Attorney Seeks To Stop State From Approving Waiver
New Haven Legal Assistance Association attorneys filed an injunction against the state Thursday to prevent it from taking any further action in pursuing a waiver application with the federal government to kick up to 13,000 low-income adults off the state’s Medicaid plan.
Sheldon Toubman, the attorney who filed the class action lawsuit against the state for its failure to process Medicaid applications in a timely manner, said the waiver will only add to the existing backlog.
In July, lawmakers heard from an unending parade of Medicaid recipients, who have had problems making sure they’re able to maintain their services through a process called redetermination. But instead of voting on the waiver application, lawmakers didn’t take any action and gave Gov. Dannel P. Malloy’s administration permission to move forward with it.
The budget adopted in June assumed the state would save $50 million next year and $100 million by 2014 by imposing a first-of-its-kind $10,000 asset test on childless adults enrolled in the program. In order to move forward with the concept the state needs the approval of the federal government to make the one-year change to the program.
Toubman argued the new application procedure necessitated by the proposed change would make things even worse for the current system, which is understaffed and dependent on paper. A computer modernization effort is under way, but the state said increasing the number of eligibility requirements will set that effort back three to four months.
“There is no question that the proposed new requirements will result in further Medicaid processing delays across the board,“ Toubman wrote in his brief. “They will delay critical technological improvements designed to address existing processing delays and impose significant new burdens on the DSS workers who will have to apply the complex new eligibility requirements.”
The number of Department of Social Service workers eligible to process applications and redeterminations is fewer than it was 10 years ago and there has been no improvement in the processing of Medicaid applications since the class action was filed eight months ago, Toubman said.
“In August 2012, 55 percent of all Medicaid applications were pending longer than the federal deadlines, the same percentage as when the case was filed,” he argues in his brief.
There have even been small organized protests of the state agency for its shortcomings in determining eligibility both for Medicaid and food stamps.
But the Department of Social Services expressed disappointment Thursday that legal services would go to court again to seek a resolution in the matter.
“As legislated in the 2012 session, DSS is required to make changes in the Medicaid for Low-Income Adults program, contingent on federal approval. That’s the current public policy of the state,” David Dearborn, spokesman for DSS, said Thursday.
“What sometimes gets lost in the discussion is that state budget and program implementation legislation is driving this waiver application,” he said. “It’s not something put forward arbitrarily.”
But Toubman’s Freedom of Information requests included as exhibits to the injunction seem to prove his point that the numbers the state estimated may be more arbitrary than initially thought.
An internal May 3, 2012, email from Officer of Policy and Management Senior Budget Analyst Susan Eccelston to DSS Commissioner Roderick Bremby says Budget Director Ben Barnes “met with the co-chairs last night. To address the increased budget gap in FY 13 due to the declining revenues, the decision has been made to increase the LIA savings from $22.5 million to $62.5 million. We have been tasked to come up with a way to achieve this savings presumably through a lower asset test.”
Initially, the administration had proposed a $25,000 asset test in the state budget, but that number was lowered to $10,000 to increase the number of people who may lose coverage if the waiver is approved.
“I know this isn’t the answer you want, but the LIA savings was increased to $50 million without any detailed analysis to support that figure,” Eccelston wrote to DSS Deputy Commissioner Kathleen Brennan on June 7th,
In a phone interview Friday, Barnes said that he appreciates “well informed estimates” and he understands the $50 million figure is slightly higher than what an independent analysis by Mercer produced.
“We had hoped the Mercer evaluation would have allowed for more savings, but they came in just under that number,” Barnes said.
He said it’s a little strange to see internal budget deliberations be used in a lawsuit, but he’s happy his staff and the Department of Social Services can be so candid with each other.
“I rather suffer the consequences of having to explain it,” Barnes said.
The $50 million in savings estimate was added to the budget adopted by the General Assembly in June. If the state doesn’t get the waiver the legislature and the governor will be forced to find $50 million in savings elsewhere in the budget.
The Centers for Medicare and Medicaid Services could act as soon as Nov. 3 on the waiver application, but Toubman is hoping U.S. District Court Judge Alvin Thompson takes action on the injunction before then.