Backlog begets backlog: NC food stamp woes create queue for Medicaid

Posted March 13, 2014
Updated March 14, 2014

— The state's efforts to address a backlog in food stamp applications has worsened delays in processing Medicaid applications.

State officials couldn't provide an estimate of how many Medicaid applications are overdue across North Carolina, but about 1,700 families in Wake County alone are waiting for approval so they can obtain needed medical care.

Sarah Skeen, for example, applied for Medicaid in Wake County five months ago after a routine physical at a Planned Parenthood clinic found a lump in one of her breasts.

A follow-up breast scan, arranged through the Komen Foundation, found a second lump. One, doctors said, needs to be biopsied.

Skeen, who is not insured, couldn't afford the cost of a biopsy, so she turned to Medicaid for help.

"I filled everything out, submitted all my paperwork, and I was told by the woman at the counter (it would be approved at the) latest December, maybe the beginning of January," Skeen said Thursday.

That date came and went. Skeen has been calling Wake County's Division of Social Services every few days for updates on her application. Lately, she says, she can't even leave a message – the voicemail boxes are full. 

"They haven’t even looked at my application. That’s the one answer I have managed to get," she said. "It’s really a joke. Not a funny joke, but it’s a joke."

"It’s an urgent matter," she said. "If I had my Medicaid and I went into the doctor and said I need a biopsy, they’d give me my biopsy. What if it’s cancer? They’re not going to make you wait."

County DSS Assistant Director Liz Scott said she couldn't discuss Skeen's case due to privacy rules, but she said Wake County would focus its resources on the Medicaid backlog as soon as the food stamp backlog is cleared.

The state faces a March 31 deadline to clear all overdue food stamp applications or risk losing federal money that helps administer the program.

The state's decision to shift Medicaid applications to the back burner in recent weeks comes at a time when the Affordable Care Act online marketplace is sending more applicants into the queue.

"Something needs to be done," Skeen said. "There are people sick. There are people suffering. There are people who need help, and they can’t get it right now."

She said she makes just enough money at her Web design job to meet the monthly bills for herself and her 9-year-old daughter. Cancer treatment, if needed, can't fit into her budget.

She's never asked for help before, even though she would qualify. "At the end of every week, I'm counting my change out, but I make it," she said. "I like being self-sufficient. I like not having to ask for help. That’s me. But I need help. I need medical care. And I can’t get it right now."

Skeen is on a waiting list for financial help at Rex Hospital, and she's trying to stay positive for her daughter, but after five months, her patience is wearing thin.

"It's a very long time, and its very scary," she said.


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  • sunshine1040 Mar 15, 2014

    This is emergency surgery and needs to be taken care of immediately. It would have been treated by cancer center before Obama care changed all the rules. I have insurance that paid for my cancer treatments but do you know how much you the taxpayers paid for it one year you paid $3000 a month for a shot. Years before you paid for 8 chem treatments and 12 weeks of radiation. I could not work because of side effects of the treatment for over a year and then all the test you have paid for because I was one of the few that had a good heath insurance plan My husband and I did not have to file for bankruptcy like many I know did and will now have to with their new low cost insurance.

  • matlock7777 Mar 15, 2014

    View quoted thread

    Please read my post. Caseworkers are working crazy overtime and are stressed to the max trying to get these applications processed and their normal work done as well. These backlogs, cases that will not go through, having to work many different programs FS and Medicaid- etc. to now being a universal worker is out of their control. One can blame who they wish, but know that it is not because the workers don't want to do their jobs.

  • matlock7777 Mar 15, 2014

    The Foodstamp and Medicaid issues are NOT fault of the Counties or the county employees. This is a system that NC was forced to push out before it was ready and due to the ACA. It started with FS going on to the new NCFast system., many counties got behind-main reason was due to they system not working properly. Then with the ACA and the open enrollment in Oct 2013 people could go online to "shop" for lower cost subsidies but are directed to apply for Medicaid (even if not eligible) -in order to get a denial letter. This obviously created a HUGE amount of online applications in the Federal marketplace . Since Jan. , those applications are coming from the Feds to the counties and being distributed to the caseworkers to evaluate and process each and every application -(which is not a simple/ quick task) ON TOP of their normal applications for Medicaid and Foodstamp applications and renewals that they have coming in daily. The workers are now universal workers for various programs.

  • goldenosprey Mar 14, 2014

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    What makes you so sure she can pay on a sliding scale? Source?

    How do you know the scale slides far enough?

    If she DOES pay on a sliding scale, are not other patients on the other end of that scale picking up the slack? Isn't that dreaded socialism?

    I would argue she should NOT have to pay full price because the only reason it costs what it does is because of the backwards profit driven system we insist on maintaining, as patients declare bankruptcy right and left. No one in the world, NO ONE pays what we do for healthcare, whether it is full on free market or single payer. Inexcusable.

  • sabsco Mar 14, 2014

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    The answer to every one of your questions is right there in the article.

  • smccaskill1 Mar 14, 2014

    My question is does she work? Is she disabled? Does she have children? So many questions that this does not make sense.

  • goldenosprey Mar 14, 2014


    She was simply enjoying her "freedoms" to not be paid a living wage or have insurance paid for by magic beans. Typical conservative responses are "don't expect taxpayers to pay for YOUR problem" and "work out a payment plan for hundreds of thousands of dollars worth of cancer treatment, especially after it is made worse by delays." My favorite is the complaint this was caused by government healthcare when the opposite is true. This was caused by a LACK of government healthcare. If we had universal coverage this woman and her kids would not be in this fix. But it's so much better to pay twice as much what other countries do...

  • flyfish42 Mar 14, 2014

    Has it occurred to anyone else that perhaps the McCrory/Pope regime (and Aldona Wos) are intentionally screwing up the administration of these systems in order to make a case for privatizing them, and because they feel that everyone on Medicare, food stamps and/or unemployment are simply lazy and unwilling to "get to work"?

  • Eq Videri Mar 14, 2014
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    Quite right, CT. This is mostly a county NC FAST implementation problem.

    It is easy to find problems with Wake County DSS, because it has been poorly managed for years, unfortunately with no sign of improvement. Maybe the incoming county manager will turn things around, but that would take time.

    Look on either side of Wake, though, and other Triangle counties have done very well with NC FAST: Orange, Johnston, etc., as well as other counties around the state.

    Meanwhile Mecklenburg, which has a population similar to Wake's, with even more Medicaid recipients, has done much better with NC FAST than Wake has. Why is that?

    When some counties perform so much better than others at implementation, that tells you that the main problem is local county management, not the underlying state or federal system.

    It would be helpful to voters, taxpayers, and Medicaid recipients if WRAL looked into that.

  • doctorgraves71 Mar 14, 2014

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    So your saying the old system was better for everyone or just you? BTW, this has nothing to do with big gov, it's the people you voted for that are dazed and confused....AHCA is the law, get used to it..