What is Medicaid unwinding, and what do Georgians need to know?

What is Medicaid unwinding, and what do Georgians need to know?

Medicaid and PeachCare for Kids provide health insurance coverage to 2.4 million Georgians, most of whom are children. Though Medicaid and PeachCare typically involve a complex annual renewal process, members were relieved of it throughout the COVID-19 pandemic. Instead Georgia’s Medicaid agency (the Department of Community Health, DCH) has been required to keep Medicaid and PeachCare members continuously enrolled in exchange for additional federal funding.

Since March 2020, more than 610,000 Georgians1 have newly enrolled in Medicaid/PeachCare and have benefited from the continuous coverage protections. However, today (April 1st, 2023) Georgia begins a renewal process to see which members are still eligible and to disenroll those children and adults who no longer qualify.

This process is known as the “Medicaid Unwinding.” The unwinding will last more than a year, from April 2023 to June 2024. As many as 545,000 Georgians will lose Medicaid or CHIP coverage during this period because they are no longer eligible or because of administrative barriers. Examples of administrative barriers may include:

  1. Georgia agencies are unable to contact the member or family
  2. The member can’t or doesn’t submit their proof of eligibility by the deadline
  3. Lack of internet connectivity at home to log into the Gateway system
  4. Lack of transportation or work flexibility to go to a county Dept. of Family & Children’s Services office during government hours 
  5. Language barriers, and many others

A survey conducted by the Kaiser Family Foundation showed that a majority (62%) of Medicaid-enrolled families were not aware of upcoming renewals. We need to spread the word so all Georgia members know what to expect, when to act, and how to stay in charge of their coverage!

Some Georgia children, parents or others who are disenrolled due to unwinding may be eligible for other insurance plans, such as through new jobs or the healthcare.gov marketplace. Sadly though, many Georgians will become newly uninsured (in part because Georgia has not yet expanded Medicaid to low-income adults, including some parents). As the Medicaid unwinding unfolds, doctors, pharmacists, and community members are likely to see an increase in the number of uninsured children and adults. These Georgians may be newly unable to access care or have difficulty filling a prescription.

The Medicaid unwinding will impact the health coverage of one out of every four Georgians. It is important that all Georgians understand their role in helping all Medicaid members keep their coverage, transition to new coverage, or raise their voice about the injustice of Georgia’s inaction on Medicaid expansion. Consider how you can help with the following action steps:

  1. Medicaid members: Update your mailing address, email address, phone number, and other contact information at staycovered.ga.gov. Georgia will check to see if you are still eligible for Medicaid or PeachCare for Kids coverage sometime between April 1, 2023 and June 2024. During this time, Medicaid and PeachCare for Kids members may be asked to provide more information or complete certain steps. It is very important to respond to these requests. The requests will be sent in the mail or to your email. That’s why it’s so important to update your contact information at staycovered.ga.gov!  Need help with your renewal or want to help other Medicaid members? Start here!
  2. Community members and community groups: Most Georgia Medicaid members are children and many of their families do not realize their coverage must be renewed. Other Medicaid members include pregnant women, new parents who have given birth since March 2020, some people with disabilities, and some seniors. To help these Georgians keep their coverage, we all need to spread the word! Use and share this grassroots toolkit to activate others in your community.
    • Schools, child care centers, and after-school programs–this includes you! Make sure all of your students and families know that the unwinding is happening and what they can expect. They trust you, which makes you incredibly important for helping them through their renewal!
  3. Nurses, doctors, pharmacists, social workers, and other professional helpers: Spread the word. Print fliers like this one to give to your patients when they come in for appointments or put them on the counter at your pharmacy. If your practice or organization uses email or social media to stay in touch with your patients or clients, consider using this grassroots toolkit to share information about the unwinding with them.
  4. Health insurance navigators, Medicaid assisters, social workers, and other consumer helpers: You’re already helping to spread the word, so tell us how the unwinding is going! GHF will be hosting opportunities for assisters like you to share what’s going well or where consumers are getting stuck. We will help amplify your best practices or help state agency officials understand how to fix the pain points for Georgians.

The Medicaid unwinding will be the biggest health coverage event since the Affordable Care Act rolled out in 2012. By working together, hand-in-hand with Georgians of all stripes across the state, we can keep Georgia’s children and families covered and in charge of their health! 

1GHF analysis of CMS’s State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data

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