Medicaid enrollment climbs as pandemic brings hardship

The economic downturn triggered by COVID-19 is producing the expected result in Georgia’s Medicaid program: A surge in enrollment.

State figures show Georgia’s Medicaid enrollment increased by 42,000 in May. That rise followed an enrollment spike of 91,000 in April.

During those two months, the pandemic devastated the economies of the state and nation, leading many people to lose jobs and income.

During such tough times, more individuals and their family members wind up enrolled in Medicaid, the federal/state program for the poor and the disabled.

Nearly 2 million Georgians are currently members of Medicaid and PeachCare – and most of them are children.

States that have expanded their Medicaid programs under the Affordable Care Act (ACA) are expected to have even bigger increases in enrollees amid the pandemic, because they allow more coverage for low-income adults. Georgia is one of 14 states that have not expanded the program, with the state’s Republican political leadership saying the move would be too expensive.

With all the job losses amid the pandemic, Georgia is likely to see a big jump in the number of people who are uninsured, according to Bill Custer, a health insurance expert at Georgia State University. Georgia already has the third-highest rate of people without health insurance, at 13.7 percent.

The financial hit on states’ Medicaid program from higher enrollment was cushioned when early in the COVID pandemic, Congress enacted a temporary 6.2-percentage-point boost in the federal Medicaid matching funds rate.

The legislation conditioned the higher federal rate on states maintaining pre-COVID Medicaid eligibility standards. The increase and coverage protections will expire when the emergency declaration is lifted.

The Kaiser Family Foundation reported that 43 states have made changes to facilitate access to Medicaid and/or Children’s Health Insurance Program (PeachCare in Georgia) in response to the COVID-19 crisis, beyond those required to obtain enhanced federal funding.

These include changes to expand eligibility or modify eligibility rules, eliminate or waive premiums, and streamline application and enrollment processes.

Georgia’s Department of Community Health has suspended the collection of all Medicaid co-pays for services and PeachCare premiums and co-pays. The suspension of payments will continue through the duration of the coronavirus national health emergency, or when the state is approved to reinstate applicable premiums and/or co-pays, whichever comes first.

And Georgia is one of 14 states that are facilitating continuous coverage for CHIP enrollees, mirroring the requirements in Medicaid to receive enhanced funding, the Kaiser Foundation said.

Community Health officials indicated this week that overall use of medical services by Medicaid members has dropped. That’s part of a trend across the health care system during the COVID-19 crisis, as many patients have chosen to forgo or delay care due to fear of infection, financial hardship or other reasons.

But pent-up demand for medical services is expected to be unleashed at some point, and that will combine with the expiration of the extra federal funding to put a financial squeeze on the Georgia Medicaid program, Custer said Friday.

“There are costs that cannot be avoided by state government. It will put pressure on the state budget process,’’ he added. “Without some additional help from the federal government, this will be a hard lump to swallow for the state budget.’’

And the rise in uninsured people will not only leave hospitals with more non-paying patients, but it will also strain the state’s programs that help rural hospitals, Custer said.