EDITOR’S NOTE: This story has been changed to correct the placement of a closing quotation mark. The Department of Human Services stated that people “will need to check the ‘I want to continue receiving benefits’ box on the form at the end of the denial letter” in order to continue receiving coverage. There are additional requirements beyond checking the box.
Thousands of Georgians who depended on Medicaid for health insurance during the pandemic may lose coverage Thursday as the state finishes its first batch of policy re-evaluations, as emergency protections lapse, state records show.
For three years during the pandemic health emergency, states suspended rules that usually require their Medicaid beneficiaries to periodically re-file their qualifying paperwork. The federal emergency ended this spring, however, and all states are now starting up those re-evaluations.
Federal and nonprofit experts have predicted that large numbers of Medicaid beneficiaries will lose coverage — not because they no longer qualify under the rules, but because of bureaucratic or their own personal mistakes.
Medicaid now insures 2.8 million Georgians: low-income residents who are children, pregnant, new mothers, federally declared disabled and some elderly. The beneficiaries total just over one-quarter of the state’s population.
Georgia officials say it will take a year to go through all its case files, in batches. The first group of disenrollees — those whose paperwork shows they no longer qualify, or those not responding to the state — are scheduled to lose coverage Thursday.
Just how many has not been revealed by the state. Preliminary data from when initial warning letters went out raised concerns among some experts.
Starting April 17, the state mailed or emailed notices to about 7,000 enrollees, saying that they needed to re-apply for their Medicaid coverage in order to keep it. By May 12, the state said it had received no response in about 88% of those cases.
The deadline has now arrived for them to successfully reapply or lose coverage Thursday.
A spokeswoman for the state Department of Community Health, Fiona Roberts, said the agency could not yet provide more current numbers.
Of the initial batch of 12,000 beneficiaries, about 5,000 were automatically re-enrolled using computer records and were not in danger of losing coverage.
The state started small with the first batch of 12,000. Succeeding batches will each total more than 200,000 per month.
Federal and nonprofit experts have raised alarms that millions of Americans will lose Medicaid coverage not because they no longer qualify, but because they’ve changed addresses or because of bureaucratic errors. Despite national news headlines about the issue, a nonprofit study in March found that 72% of Medicaid enrollees around the country did not know the national process of re-application was under way.
“A substantial portion of the terminations that we’ve seen in April were due to folks not responding, or red tape,” Daniel Tsai, CMS deputy administrator and director of the Center for Medicaid and CHIP, said during a May 30 call with reporters, according to the newsletter Becker’s Payer Issues. “Discussions with on-the-ground stakeholders indicate that most Medicaid enrollees are not aware that Medicaid eligibility checks have restarted.”
Jen Tolbert, associate director for the Program on Medicaid and Uninsured at KFF, a health research organization, gave Georgia credit for looking through computer databases to automatically enroll some people, and for researching addresses beyond its own databases to try to find beneficiaries with whom it may have lost touch.
But Tolbert added, the simple fact of having bureaucratic hoops to jump through will lead to people losing coverage not because they deserve it, but because of logistical problems getting through the hoop.
That’s especially true for the population that relies on Medicaid, which includes people who may be more likely to change addresses, be unstable, or have difficulties with processes. Their disabilities may be a hindrance, or they may need to find a translator. Or parents or guardians of children — children comprise the largest number of Georgia’s Medicaid beneficiaries — may not realize that their own Medicaid has expired but their children are still eligible and for whom they should reapply.
“It sounds so simple, right, like, ‘just sign the form and send it back to the state,’” Tolbert said. “But often it’s just not that easy.”
A spokeswoman for the state Department of Human Services, which is working with DCH, stressed that people who appeal a denial of coverage “will need to check the ‘I want to continue receiving benefits’ box on the form at the end of the denial letter in order to continue receiving coverage.”
The spokeswoman, Kylie Winton, said those who appeal and seek continuing benefits will not receive that interim coverage if they don’t check that box.
Winton also pointed out the state is sending numerous reminders in as many formats as it can, including text messages. And if people successfully appeal within the allowed time window — 90 days for people who’ve been rejected because they didn’t respond — their coverage will be reinstated retroactively.
“There are a lot of resources on our website, staycovered.ga.gov, that discuss where to go with questions, such as a member’s local DFCS office,” Winton said, in an email. “We strongly encourage members to visit the site for more information and for detailed FAQs. Some resources are available in Burmese, Korean, Nepali, Portuguese, and Vietnamese.”
Credit: Ariel Hart
Credit: Ariel Hart
Credit: ariel hart
Credit: ariel hart
Credit: HYOSUB SHIN / AJC
Credit: HYOSUB SHIN / AJC
Credit: Hyosub Shin/AJC
Credit: Hyosub Shin/AJC
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