REPORT: Nearly half of state’s Medicaid recipients were not eligible


In May, Oregon Health Authority officials told a legislative committee that the agency might have provided Medicaid benefits to some 32,000 people who no longer qualified for them. That number was updated on Saturday to reveal that more than 37,000 people who were ineligible for benefits received them anyway, and it’s likely to go higher, according to a new report from The Oregonian.

As the agency processes a backlog of 115,000 Medicaid renewals, 28 percent of them may exceed income requirements, but Lynne Saxton, director of Oregon’s health authority, flatly denied that this poses a financial risk for the state. However that backlog means that the rate of people being deemed ineligible is closer to 45 percent.

This information comes as Oregon lawmakers consider imposing a new tax on health care providers.

So far, approximately 37,000 ineligible Oregonians have received free health care, which means that taxpayers paid out as much as $191 million in benefits to people who should have been disqualified. Add that to the hundreds of millions of dollars Oregon has already spent on failed and lackluster healthcare-related information technology projects.

Then again, $191 million is a drop in the bucket when compared to the fact that taxpayers annually spend more than $7 billion on Oregon’s Medicaid program. In fact, the federal government pays about 75 percent of that massive bill.

State officials claim that the U.S. Centers for Medicare and Medicaid gave them approval to keep Oregon recipients on the program until their qualifications were checked, but one Republican lawmaker warned that the state might be on the hook to pay back some of its federal funding after Oregon missed a 2016 deadline.

“There is so much waste, it’s just unacceptable,” said Republican lawmaker Cedric Hayden of Roseburg. “We’re at about $700 million now in IT contracts. I am a strong supporter of Medicaid and the Medicaid expansion. But at some point, the feds will come in and say, ‘Uhh uhh. We’re not going to do this anymore.'”

Robb Cowie, communications director for the Oregon Health Authority, claimed that such a move would be unprecedented. “We are not aware of any state that has been subject to a recoupment from (the U.S. Centers for Medicare and Medicaid) due to eligibility issues stemming from a technology failure,” he wrote in an email Thursday.

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