Recently, Georgia has removed over 488,000 individuals from its Medicaid program, a government health insurance initiative aimed at supporting the economically disadvantaged. This mass disenrollment is part of a federally mandated project designed to reassess the eligibility of all 2.8 million Medicaid recipients in the state.
Beginning with the redetermination process with 2.8 million recipients, constituting a quarter of Georgia’s population, the state is facing delays in evaluating even half of its Medicaid beneficiaries. Officials cite a shortage of workers as the primary cause of this setback, revealing the magnitude of the challenge at a legislative session.
Old Requirements for Medicaid Are Back
The pandemic had temporarily suspended the annual paperwork requirement for Medicaid recipients, allowing them to maintain coverage without requalification. However, this amnesty ended last spring, necessitating all states, including Georgia, to undertake the extensive task of recertification.
Federal officials cautioned Georgia in December about the rapid disenrollment of children from Medicaid coverage, surpassing rates in most other states. Unfortunately, the recently released data for 2023 by the state Department of Community Health did not specify the number of disenrolled children. Notably, the majority of Medicaid enrollees in the state are children.
Moving forward, the state announced a 12-month amnesty for children disenrolled after January 1, 2024, enabling them to retain coverage while having an opportunity to reapply.
Nationwide, concerns arise about individuals being dropped due to the state’s inability to locate them. In Georgia, a staggering 85% of disenrollments occur not because of ineligibility, but because the state alleges receiving no paperwork after issuing multiple warnings.
Why Medicaid Users Are Disenrolled and How to Get Healthcare Back
Medicaid users can be disenrolled from the program for a variety of reasons. One of the most common reasons why Medicaid users lost their coverage are changes in their income status. Individuals must meet certain income criteria to qualify for the program. If their income increases above the established limits, they may be disenrolled.
Eligibility requirements for Medicaid can change periodically. If a user no longer meets the requirements, they may be disenrolled. They must also renew their coverage each year. If they do not renew their coverage on time, they may be disenrolled.
If a Medicaid enrollee experiences disenrollment, there are specific steps they can take to regain access to healthcare. The available options vary based on the reason for disenrollment. If the disenrollment resulted from changes in income status, the individual can request a new eligibility review to assess whether they still meet the income criteria.
If changes in eligibility led to disenrollment, the individual should contact their local Medicaid agency for detailed information on the updated eligibility requirements. In cases where disenrollment occurred due to a failure to renew coverage, individuals can renew by reaching out to their local Medicaid agency via phone or by visiting their website.
For disenrollment resulting from administrative errors, individuals have the option to appeal the decision by contacting their local Medicaid agency or utilizing their website. You can find more information about financial assistance programs at healthcare.gov.