500,000 mistakenly dropped from Medicaid nationwide

Unclear how many in Georgia were affected.
(PHOTO via Dreamstime/TNS)

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(PHOTO via Dreamstime/TNS)

Federal health officials on Thursday announced that 30 states, apparently including Georgia, had mistakenly dropped people from Medicaid while re-examining their rolls. So far, at least 500,000 children and families nationwide have been improperly marked for cancelation and then reinstated to coverage after officials recognized the problem, according to the U.S. Centers for Medicare and Medicaid (CMS).

As of Thursday, Georgia was still trying to figure out how many Georgians were affected by the mistake, according to federal documents.

Like all states, Georgia is re-evaluating all 2.8 million people enrolled in the state’s Medicaid health insurance program for the poor to see who still qualifies after pandemic protections ended. Medicaid in Georgia covers low-income children and some adults including new mothers, and some elderly and disabled people. Children make up the vast majority of Georgia’s Medicaid enrollees, and children and teens make up the majority of those disenrolled so far.

CMS said that it had required states who made the error to suspend some of their removals while they worked out the issue. Georgia is continuing its disenrolments and “the process is on-going while we continue to assess and mitigate issues, as discussed with CMS,” said Fiona Roberts, a spokeswoman for the state Department of Community Health, which oversees Medicaid.

Health officials and advocates alike are deeply concerned that thousands who still qualify for Medicaid will be dropped simply because they lost contact with the state and didn’t know they had to reapply. In each case, state caseworkers first must send a letter or email to the Medicaid beneficiary or the adult who handles Medicaid for them, letting them know it’s time to re-file their eligibility paperwork in order to stay on. However, families on Medicaid are disproportionately likely to move and change contact information, experts have said.

Indeed, as the state moves through the re-evaluations, more than 80% of the Georgians dropped from coverage so far were dropped for lack of paperwork. The state says it doesn’t know how many were actually eligible but didn’t know to respond.

The new mistaken removals are related to that concern.

The mistake started with looking at entire households that are on Medicaid, and not looking instead at the qualifications of each individual in the household, according to a letter the feds sent to states on Aug. 30.

For example, if a household includes both adults and children, the children may qualify for Medicaid while the adults don’t. And regardless of whether the family filed the proper paperwork, the state has an obligation to look through its existing databases for those children’s separate qualifying information. According to the feds, though, that didn’t happen.

Instead, CMS found, some states were removing the entire household, qualified children included, based only on the fact that it didn’t get paperwork back from the adults in the household.

Several states reported tens of thousands of people affected. Pennsylvania and Nevada reported more than 100,000 each. Georgia reported that it was still assessing how big the problem was here.

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