Georgia ranked third worst in nation for kicking kids off Medicaid

Following AJC report on broken Medicaid system, state officials direct $54 million to improve process, hire staff
(PHOTO by Paul Morigi/Getty Images for MomsRising/TNS)

Credit: TNS

Credit: TNS

(PHOTO by Paul Morigi/Getty Images for MomsRising/TNS)

Georgia is disenrolling children from Medicaid in greater numbers than most other states, many of whom may actually be eligible for coverage, according to information released Monday by the U.S. Department of Health and Human Services.

The news came on the same day Georgia announced a new allocation of $54 million to bolster and repair the understaffed effort to requalify the state’s Medicaid recipients. Georgia officials made the decision one month after an Atlanta Journal-Constitution report documented a processing system so broken that enrollees are often given instructions that are impossible to follow, or information on a cell phone screen that contradicts what they see on a desktop screen for the same Medicaid account.

“This allocation is key in helping the state streamline processes and add critical resources where they are needed most so we are more efficient in serving Georgia families and ensuring those who are eligible for Medicaid remain covered,” said Governor Brian Kemp. “We are grateful for all of our caseworkers who have worked tirelessly throughout this federally initiated Medicaid redetermination process, and look forward to the impact this strategic surge will have on their efforts and eligible Georgians.”

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 previous data has shown that children and teens make up the majority of those disenrolled.

Federal officials in their briefing Monday morning called for Georgia and eight other states to take action to ensure children are not being dropped by mistake. They suggested that Georgia take such measures as extending the time that parents are given to file new paperwork, conducting more targeted outreach, and allowing Medicaid insurance contractors to help process renewals. And HHS officials suggested the state expand its Medicaid rules to cover teens who no longer qualify when they turn 19.

“Children depend on Medicaid for their health care coverage,” said Dr. Hugo Scornik, a Conyers-area pediatrician who has led the American Academy of Pediatrics’ Georgia chapter. Families “are coming into the office and then finding out that they’re not covered.”

In the first six months after Georgia began updating up its Medicaid rolls this March, the state dropped 149,000 children from the health insurance program, according to the data. Georgia was No. 3 in the nation for the number of children dropped from Medicaid. Federal officials and public advocates believe many of the children still qualify for the coverage, but were dropped in error — most often due to paperwork errors, either by the family or by the state.

“State choices matter,” U.S. Health and Human Services Secretary Xavier Becerra said in a call with reporters. He and his aides said Georgia had followed only 7 out of 20 recommended tips for states, where other states had taken up as many as 15.

The number of all ages that the state has reported disenrolled as of October 31, 2023 totals 389,000. The vast majority of those — 86% — did not fall out of eligibility. They were disenrolled because of red tape.

That might be because they were notified as required to file their paperwork and simply didn’t respond. But an Atlanta Journal-Constitution report in November, half a year in to the process, documented a broken customer service system facing Georgia parents who learn that their families need to reapply.

Lawyers reported that people would send in their paperwork, but the state Department of Human Services would not recognize that the paperwork was received. Enrollees and public advocates told the AJC that phone lines are almost always busy and caseworker voicemails almost always full.

The state DHS suggests that if people absolutely can’t solve their problems by computer or telephone, they can show up to a state office in person. But it does not tell them that when they do that, the caseworkers may not even be there. Caseworkers often work remotely.

To navigate that bureaucracy, people have just 45 days from the date their case is opened for evaluation to the date the decision takes effect.

Daniel Tsai, an HHS official who works on Medicaid, pointed out that Georgia was first called out in September as one of 29 states that were disenrolling children who shouldn’t be disenrolled, and made to re-enroll some.

Georgia on Monday announced it would suspend disenrollments for children starting early in 2024, but did not say whether that meant parents would have more time to sort out their cases once notified. It did not mention giving families disenrolled for paperwork in 2023 a second chance.

It doesn’t have to happen this way, the officials hammered home. For example California, the most populous state with 39 million people, has disenrolled fewer than half as many children as Georgia has, at 66,000.

Scornik has one patient, a newborn, who should be eligible for Medicaid because of the parents’ low incomes, Scornik said, but the parents have spent months trying to sort out a problem with one of their Social Security numbers. The baby spent two months in the hospital uninsured and the family may have a million-dollar bill coming. The main problem now, though, he said, is the family can’t get the frail baby vaccinated without Medicaid.

EDITOR’S NOTE: This story has been changed to note that Dr. Hugo Scornik is based in Conyers.