Concerns Georgia’s Medicaid expulsions would most heavily affect children are coming true as the state confirmed that children and teens made up 71% of state residents who lost the insurance coverage in June.
Advocates worry that many families may not even realize their children have lost Medicaid until they show up at a doctor’s office and are turned away.
As part of a national Medicaid “unwinding,” an effort to cull out enrollees who no longer qualify, Georgia canceled the Medicaid health insurance of more than 67,000 children and teens in June, according to state data. However, 63,000 of those children and teens were dropped simply because the state found their parents or guardians had not filed the necessary application.
Medicaid is the government-funded health insurance program for poor children and some poor Georgia adults who are elderly, federally declared disabled, or meet certain work and activity requirements. During the pandemic federal emergency, everyone in the U.S. who got on Medicaid stayed on without having to reapply. That amnesty ended this spring.
Like all states, Georgia is now re-examining all 2.8 million of its Medicaid enrollees, to ensure everyone enrolled on the program is still eligible. But the data shows that the vast majority of those being dropped from Medicaid might still qualify. The state never got that far in those cases, but dropped them for lack of response.
Credit: HYOSUB SHIN / AJC
Credit: HYOSUB SHIN / AJC
Among the 96,000 Georgians dropped from the program in June, children or teens made up the vast majority, 71%. But among those whose cases were reviewed and their Medicaid was renewed, children and teens were outnumbered by adults.
The numbers only apply to June’s disenrollments and the term “children” was used to apply to enrollees up to age 18, because many of Georgia’s child Medicaid programs allow the child to stay through age 18. The state was not able to count enrollees by age group beyond that. The number of child disenrollees for red tape was first reported by the Georgia Recorder.
Advocates for children fear that those being kicked off have parents or guardians who didn’t realize they needed to reapply.
Jack Grote, a senior staff attorney with Atlanta Legal Aid, works with Medicaid enrollees to resolve problems with the system. He said his fear is the families will only learn that they’ve lost their coverage when they show up at the doctor’s office and get turned away.
“Frankly, the thing that I’m most concerned about is how little I’m hearing,” Grote said. “Considering the numbers that we’re seeing, I think myself and a lot of other advocates around the state were expecting an avalanche of calls. ... That makes me very concerned that a lot of these people probably don’t even know that they were kicked off Medicaid. They probably never got the notice in the mail. Or it was sent to the wrong address or something happened.”
Dr. Anu Sheth, a Lawrenceville pediatrician and member of the executive board of the Georgia chapter of the American Academy of Pediatrics, said her practice has already had that happen.
“It’s a mess,” Sheth said. “It’s really going to become a huge healthcare crisis.”
It’s bad enough for kids with normal health who may lose touch with their doctor and regular visits, Sheth said.
“The big issue is our chronically ill kids,” she said. That includes children with developmentally delayed autism, seizure disorders, asthma, diabetes or other conditions.
In the case of a child with asthma, Sheth said, “when they lose coverage, they lose their prescription medication, their controller medication. So now these are kids who are asthmatic, they get sick, they end up having respiratory distress, they wind up in the emergency room. ... If we’re not managing their asthma, then what it leads to is chronic inflammation in the lungs and long term complications. So now when they’re adults, they have COPD, because it wasn’t managed when they were children.”
From Sheth’s experience, children’s vulnerability to paperwork snafus can have many causes. Kids in low-income households are more likely to shift addresses, or custody, or even their names. The people responsible for making sure they’re on Medicaid may be disengaged or overwhelmed.
State officials say they’ve pulled out all the stops to get in touch with families. They’ve sent sent letters, emails and text messages. They’ve taken out TV and radio ads in English and Spanish. They’ve put up signs at bus shelters, on billboards and done social media ads. They’ve worked with community groups.
“There’s been a special emphasis on children through back-to-school events, communication with principals, etc.,” said DHS spokeswoman Kylie Winton.
In all cases, the state is first attempting to re-enroll people without having to make contact at all, if it already has enough information about them in its other databases.
If it can’t do that, and people don’t respond to the state’s warning notices and re-file their application, they’re dropped from coverage.
In 94% of cases where children were dropped, the reason cited was lack of paperwork. The decision to stop coverage for people because of mistakes or bureaucracy is something federal officials warned states against.
U.S. Secretary of Health and Human Services Xavier Becerra wrote in a letter to governors recently that he was “deeply concerned” about those losing Medicaid coverage due to red tape. That especially went for parents who no longer qualify for Medicaid themselves, he said, but may not realize that they still need to reapply for their kids to stay enrolled.
Medicaid case file re-evaluations for June 2023
Total re-enrollments: 64,423
- Children: 31,383 (49%)
- Adults: 33,040 (51%)
Total disenrollments: 95,578
- Children: 67,454 (71%)
- Adults: 28,124 (29%)
Of those, the number disenrolled for lack of completed application: 89,168
- Children: 63,481 (71%)
- Adults: 25,687 (29%)
Of those, the number disenrolled because the person no longer qualified for Medicaid: 6,410
- Children: 3,973 (62%)
- Adults: 2,437 (38%)
Source: Georgia Department of Community Health
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