‘Catastrophic’: Letter from federal lawmakers to Gov. Kemp demands Medicaid redetermination answers

ATLANTA — Two of Georgia’s federal lawmakers are demanding answers from Gov. Brian Kemp for what they call a “catastrophic outcome” when it comes to children in the state losing their health coverage due to the Medicaid redetermination process.

Sen. Jon Ossoff and Rep. Lucy McBath sent a letter to Kemp on Wednesday expressing concerns over the roughly $149,080 children who lost their medical coverage between March and September 2023. Data published on Dec. 18, 2023 by the U.S. Centers for Medicare and Medicaid Services reported 149,080 children had lost their enrollment status by September 2023 in Georgia.

As of December, state data shows a few more than 503,500 patients, or roughly 41% of those attempting to renew or receive coverage through the program, were terminated or deemed ineligible.

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According to the letter from Ossoff and McBath, due to Georgia’s “mismanagement of Medicaid redetermination,” children who had lost coverage were unable to reenroll.

Additionally, Ossoff and McBath accuse Georgia officials of violating federal requirements regarding the Medicaid program’s management.

“This catastrophic outcome results from the State’s decision to disenroll entire Georgia households from Medicaid, in violation of Federal requirements that children and other eligible Georgians be auto-enrolled at the individual level,” the letter alleges.

Ossoff and McBath also said in their letter that the Georgia Department of Human Services is “now failing to efficiently process re-enrollment cases, leaving a huge number of Georgians without health coverage for an extended period,” many of the homes they say lost the coverage due to “failures by the State to competently process their claims.”

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“The State’s failure to auto-renew children at the individual level, as required by the federal government and to competently execute the Medicaid redetermination process leaves Georgians who have lost coverage at risk. The State of Georgia has a responsibility to manage programs correctly to serve the people of Georgia and is currently failing to do so. Your administration must take immediate corrective action,” the lawmakers said.

Regarding these issues, Ossoff and McBath asked the governor’s office to provide answers to several questions regarding the state’s Medicaid program management, such as speeding up the redetermination process, addressing issues reported with the Gateway computer system, addressing the healthcare needs of children while their eligibility for health benefits is predetermined and asking how many children are still left waiting for their benefits to be redetermined.

According to the letter, “the State has chosen to not report the number of children disenrolled from Medicaid who still lack coverage.”

In February, Channel 2 Action News reported that more than half a million people had lost their medical coverage as a result of the state’s redetermination and Medicaid unwinding process.

The letter from Ossoff and McBath follows both a letter from the U.S. Secretary of Health pushing Georgia to improve children’s access to healthcare, and a lawsuit against the federal government filed by the state of Georgia over its Georgia Pathways to Coverage program.

Responding to requests for comment by Channel 2 Action News, a spokesman for the governor’s office gave the following statement:

“It is extremely disheartening that Senator Ossoff and Congresswoman McBath would offer nothing but misinformation and criticism of a process that they voted to initiate. Contrary to their claim, Medicaid recipients are NOT waiting without health coverage until the redetermination process is complete. Furthermore, according to data provided by DHHS, Georgia does not place in even the top 10 states with the highest percentage of child Medicaid coverage losses, but 80% of those states who did - fully expanded Medicaid. Our state has taken considerable steps, including allocating $54 million in surge staff funding, to efficiently and effectively carry out the review process within the confines of federal guidance, and provide innovative alternatives through Georgia Pathways and Georgia Access for those who are no longer eligible for traditional Medicaid coverage.”

In addition to the statement, the governor’s office provided a graphic showing the top 10 states for lowered child enrollment in Medicaid across the United States, showing that in eight of those states, Medicaid had been expanded for adults, but changes in enrollment still ranged between 12% and 27% lower as of September 2023.

The governor’s office also provided the following actions being taken by the state to increase outreach and awareness of various programs supported by the state to improve healthcare access, including digital advertising and social media outreach, community partnerships and briefings, outdoor advertising, bus stop signage and billboards and direct mail efforts, among others.

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