Thread by @LChurchilll

NEW: Under the Trump Administration, @CMSGov bore down on the state of Idaho and ordered it to alter procedures aimed to help eligible recipients keep their Medicaid coverage.

Many with no income, the self-employed and special-needs children now face BIG new barriers. (THREAD)

@CMSGov 2/ Families with Katie Beckett coverage, a type of Medicaid for children with special-needs, were especially impacted by the changes. Kids on Katie Beckett are among the nation’s most vulnerable, with complex medical needs or long-term disabilities.

Like Paul Petersen...

@CMSGov 3/ Paul is a 4-year-old who has been under treatment to restore use of the right side of his body since having a stroke around his first birthday.

He lost Medicaid coverage weeks before a scheduled surgery to close a hole in his stomach.

@CMSGov 4/ To keep their coverage, Idaho families like Paul’s were used to updating their medical evaluations every three years. Their financial information was typically checked by the state internally.

@CMSGov 5/ Changes ordered many to report their updated income for the first time this year, but they say nobody ever told them.

@CMSGov 6/ Paul’s family could not afford to pay for the surgery without Katie Beckett coverage, so they canceled the procedure until they were reinstated weeks later after being forced to reapply for the program altogether.

His surgery in early September was successful.

@CMSGov 7/ Idaho’s Katie Beckett challenges serve as a small window into a larger enrollment trend within the state and nationwide.

Idaho has lost 8% of Medicaid and CHIP enrollment since December 2017. One million children across the country have disappeared from the programs.

@CMSGov 8/ Researchers say several changes have led to the decline, including a healthier economy, a few Trump policies and new state-level administrative burdens.

Idaho is the first state to attribute its new paperwork requirements to direct instructions from CMS.

@CMSGov 9/ Idaho previously led the nation in automatically renewing recipients’ income without requiring additional paperwork, but after finding payment errors during an audit @CMSGov told the state they needed more documentation.

@CMSGov 10/ @CMSGov said in a statement it determined Idaho was not complying with verification rules established under the Obama administration’s Affordable Care Act. “CMS provided Idaho technical assistance on the issue, and the state plans to revise their process,” the statement said.

@CMSGov 11/ Read more about the changes and families like Paul’s who are struggling to maintain coverage because of them: bit.ly/2qhKl5R

@CMSGov 12/ And keep up with new @propublica stories as they come by signing up for our Big Story newsletter: go.propublica.org/bigstory-social