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ATLANTA — More than 15 million people nationwide could lose their current Medicaid or Children’s Health Insurance Program coverage as COVID-related Medicaid expansions come to an end April 1.

In Georgia, that means more than 550,000 people will likely have to find coverage through the Marketplace or other health care coverage.

The Medicaid expansion was authorized in March 2020 through the Families First Coronavirus Response Act (FFCRA), which gave states an extra 6.2% in federal Medicaid funding in exchange for maintaining enrollment for most individuals. Before the act was passed, states reevaluated Medicaid eligibility every year.

Medicaid recipients, including an estimated 2.7 million Georgians, are encouraged to regularly check their mail and email for a notification from the Department of Human Services and Medicaid offices to begin the process. Those with Medicaid should check their Gateway account to make sure all information is up-to-date.

“This will be something new for a lot of people,” said Antrell Tyson, director for the U.S. Department of Health and Human Services, Region IV, which represents much of the southeast. “…The likelihood of having outdated mailing address is going to be probably the biggest problem, especially in areas where housing prices are going up and people are moving.”

Since February 2020, nearly 21 million people (resulting in a 29% increase) enrolled in health coverage through Medicaid or CHIP as of October 2022.

Those who lose Medicaid/CHIP coverage between March 31 to July 31, 2024, will be eligible for a 60-day special enrollment period beginning the day they submit a Marketplace application.

“It won’t be everybody at one time, so that’s why people have to continually check their email and their mail to know when they their redetermination (has started),” Tyson said. “So everybody won’t be due on April 1. That’s just when it starts.”

Georgia is one of nearly a dozen states that has not fully expanded Medicaid to cover more low-income Americans up to age 64 by expanding to incomes up to 138% of the federal poverty level. The federal government would increase its share of the costs to 90% and the states would bear a 10% cost under a full expansion.

Gov. Brian Kemp and Georgia republicans have cited cost concerns in opposition to Medicaid expansion. During a budget presentation in January, Caylee Noggle, commissioner of the Georgia Department of Public Health, said Georgia’s growth of more than 570,000 Medicaid members since the start of the pandemic has resulted in an added cost of $3 billion to the state.

Instead of a full expansion, Kemp is preparing to launch the Pathways to Coverage Medicaid waiver plan in July, which is estimated to add 50,000 uninsured Georgians to a Medicaid plan. Those enrolled in Pathways will have to complete a minimum of 80 hours per month of work, job training, education, volunteering or similar activities.

Approximately 250,000 Georgians who gained coverage during the pandemic period could potentially transition to the Pathways, which will cost the state $610 million, according Leah Chan, senior health analyst at Georgia Budget and Policy Institute.

“If we were to fully expand Medicaid now, it would cover almost double that amount of people and the state’s costs would be offset by the federal funding flowing to the state for at least the first two years thanks to the new financial incentives offered under the American Rescue Plan,” Chan said. “When you add it all up, fully expanding Medicaid now makes good financial sense and could help Georgians avoid harm to their health and to their financial security during the upcoming Medicaid unwinding.”

Chan said hospitals and health care facilities will likely begin experiencing revenue losses as uncompensated care is expected to increase as people drop off of Medicaid.

“We know that here in Georgia, it is children and communities of color that will be disproportionately harmed by Medicaid unwinding, and that rural and safety net hospitals that have been temporarily propped up by pandemic era federal funding will again feel that mounting financial strain of uncompensated care,” she added, noting that 70% of those covered by Medicaid and PeachCare for Kids are children.

During the unwinding period, states’ Medicaid workforces and existing processes are expected to be burdened.

Georgia lawmakers recently approved $8.4 million for staffing and technology needed for Medicaid redetermination in the amended FY mid-year 2023 budget.

According Georgia Medicaid, eligible recipients must have low income and either be pregnant, a child, 65 and older, have a disability or need nursing home care. Generally, however, household incomes at or below 133% ($18,075) of the federal poverty level are likely to be eligible for Medicaid. Figures increase with the number of children and household size.

Georgia DHS encourages Medicaid recipients to check their Gateway account online to make sure that their information is up-to-date as the re-evaluation period begins in the coming months. CMS recommends that Medicaid/CHIP enrollees submit or update an application on HealthCare.gov as soon as they receive their Medicaid/CHIP termination letter from the state.