During the period of the public health emergency of COVID-19, states were required to keep individuals on Medicaid rolls without annual reviews. In May of this year, the Biden administration removed the public health emergency. Now states have from April 2023 to June 2024 to requalify for Medicaid. This period is referred to as Medicaid Unwinding. Nationally, 93 million Americans were on Medicaid during the pandemic. In Georgia 2.7 million adults and children receive Medicaid.
On August 30th, The Centers for Medicare and Medicaid alerted state that they may be incorrectly disenrolling participants – mostly children – from Medicaid and the Children’s Health Insurance Program (CHIP). Two programming errors occurred during this period of unwinding. First, states evaluated Medicaid eligiblity per household as a whole rather than separately by children and adults. Second, states that were awaiting replies to questions from one household member would disqualify the whole household. These procedures violate Medicaid and CHIP regulations.
Georgia is one of ten states that have not fully expanded Medicaid. Georgia began a limited Medicaid expansion in July 2023. Adults who earn less than $14,600 a year will now clear the income threshold to apply for a Medicaid insurance card. However, applicants must complete 80 hours of work, job training or qualifying activity each month to keep their coverage. For those awaiting a decision on Social Security disabilty, they will not be eligible because the work requirements would eliminate disability eligibility. Georgia is the only state with a work requirement for Medicaid eligiblity.
An estimate 545,000 Georgians will lose coverage during Medicaid Unwinding. Children represent 69% of all Medicaid and Peachcare enrollment. Increasingly, paperwork burdens to show monthly eligibility make it difficult for low income families to maintain Medicaid coverage. Families are limited by lack of internet access, language barriers, and lack of transportation to offices in rural areas. If a person loses Medicaid coverage, that individual has thirty days to appeal the decision. If the person has failed to provide documentation or to respond to request for documentation, the person has 90 days to provide documentation in order to reinstate coverage.
Health policy advocates question whether the Georgia Department of Human Resources is adequatlely staffed to handle the enormous task of both the Medicaid Unwinding and the Medicaid Limited Expansion. The Georgia Budget and Policy Institute believes that without strategic investment these combined activities “create an unnecessary risk that could be harmful to those who depend on Georgia’s health care safety net, burdensome for state employees, and costly for the state.”