Medicaid, PeachCare for Kids termination notices going out as Georgia rolls out 'unwinding'

Anyone notified about potential termination will have another 90 days to submit any requested documents to the state. They can also file an appeal.

During the official pandemic public health emergency, which ended May 11, the federal government had barred states from cutting off members’ Medicaid coverage.

The goal was to make sure people had health insurance when they needed it during the crisis.

With the COVID-19 emergency now ended, the federal government is mandating all states recertify the eligibility of every single Medicaid member.

Lynnette Rhodes, executive director of medical assistance plans at the Department of Community Health, said the state is first using records from SNAP and TANF to automatically renew any Medicaid members who are also participating in those programs and remain eligible for health coverage

“Those who can’t be auto-renewed will be contacted to provide the required information,” she said.

So far, the state has automatically renewed more than 5,100 people. Another roughly 7,400 whose names have been matched using SNAP and TANF have not yet renewed.

Numbers showing exactly how many people in the initial round of recertifications are terminated for Medicaid or PeachCare for Kids are expected by the end of May.

Chiquita Brooks-LaSure, the administrator for the U.S. Centers for Medicare and Medicaid Services, was in Atlanta Monday.

She said it’s critical that states get the word out to Medicaid recipients that they need to update their personal contact information with their Medicaid plans, and watch their mail for notifications.

“This is an all-hands-on-deck time that’s going to evolve over the next year,” Brooks-LaSure said. “We all need to be focused on making sure that people know they either need to reenroll in Medicaid or apply for marketplace coverage.”

Georgia’s unwinding is happening as the state is also readying the launch of its work-requirement Medicaid program Georgia Pathways to Coverage.

Pathways will require low-income adults up to age 64 on Medicaid to complete 80 hours of work or volunteering per month in order to receive health coverage through the program.

Democratic U.S. Sen. Raphael Warnock of Georgia criticized the work-requirement program and said he’ll continue to push for full Medicaid expansion under the Affordable Care Act.

The Kaiser Family Foundation estimates full expansion would insure nearly half a million Georgians with incomes up to 138% of the Federal Poverty Level, $17,609 for an individual in 2020.

“And the plan put forward by state-level politicians is covering only a small fraction of those people. There are far too many Georgians, hundreds of thousands who are unnecessarily left out of coverage,” Warnock said.

This fall, the state is also expected to roll out a state-based Affordable Care Act marketplace for Georgians who currently use the healthcare.gov website.

And health advocates have expressed concern that launching Pathways and a state-based exchange this year, while also recertifying almost three million Medicaid members for eligibility could sow confusion.

“Some folks who are currently covered by Medicaid will be transitioning to the ACA marketplace because of the unwinding, and we don’t want that process to be any more confusing or hard than it already is,” said Georgians for a Healthy Future Executive Director Laura Colbert. “If Georgia switches to a state-based marketplace in the middle of the unwinding, that means that will put some extra burden on our Medicaid agency. They’ll need to update their notices. They’ll need to help Georgia Medicaid members understand that if they are disenrolled and they’re eligible for ACA coverage, that they need to go to a new place instead of healthcare.gov. That will be in an added difficulty.”

The state insurance department has sent a formal request to the U.S. Center for Medicaid and Medicare Services to expedite the timeline for launching the Georgia-run marketplace.

The agency typically requires states to take at least 15 months to set up their state-based marketplaces.

A spokesman for Gov. Brian Kemp’s office said the additional time is not needed because Georgia has already partially built the new state exchange website.

It’s now up to CMS to sign off on whether the state will be cleared to roll out the new website this fall.

CMS will also have oversight as the state launches the marketplace, said Brooks-LaSure.

“We have standards when we let states take the marketplace over. And we’ll make sure that if Georgia wants to do that, that they’re going to meet the standards that we have set in the law,” Brooks-LaSure said.

Cick here for information on how to prepare for Medicaid recertification.