Georgia reinstates Medicaid coverage for some adults and children amid 'Unwinding'

A hospital bed in Atlanta. Georgia has until next summer to complete its Medicaid redetermination process. (Jess Mador/WABE News0
Georgia has until next summer to complete its Medicaid redetermination process. (Jess Mador/WABE News)

Nearly 18,000 people will see their Medicaid or PeachCare for Kids coverage reinstated after the Georgia Department of Community Health earlier acknowledged it had inappropriately cut off their coverage during an ongoing process dubbed the Medicaid unwinding. 

Until April, federal COVID-19 public health emergency declarations prevented states from removing anyone from their Medicaid rolls. The goal was to ensure as many Americans could access health care as possible during earlier phases of the pandemic. 

Now that the Biden administration has phased out these initial public health emergency rules, states are “redetermining” all of their Medicaid recipients.

And all recipients have to submit applications to renew their coverage for another year. 

In Georgia, this means the state is reevaluating the eligibility of roughly 2.8 million adults and children for continued health insurance through the safety net programs ahead of a federal deadline next June. 

In a recent letter, the United States Centers for Medicare and Medicaid Services, or CMS, identified 30 states across the country, including Georgia, the agency said had inappropriately disenrolled people because of a so-called systems issue.

The issue resulted in the states inappropriately disenrolling people, CMS said, despite having information showing the individuals remained eligible for coverage. 

CMS directed the states to mitigate the problem to prevent additional improper disenrollments, pause procedural disenrollments, and reinstate coverage for affected individuals, which CMS estimated at around half-a-million people nationwide.

Georgia officials said last week that the state would not pause its process.

And this week, the state Department of Community Health reported it had, “addressed CMS’s updated guidance surrounding ex parte renewals to prevent terminations of eligible persons,” living within the same household. 

The change refers to the state’s process for redetermining a household that includes family members with mixed Medicaid-eligibility statuses, for instance, where the children continue to qualify but the adults in the household do not. 

Under federal regulations surrounding the Medicaid unwinding, states are required to individually renew Medicaid recipients rather than consider entire households at once. 

“As a result, the Medicaid/PeachCare for Kids coverage of 17,940 individuals has been reinstated, retroactive to their date of termination. DCH will continue to follow federal guidance throughout the redetermination process and remains committed to ensuring the availability of coverage for eligible Georgians,” a spokesperson for the agency said in a statement. 

Some Democrats in Georgia’s Congressional delegation have expressed concern about the impacts of the state’s Medicaid unwinding. 

In a letter to the U.S. Department of Health and Human Services and Chiquita Brooks-LaSure, the administrator for CMS, U.S. Sens. Raphael Warnock and Jon Ossoff, and U.S. Reps. Hank Johnson, Sanford Bishop, Jr., Lucy McBath, David Scott and NikemaWilliams asked the federal agencies to ensure that Medicaid recipients who remain eligible for Medicaid programs keep their coverage.  

“We are gravely concerned that this error has led to thousands of children losing coverage and applaud CMS’ commitment to work with Georgia to assure that people are reinstated, that procedural disenrollments are paused, and that the state fixes its system going forward. However, we encourage CMS and HHS to do more to ensure that eligible Medicaid enrollees are not erroneously removed for procedural technicalities,” the letter read. 

So far, Georgia has initiated renewals for more than 800,000 adults and children across the state. 

Georgia is among those seeing a high percentage of Medicaid recipients terminated for procedural reasons, according to state data, such as not responding to document requests or completing their renewal paperwork in time. 

In August alone, the state reported that 57,196 people lost their health insurance coverage for these reasons.