Missouri Medicaid rolls have been dropping dramatically lately, a phenomenon that state officials say is due to an improving economy. That would be a nice thing to believe, but advocates for the poor say something else is at work: Many of those leaving the system are being expelled by a state eligibility crackdown that's ensnaring eligible families.

Ensuring that people on Medicaid meet the standards set for the program is important. But too many stories are circulating about genuinely needy recipients getting dropped without warning, or because they're unable to quickly comply with requests for voluminous documentation, and then having trouble getting back on.

Medicaid is the federal-state health care program for the poor that serves close to a million Missourians, most of them women and children. Income below certain levels and other factors are required for families to qualify. This program serves society's most vulnerable populations. Missouri officials need to take a closer look at what they're doing here.

Almost 70,000 people left Missouri's Medicaid rolls in 2018, saving an estimated $50 million. State officials have attributed it to improved employment rates pulling families up so that they no longer needed those benefits.

Certainly, a better economy can move people off Medicaid. But there was a 7 percent drop in Missouri Medicaid enrollment last year, compared to a national drop of about 1.5 percent. Does anyone think Missouri's economy outperformed the national economy last year by that margin?

Eligibility verification sounds like common sense: The state sends you a request for information, you fill out the forms and send them back. However, as advocates for the poor point out, low-income people tend to relocate more often, or may be homeless.

Even those who get the forms may not understand what's required to remain enrolled in the program. According to the Missouri Department of Social Services, Medicaid recipients who got letters seeking information about their eligibility had just 10 days to respond.

It's a process that has led to problems for genuinely eligible people like Tangunikia Ward, a single mother in St. Louis who learned only during a doctor's visit with her 10-year-old son that she'd been dropped from Medicaid. It took her weeks of calls and forms and, finally, getting a legal services organization to help her before her coverage was reinstated.

It's a story that's being repeated too often to be mere isolated mistakes. "When we see over 50,000 children come off the Medicaid rolls, it raises some questions about whether the state is doing its verifications appropriately," Herb Kuhn, president of the Missouri Hospital Association, told Kaiser Health News.

Those questions are worthy of an official inquiry from the Legislature or the governor's office. You don't reform a system by hurting the people it's supposed to help.

– St. Louis Post-Dispatch