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.