Thousands of Georgians could lose Medicaid and PeachCare for Kids as COVID-19 rules phase out
Health officials are urging Georgians with Medicaid and PeachCare for Kids to confirm that all of their contact information is updated in the state’s online Gateway system. On April 1, Georgia and other states began the so-called Medicaid unwinding, a nationwide process to recertify Medicaid recipients’ continued eligibility for coverage through the program.
For the last three years of the COVID-19 pandemic, the federal government required states to continuously cover people enrolled in Medicaid programs to ensure access to health insurance during the public health emergency. That official Public Health Emergency expires in mid-May. And the federal government is giving states until April 2024 to initiate renewals, and until June 2024 to complete eligibility reevaluations for every single Medicaid recipient.
In Georgia, that’s about 2.7 million people, most of them children.
What to know if you currently participate in Medicaid or PeachCare for Kids
The Georgia Department of Human Services is expected to notify Medicaid recipients either by mail or email about 45 days in advance of their individual redetermination deadlines.
Kylie Winton at DHS said anyone found to be ineligible for continued coverage would be notified about the next steps and instructions on how to appeal a coverage determination.
“If a member’s coverage renewal is denied, they will receive a letter notifying them of the decision and explaining the reason why. If the reason is that the member ‘failed to submit’ their documents, they can still submit their documents within 90 days of their redetermination date for reconsideration,” Winton said.
A Kaiser Family Foundation analysis found that the first round of Medicaid disenrollments will occur 60 days after recertification is initiated.
Who risks losing coverage
Georgia’s strategy for helping ineligible recipients includes referrals to the federal health insurance marketplace healthcare.gov.
Georgia is one of 11 states that have not expanded Medicaid under the Affordable Care Act. And advocates have expressed concern that the unwinding will leave people totally uninsured because they no longer qualify for Georgia Medicaid programs but can’t afford private insurance on the marketplace, nor are they eligible for federal insurance subsidies.
“As the Medicaid unwinding unfolds, doctors, pharmacists and community members are likely to see an increase in the number of uninsured children and adults. These Georgians may be newly unable to access care or have difficulty filling a prescription,” according to a Georgians For a Healthy Future report.
The nonprofit group estimated that nearly 550,000 Georgians will lose coverage, either because they are no longer eligible or for administrative reasons. These could include problems, such as a letter being mailed to the wrong address, lack of home internet or language barriers.
The national picture
Nationally, the U.S. Department of Health and Human Services forecasts that 8 million Medicaid enrollees will leave the program due to a loss of eligibility. Another group of enrollees, approximately 7 million people, will be rejected despite still being eligible for coverage. Nationally, HHS predicts that nearly one-third of people who lose coverage –– 4.6 million –– are Latino. And 15% –– 2.2 million –– are Black. In addition, the agency reports children and young adults will also be disproportionately affected.
The federal government requires states to report their progress during the unwinding and adhere to federal civil rights laws. This includes a federal mandate to provide “meaningful language access for individuals with limited English proficiency and effective communication for individuals with disabilities.”
Federal regulators also require states to track their progress and make the data public. Georgia Medicaid data and reports are expected to be made available during the unwinding through the DHS website.
How to update your contact information before your recertification
In order to update contact information, enrollees can go online to the Gateway website, call by phone at 877-423-4746 or arrive in person at their local Division of Family and Children Services office. Locations and hours are here: dfcs.georgia.gov/locations.
If you are determined to be ineligible and need help
Call the Georgia Legal Services Program Public Benefits Hotline. The hotline number is 888-632-6332, and it’s available on weekdays from 9 a.m. – 4 p.m.
For free assistance signing up for new health insurance, including through healthcare.gov, you can speak with a certified Legal Services Program navigator by calling 866-442-3676 or making an appointment online.