Affordable Care Act
2:36 pm
Wed April 23, 2014

Ohio Medicaid Slogging Through Massive Application Backup; At Least 70,000 In Limbo

The total numbers of backed up Medicaid applications by county. Ohio Medicaid as well as the federal Affordable Care Act have had backlogs piling up the last few months.
The total numbers of backed up Medicaid applications by county. Ohio Medicaid as well as the federal Affordable Care Act have had backlogs piling up the last few months.
Credit Ohio Governor's Office of Health Transformation

The Ohio Department of Medicaid is just beginning to process through a giant backlog of applications received between October 1, 2013 and March 31, 2014, many of which are because of the expansion of the program under the Affordable Care Act. On January 1, 2014, Ohio Medicaid changed its eligibility to include all adults making up to 138 percent of the federal poverty level. That expanded eligibility for low-income people was part of the design of the federal health care reform law, but only about half the states have actually accepted the billions in federal funds associated with the program.  

Since December, Ohio Medicaid has seen a surge in applications, and now anyone with a qualifying income who seeks out a plan through federal website also gets forwarded to the state-run Medicaid program.

But at least 70,000 people who applied for health care through the federal ACA exchange have been waiting weeks or months for their applications to be processed through Ohio Medicaid. A total of 117,000 applications through the federal website or phone number were forwarded to the state, but Sam Rossi of the Ohio Department of Medicaid says Ohio didn’t receive any of those applications until late February. Many of them had small glitches and inconsistencies in the data, and around 45,000 were found to be duplicates with applications that had already come directly to the state.

Finally, the state says some smaller counties started receiving some of the more complicated applications within the last few weeks. Montgomery County is expecting to start getting applications in batches of several hundred a week by the end of April.

These applicants who have been on hold have seen several deadlines and deadline extensions under the ACA come and go—but the feds say they won’t be subject to the law’s penalties for not having coverage by March 31 as long as they started an application sometime before then.

Even without the web of ACA complexities, Ohio Medicaid is dealing with a backup: as of March 31, another 119,725 Medicaid applications received directly by the state were still pending; the Ohio Department of Medicaid expects to get through the overall backlog sometime in May.

Ohio Medicaid got almost 350,000 applications from Oct. 1-March 31; about 65 percent of those have been processed.

As of March 31, 106,238 had been enrolled in the health insurance program based on the new, expanded eligibility.

CORRECTION: A previous version of this story stated that Montgomery County is already receiving Medicaid applications from the state in batches of several hundred a day. In fact, the county is expecting them the week of April 28, in batches of several hundred a week.

Lewis Wallace is WYSO's economics reporter. Follow him @lewispants.