Staff assured the crowd that everyone there would get to see a DFCS case worker.
“It’s serious,” Ford said. “It’s serious.”
Georgia’s Medicaid disenrollment is part of a year-long “redetermination” process mandated by the federal government, so all states are going through the same process. Since recertifying began last April, Georgia has dropped more than 503,000 people from Medicaid — one of the highest rates of disenrollment in the nation.
Credit: Ariel Hart
Credit: Ariel Hart
Medicaid is the government health insurance for poor children and some poor adults. During the pandemic, federal rules allowed everyone on Medicaid to remain covered without filing paperwork to make sure they still qualified. The rolls swelled to historic levels: 2.8 million in Georgia, or a quarter of the state’s population.
That pandemic amnesty ended last spring, sending all states scrambling to recertify that each Medicaid recipient still qualifies. Those who do not, and those who can’t be reached, are dropped.
Many families only learn they’ve lost Medicaid when they show up at the doctor’s office and are told they’re no longer covered.
Of those disenrolled in Georgia, 85% lost their coverage because the state either didn’t receive or couldn’t find their paperwork, according to attorneys who deal with beneficiaries and state data.
Because most caseworkers work remotely, the in-person attention like was available in Stonecrest isn’t always possible at state Medicaid offices.
The Atlanta Journal-Constitution’s reporting over several months has showed that for many, getting a state caseworker to help them has been crucial to cutting through bureaucratic glitches. But the state’s Department of Human Services, which oversees Medicaid workers, has been understaffed and overwhelmed by the demands for help. The Georgia Department of Community Health oversees DHS when it comes to Medicaid.
DHS officials say they’ve hired more than 1,000 additional workers to deal with the effort and are still hiring. They point to the federal government for placing “extraordinary pressures ... on DHS staff.”
DHS officials have also said some former Medicaid recipients didn’t bother to reapply for coverage because their income has become high enough that they now qualify for health insurance on the Affordable Care Act exchange marketplace.
Data compiled for all states by the nonprofit health research organization KFF show that Georgia has among the highest rates of disenrollment in the nation, in the top 10.
Tabata Champagnie came to the DeKalb DFCS event Saturday afternoon, after the crowd had thinned. She was trying to help seniors she works with who depend on Medicaid to pay for their nursing home care. Some have had their Medicaid cut off with no explanation, she said — so many that she’s now keeping a spreadsheet.
She said a Medicaid worker told her about a month ago there’d been a glitch with a contractor who was supposed to send out the warning letters giving Medicaid recipients 45 days’ notice they were losing coverage.
Department of Human Services spokeswoman Kylie Winton responded that “notices have been sent out within an appropriate time frame every month.”
Samantha Ferguson is an enrollee in both Medicaid and Medicare, she said — or at least she was before she lost coverage. She came to the DeKalb County event after two months of bouncing between phone calls trying to get information on how to get her coverage back.
Ferguson is blind in one eye and visually impaired in the other, and has been participating in treatment for mental illness, she said. She said she ran into trouble proving she’s still disabled, but her case worker at her doctor’s office is the one that has helped her through process.
Ferguson, like many who are kicked off by mistake, said she found out she lost Medicaid when she went to the doctor. She left the DeKalb event believing her coverage will eventually be restored. Still, she said, she’s lost more than two months of health services while she figured out how to regain coverage, all with a disability that makes it difficult for her to navigate the system.
After the event, Winton of DHS said, “We continue to work tirelessly, investing considerable time and resources, to help make sure eligible Georgians have the information they need to stay in control of their coverage options.”
Winton noted the advertisements and individual notices DHS has sent in outreach, including in videos and at community events. They placed a special emphasis on reaching children covered by Medicaid through school events and outreach to educators.
As of mid-December, Georgia had the nation’s third-worst rate of disenrolling children, according to federal data. Washington called on Georgia and eight other states to do more to keep children enrolled, including lengthening the amount of time parents have to respond.
EDITOR’S NOTE: This story has been updated to correct the spelling of a DHS spokeswoman’s last name; it is Winton. The update also includes additional responses from the Department of Human Services.
What’s happening: All 2.8 million Georgians on Medicaid as of last spring are now being re-evaluated to make sure they still qualify.
So far: As of December 31, eight months into the process, 966,000 case reviews were completed. Of those, fewer than half kept their coverage.
The great disconnect: 430,000 Georgians, or 85% of those disenrolled, were disenrolled for lack of paperwork as of Dec. 31.
Resources: The first place to look for warning letters and communication on Medicaid coverage is the patient’s Gateway computer account. More resources are available at https://staycovered.ga.gov/.