EDITOR’S NOTE: This story has been edited to correct the placement of the closing quotes. The Department of Human Services said people will need to check the I want to continue receiving benefits box on the form at the end of the denial letter 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 could lose coverage Thursday as the state ends its first batch of policy reevaluations as emergency protections expire, state records show.
For three years during the pandemic health emergency, states suspended rules that usually require Medicaid beneficiaries to periodically file qualifying documents. The federal emergency ended this spring, however, and all states are now initiating such reassessments.
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 personal mistakes.
Medicaid now insures 2.8 million Georgians: low-income residents who are children, pregnant women, new mothers, federally declared disabled, and some senior citizens. The beneficiaries amount to just over a quarter of the state’s population.
Georgia officials say it will take a year to go through all of his files, in batches. The first group of unregistered are those whose documents show that they are no longer eligible or those who do not respond to the state they are expected to lose coverage on Thursday.
How many have not been disclosed by the state. Preliminary data since the first warning letters were sent has raised concerns among some experts.
As of April 17, the state mailed or e-mailed notices to about 7,000 enrollees saying they had to reapply for their Medicaid coverage to keep it. By May 12, the state said it had received no responses in about 88 percent of those cases.
The deadline has now arrived for them to successfully reapply or lose their coverage on Thursday.
A spokeswoman for the state Department of Community Health Fiona Roberts said the agency was unable to provide more up-to-date numbers yet.
Of the initial batch of 12,000 beneficiaries, approximately 5,000 were automatically re-enrolled using computerized records and were in no danger of losing coverage.
The state started small with the first batch of 12,000. Subsequent batches will each total more than 200,000 per month.
Federal and nonprofit experts have sounded the alarm that millions of Americans will lose Medicaid coverage not because they no longer qualify, but because they changed addresses or because of bureaucratic errors. Despite national news headlines on the issue, a nonprofit study in March found that 72 percent of Medicaid enrollees across the country were unaware that the national re-application process was underway.
A substantial portion of the terminations we saw in April were due to unresponsive people or red tape, Daniel Tsai, deputy administrator of CMS and director of the Center for Medicaid and CHIP, said during a May 30 call with reporters, according to The newsletter Payer problems from Beckers. Discussions with stakeholders on the ground indicate that most Medicaid enrollees are unaware that Medicaid eligibility checks have restarted.
Jen Tolbert, associate director for the Medicaid and uninsured program at KFF, a health research organization, credited Georgia with searching computer databases to automatically enroll some people and looking through its own databases for addresses to try to find beneficiaries with whom he may have lost contact.
But Tolbert added, simply having bureaucratic hurdles to overcome will lead to people losing coverage not because they deserve it, but due to logistical issues getting through the hoop.
This is especially true for the Medicaid-reliant population, which includes people who may be more likely to change address, be unstable or have difficulty with processes. Their disabilities may be an obstacle or they may need to find a translator. Or parents or guardians of children, the children who make up the largest number of Medicaid recipients in Georgia, may not realize that their Medicaid has expired, but their children are still eligible and should reapply for them.
It seems so simple, right, just sign the form and send it back to the state, Tolbert said. But it’s often not that easy.
A spokeswoman for the state Department of Human Services, which is working with DCH, noted that people appealing 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. receive coverage.
The spokeswoman, Kylie Winton, said those who appeal and seek continued benefits would not receive that interim coverage if they don’t check that box.
Winton also pointed out that the state is sending numerous reminders in all possible formats, including text messages. And if people successfully appeal within the 90-day allowable time frame for people who were turned away because they didn’t respond, their coverage will be reinstated retroactively.
There are many resources on our website, staycovered.ga.gov, discussing where to go with questions, such as a members local DFCS office, Winton said, in an email. We strongly encourage members to visit the site for more information and detailed FAQs. Some resources are available in Burmese, Korean, Nepali, Portuguese, and Vietnamese.
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