Secretary of State Dennis Richardson is doing what he said he would do if elected: Use the auditing function of his office to keep a sharp eye on how state agencies spend public money. This week, he issued an "audit alert" warning that the Oregon Health Plan may be paying health benefits to Oregonians who are no longer eligible for the federal Medicaid program.
The reaction from both sides of the aisle in the Legislature was swift and predictable. A House Democrat said the alert amounted to "grabbing headlines" before all the facts were in. The Senate Republican Office called the situation a "Medicaid fiasco," and Senate Minority Leader Ted Ferrioli called for an investigation. Both responses are overreactions.
The rapid expansion of the Medicaid program under the Affordable Care Act and the disastrous failure of the Cover Oregon website led to gaps in eligibility determinations — with the blessing of federal officials — and state health officials are now trying to catch up. But Richardson is right to raise concerns about payments on behalf of potentially ineligible recipients now, rather than waiting for his staff to finish its audit in the fall.
More than 1 million Oregonians are enrolled in Medicaid, and have to have incomes below federal eligibility guidelines to qualify. The Oregon Health Authority, which administers the system, asked federal regulators to waive eligibility renewals for three years while the state shifted from the failed Cover Oregon system to a new enrollment system. A year ago, the state resumed eligibility renewals, and has entered nearly 734,000 eligible recipients into the new system.
The state is dropping 14,000 recipients who did not respond to attempts to contact them about renewing eligibility. An additional 17,000 did respond and their eligibility is being evaluated.
The health authority has said it will determine by the end of the month what to do with the remaining recipients.
Richardson says many of those may be ineligible, potentially costing state and federal taxpayers hundreds of millions of dollars over the past three years. That's a valid concern, but it's impossible to know how many are actually ineligible until that is determined.
The health authority appears to be working to clean up the backlog, but it's certainly appropriate for Richardson to make sure lawmakers are aware of the situation as they work to assemble a budget for the next two years.