Tag Archives: National Center for Law and Economic Justice

Low-income Marylanders with disabilities file lawsuit over Medicaid delays

Last week, the Public Justice Center and the Homeless Persons Representation Project filed a class-action lawsuit against the Maryland Department of Human Resources to challenge longstanding delays in processing applications for and providing Medicaid benefits to eligible adults with disabilities.  For these low-income Maryland residents with serious medical needs, Medicaid is the only way they can afford critical doctor care and prescription drugs.

“No one should have to go through this,” said Mary Lou, the named plaintiff, who had been waiting for nearly a year for desperately needed medical benefits.  “It’s just wrong and I want to do my part to make sure other people don’t have to suffer and get sicker just because they don’t have the money or the insurance.”

Mary Lou lost her insurance benefits after her husband was laid off due to the economy.  Soon, she was unable to pay to see doctors to help her manage her disabilities.  Mary Lou had no other choice but to apply for Medicaid. Although an eligibility determination is supposed to be made within 60 days under state law, Mary Lou had been waiting for a decision for more than 233 days.

“Her case is typical of others I see everyday,” said Carolyn Johnson of the Homeless Persons Representation Project.  “People with serious medical conditions apply for Medicaid and then wait months, often more than a year, for the state to process their applications and provide benefits.  During that time they can’t afford to see doctors or afford testing and treatment, including prescriptions and medical supplies.  So they go without healthcare until serious conditions deteriorate and become acute or life-threatening, which often means they end up in the emergency room costing the state far more money.”

According to the state’s own report, as of December 31, 2012, there were 20,007 pending applications for MA-ABD statewide, meaning the state still had not processed and determined eligibility on these cases.  Of the pending cases, 9,940, almost half, were categorized as untimely due to “agency delay.”  Throughout all of 2012, the number of untimely pending cases never dropped below 8,300, indicating a severe and chronic backlog.

“These numbers represent real people, who are very vulnerable, very sick and need treatment,” said Camilla Roberson of the Public Justice Center. “These delays have been going on for years and are getting worse. The consequences are felt by every poor applicant whose health deteriorates each day he or she goes without needed care and by society at large when it pays for emergency room visits and hospitalization, as well as the lost potential for stabilization or recovery.”

Added Jenny Pelaez, an attorney from the National Center for Law and Economic Justice in New York: “The plaintiff, and others like her, are in dire need.  It’s unconscionable that any state, and especially Maryland — which is often thought to be at the forefront of healthcare reform — is keeping some of its neediest and most vulnerable citizens waiting for something as fundamental as healthcare access because of bureaucratic backlogs.  It’s a violation of law and basic human decency.”

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