Senator Reverend Warnock led a delegation of Georgia lawmakers in urging the Centers for Medicare & Medicaid Services (CMS) to provide tools to non-expansion states like Georgia to help them protect health care access for Medicaid enrollees who lose eligibility after the public health emergency (PHE) declaration ends and to ensure that states are held accountable if there is massive disenrollment

In March 2020, Congress increased Medicaid funding to support states during the PHE, and required state Medicaid programs to maintain beneficiary eligibility during the emergency

When the PHE ends, states will be able to disenroll non-eligible beneficiaries at the end of the month in which the PHE ends

Lawmakers: “Today, we write to respectfully request that CMS provide additional tools that will assist states in complying with unwinding guidance requirements, especially for non-expansion states which face unique challenges … we ask that CMS provide rigorous oversight throughout the disenrollment process and that states be held fully accountable if there is massive disenrollment, there is a significant increase to the uninsured population, and there are gaps in coverage.”

ICYMI from GPB: “In a letter to CMS, U.S. Sen. Raphael Warnock and others underscore the heightened reliance on the pandemic-era protections in Georgia and other states that have chosen not to fully expand Medicaid”

Washington, D.C. – Today, U.S. Senator Reverend Raphael Warnock (D-GA) led a delegation of Georgia lawmakers in urging the Centers for Medicare & Medicaid Services (CMS) to provide tools to Medicaid non-expansion states like Georgia to help them protect health care access for Medicaid enrollees who lose eligibility after the public health emergency (PHE) declaration ends. The PHE is a lifeline for Georgians as it required state Medicaid programs to maintain beneficiary eligibility during the PHE. When the PHE ends, states will be able to disenroll non-eligible beneficiaries at the end of the month in which the PHE ends. Led by Senator Warnock, the group of congressional lawmakers sent a new letter today to CMS Administrator Chiquita Brooks-LaSure requesting that the agency do as much as possible to preserve health care access for current Medicaid enrollees when the continuous coverage requirement provided by the PHE ends.  

“Today, we write to respectfully request that CMS provide additional tools that will assist states in complying with unwinding guidance requirements, especially for non-expansion states which face unique challenges. We encourage CMS to require states to engage with stakeholders to ensure that the concerns and recommendations of Georgia’s Medicaid beneficiaries and providers are heard and taken into account. It is also imperative that states support individuals who are no longer eligible for Medicaid during their transitions to the Children’s Health Insurance Program and the Marketplace so that they remain insured. Additionally, we ask that CMS provide rigorous oversight throughout the disenrollment process and that states be held fully accountable if there is massive disenrollment, there is a significant increase to the uninsured population, and there are gaps in coverage,” wrote the lawmakers.

“We cannot allow Georgians to go uninsured after surviving a global pandemic, and we must do everything in our power to keep all those eligible for Medicaid enrolled in the lifesaving program,” concluded the lawmakers.

Many adult beneficiaries who are no longer eligible for Medicaid will be able to enroll in coverage on the Marketplace where, given their income, they would be eligible for Advance Premium Tax Credits (APTCs) allowing them to enroll in affordable health coverage. However, in the 12 Medicaid non-expansion states, many of the adults benefitting from continuous coverage are parents whose income may exceed Georgia’s low income eligibility level of 33 percent of the federal poverty line when the PHE ends, but they will not be eligible for APTC’s if their income remains below the poverty line. These individuals would therefore fall into the Medicaid coverage gap, adding to the 275,000 in the coverage gap and 500,000 uninsured Georgians already unable to access free and affordable health care. Georgia children would also be impacted by Medicaid disenrollment. 

Senator Reverend Warnock has consistently been on the front lines fighting to expand Medicaid and close the Medicaid coverage gap in Georgia as well as in the 11 other holdout states. Senator Warnock has been working in the Senate to lower costs of prescription drugs and is currently working on a bipartisan pathway to lower costs for insulin—a significant driver of high costs for millions of patients in Georgia and across the country. In addition to Senator Warnock, Senator Ossoff (D-GA), Representatives Bishop (D-GA), McBath (D-GA), Bourdeaux (D-GA), Johnson (D-GA), Scott (D-GA), and Williams (D-GA) were also signatories on the letter.

The full text of the letter can be found here and below: 

Dear Administrator Brooks-LaSure,

During the COVID-19 pandemic, there have been significant protections for Medicaid enrollees. For Medicaid non-expansion states like Georgia, the continuous coverage requirement required state Medicaid programs to maintain beneficiary eligibility during the public health emergency (PHE) has been a lifeline for Georgians, especially children. We appreciate that the Centers for Medicare & Medicaid Services (CMS) also understands the critical role Medicaid has played during the pandemic and has issued guidance to assist states with the large volume of eligibility and enrollment redeterminations. Given the risk of significant coverage lost, we believe there is more CMS can do to ensure the transition is as seamless and harmless as possible.

Today, we write to respectfully request that CMS provide additional tools that will assist states in complying with unwinding guidance requirements, especially for non-expansion states which face unique challenges. We encourage CMS to require states to engage with stakeholders to ensure that the concerns and recommendations of Georgia’s Medicaid beneficiaries and providers are heard and taken into account. It is also imperative that states support individuals who are no longer eligible for Medicaid during their transitions to the Children’s Health Insurance Program and the Marketplace so that they remain insured. Additionally, we ask that CMS provide rigorous oversight throughout the disenrollment process and that states be held fully accountable if there is massive disenrollment, there is a significant increase to the uninsured population, and there are gaps in coverage. We need to ensure that states are upholding their commitment to provide health coverage to the most vulnerable and that redeterminations are evaluated properly to limit the number of people removed from Medicaid coverage.

Many adult beneficiaries who are no longer eligible for Medicaid will be able to enroll in coverage on the Marketplace where, given their income, they would be eligible for Advance Premium Tax Credits (APTCs) allowing them to enroll in affordable health coverage. However, in the 12 Medicaid non-expansion states, many of the adults benefitting from continuous coverage are parents whose income may exceed Georgia’s low income eligibility level of 33 percent of the federal poverty line when the PHE ends, but they will not be eligible for APTC’s if their income remains below the poverty line. These individuals would therefore fall into the Medicaid coverage gap, adding to the 275,000 in the coverage gap and 500,000 uninsured Georgians already unable to access free and affordable health care. Pregnant and postpartum women have also benefited from the coverage protections. We know you share our concern that these women do not have their coverage disrupted by the unwinding of the continuous coverage protections while they are in the postpartum period.

Many of those who would be impacted by Medicaid disenrollment are children especially in a non-expansion state. A recent report estimates that a minimum of 6.7 million children are at risk of losing free and affordable Medicaid coverage. Children living in Georgia, Florida, and Texas were among those identified as being most at risk. Medicaid is meant to expand health care access to low-income children, families, people with disabilities, seniors, and other adults, and we must uphold the integrity of the program. 

We cannot allow Georgians to go uninsured after surviving a global pandemic, and we must do everything in our power to keep all those eligible for Medicaid enrolled in the lifesaving program. We look forward to your response and stand ready to work with you during this transition.

Sincerely,

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