

Other types of reduced-cost health insurance exist, but Cooney said that not everyone is making the transition.

Some state legislators, including Sen. Chris Pope, D-Bozeman, have lambasted DPHHS for failing Montanans as it rushes to reprocess Medicaid eligibility.

Pope said that he believes the majority of those who have lost coverage are victims of bureaucracy, not ineligibility.

"This is a public health emergency… Montanans aren't losing their health care coverage because they aren't eligible for Medicaid anymore; it's because they're getting kicked off because of bureaucratic inadequacies,” Pope said. "They didn't get the letter, or they tried to try to submit their application and the application was kicked out, or they tried to get on the phone and the phones aren't working — it's so obvious that we have a broken system."

According to the DPHHS, of those who lost coverage, 30% were found ineligible, whereas 62% were denied because of a "failure to provide requested information." Another 1,600 likely lost coverage because their renewal letter from DPPHS never arrived.

"There's a strong argument to slow this process down and to give people the presumption that they are simply being kicked off because of bureaucratic reasons," Pope said.

Montana has also caught the attention of the Federal Department of Health and Human Services' Centers for Medicare and Medicaid Services. The federal agency has expressed concerns over the state's handling of redetermination and the high number of those deemed ineligible.

In a letter from August , the CMS noted the average call wait time in Montana was 42 minutes and 40% of all calls to DPHHS were abandoned.

Thanks to the COVID-19 pandemic, the federal government required states to keep Medicaid participants enrolled continuously through the three-year public health emergency.

By using funding incentive s for states, Medicaid enrollment soared —increasing 30% nationwide from 2020 to 2022, according to the Brookings Institution.

But with the federally mandated “unwinding” or reprocessing of eligibility, millions of Americans, including an estimated 6.7 million children, have lost coverage since protections ended in March. 

Nationally, the impact is being felt in all states, but Montana ranks among the worst by number of renewals according to an analysis by Georgetown University.

"Montana is not doing well,” said Joan Alker, the executive director of Georegtown's Center for Children and Families. "Montana’s pretty low down in terms of their percentage of people they’re renewing… and [they’ve] got quite a lot of 'procedural terminations'."

The trends, Alker says, are clear across the country and the new data only further validates previous concerns that some of the most vulnerable citizens that depend on Medicaid are at risk of being uninsured.

“It's often hard to come by a good coverage offer for yourself, when you're working service jobs or [in] landscaping or agriculture, [it’s] even harder to come by an offer for your kids.” Alker said. “We're very concerned and we know there have been a lot of problems for families during this process across the country. I've seen the numbers from Montana, and I would say, yeah, that's cause for concern.”