Just slow down a bit to check the cracks to see if any children have fallen through.
That's mainly what the organization known as Arkansas Advocates for Children and Families (AACF) is saying in the way of criticism of the state's nation-leading pace of purges from Medicaid.
Arkansas is a culture long inclined to be in a hurry to catch people suspected of being not really poor enough to qualify for the help they're getting. Welfare programs irk the ruling policymakers of the state, who prefer that people have enough of their own money to take care of themselves.
The issue is whether we're throwing out babies with the bathwater, almost literally.
As you may have heard, the federal government ordered states not to kick anyone off Medicaid during the pandemic. Now states are under federal orders to return to pre-pandemic normalcy and get people off the rolls who'd been maintained there artificially because of covid.
Our state Legislature gave us our own timetable with a state law saying everyone no longer entitled to get Medicaid had to be tossed in six months.
So, Arkansas started at lightning speed, leading the nation on a per-capita basis in April, when 72,802 persons were thrown off. In May, the number was 68,838.
At that point, a federal Medicaid official publicly called for Arkansas to drive slower and more safely. He got on the phone to Arkansas reporters to say that the federal government was advising all states that the process would or should take a year. The federal official expressed special concern for children losing insurance through any frenzy that might be at play in the Arkansas situation.
Arkansas officials dismissed all that because they had their own state timetable and don't like the federal government telling them what to do--or the federal government at all unless a crazed insurrectionist is put back in charge. They proceeded full speed ahead, producing 77,468 removals during June.
Kristi Putnam, the Sarah Sanders administration's human services director, lauded the purge performance and blamed criticism on "fabricated outrage" by "out-of-state media." But the Arkansas Advocates for Children and Families is a decidedly home-state group. For that matter, I am in the media and I come from around here.
Loretta Alexander, health policy director for Arkansas Advocates, told me the group has no problem with setting Medicaid enrollment right by removing persons who have incomes exceeding eligibility. But the concern, she said, is that about 27,000 children in each of the three months appear to have lost health insurance.
She asked for a "pause" to take a closer look at that.
A spokesman for Human Services tells me the state engaged in extensive outreach pre-emptively before the "disenrollment" period began. He said that, in the event of a Medicaid family with children losing coverage, those children were automatically rolled over to Part B of the ARKids First program, and the families so notified. He pointed out there is an appeal process allowing retroactive coverage.
But that automatic rollover applies only to families that file paperwork. It does not affect the 40,497 recipients in April--or the 34,724 in May or the 37,550 in June--who got tossed because they sent in either incomplete information or no information at all.
The state suggests that the vast majority of those people knew they made too much money for regular Medicaid absent the special pandemic circumstance. People with more experience working with poverty say something with a different emphasis--that there are bound to be Medicaid-eligible families with kids among those not responding.
Alexander says AACF has heard from parents who didn't think they were affected because they have Blue Cross-Blue Shield cards and don't consider themselves to be on Medicaid. But they're in fact on the ARHOMES, or the "private option," program, with their private insurance purchased by Medicaid. And they can lose it for that misunderstanding.
A pause, Alexander said, could enable the state to try different and perhaps better outreach programs less reliant on the Internet. She suggested emphasis instead on old-fashioned public-service announcements on local television, which many poor people are likely to see. She advocates plain language informing poor people to pay attention to mailings about Medicaid and to call a number to find out if they have lost coverage or are at risk.
In summation: Efficiency is good; people no longer qualifying for Medicaid need to be taken off it. But haste is bad; there are thousands of poor kids out there who might be ill-affected only because someone responsible for them hasn't done paperwork.
No one forced Arkansas to give itself only half the time other states can take to achieve efficiency while avoiding haste. Our state policymakers simply had a powerful itch to purge some freeloaders.
A short moratorium on scratching the itch seems in order.
John Brummett, whose column appears regularly in the Arkansas Democrat-Gazette, is a member of the Arkansas Writers' Hall of Fame. Email him at [email protected]. Read his @johnbrummett Twitter feed.