The day her Medicaid coverage ended, Beverly Likens was in the hospital after a scary trip to the emergency room.
The Kentucky resident was diagnosed with severe anemia and given a blood transfusion after her hemoglobin levels had plummeted. Likens, 48 at the time, was days from having surgery to treat chronic uterine bleeding that she said left her bleeding “constantly.”
But soon a problem appeared: The hospital said she didn’t have Medicaid coverage, jeopardizing her procedure. Likens, who is disabled, was rocked by the news. She believed she’d done what was needed to maintain her eligibility. “I was just ready to fall to pieces,” Likens said, fearing she was “going to spend the rest of my life getting blood transfusions.”
Millions of people nationwide have lost Medicaid benefits after a pandemic-era mandate for coverage expired in March — most of them for administrative reasons unrelated to their actual eligibility. Even the Biden administration and state officials had braced for complications in the historic unwinding of the continuous enrollment requirement, and had assured the public they would guard against such lapses.
Likens and an attorney who had tried to help retain her coverage said technological errors in Kentucky’s eligibility system and state missteps caused Likens’ coverage gap, throwing her surgery into limbo. As her situation demonstrates, a lapse of even a few days can have life-altering consequences.
The state never should have let Likens become uninsured, said attorney Cara Stewart, director of policy advocacy at Kentucky Voices for Health. Stewart tried to submit a new Medicaid application for Likens before her coverage stopped in June. She got stuck in a loop in Kentucky’s online system that “didn’t go away” and prevented the form from getting through. “I was just furious,” Stewart said.
Likens should never have had to reapply for coverage, Stewart said, arguing that the state violated federal regulations that say, before concluding someone is ineligible and terminating benefits, states must consider all scenarios in which someone might qualify. Likens, who doesn’t have children and isn’t working, should have qualified for Medicaid based on her income, which falls below federal limits.
Medicaid, a safety-net health program jointly run by the federal government and states, covers millions of people with disabilities, pregnant women, children, adults without children, and seniors. Often a person who qualifies for Medicaid initially for one reason could remain eligible even when life circumstances change, as long as their income remains below certain thresholds.
Before she lost her coverage, Likens qualified for Medicaid because she had Supplemental Security Income, a program for people with little to no income or assets who are blind, disabled, or at least 65 years old. Likens has multiple chronic conditions, including diabetes, hypertension, and heart disease, and said she initially got on the program after her grandfather, who supported her financially, passed away. Likens was his caretaker and didn’t go to college; following his death, she grappled with depression and anxiety that she still treats with medication and therapy.
Apart from limits on earnings, the SSI program limits beneficiaries’ assets to $2,000 for individuals and $3,000 for couples. After the Social Security Administration told her in March she was no longer eligible for SSI because she had assets whose cash value exceeded federal limits, a Kentucky agency that oversees Medicaid sent Likens a notice in April stating her health benefits would automatically stop at the end of June.
©2023 KFF Health News. Distributed by Tribune Content Agency, LLC.