Georgia Medicaid Unwinding (2023-2024): What Happened

Between April 2023 and June 2024, Georgia rechecked about 2.7 million Medicaid and PeachCare for Kids enrollments and ended coverage for more than 802,000 people.1 The "unwinding" was the one-time return to normal annual eligibility checks after a COVID-19 rule had frozen most disenrollments for three years, and Georgia, like most states, dropped a large share of those people over paperwork rather than because they were found ineligible. This guide is a plain-language record of what the unwinding was, the numbers Georgia posted, the permanent renewal rules it left behind, and the concrete steps to take if you or a family member lost Medicaid during it. For how renewals work in Georgia today, see our Georgia Medicaid recertification and renewal guide; this page is about the 2023-2024 event itself.

What the Georgia Medicaid unwinding was

The Georgia Medicaid unwinding was the state's one-time return to normal eligibility checks after a three-year pause on disenrollments that began with the COVID-19 pandemic. It is a settled, concluded event: it started April 1, 2023, ended June 30, 2024, and covered roughly 2.7 million Medicaid and PeachCare for Kids members whose eligibility had not been formally rechecked during the freeze.1

Two federal laws bracket the story. Early in the pandemic, the Families First Coronavirus Response Act (FFCRA) gave states a temporary 6.2 percentage-point bump in federal Medicaid funding on the condition that they keep almost everyone enrolled, so for three years most Georgians could not be disenrolled even if their income rose or they stopped responding to mail.3 When that condition ended, the backlog of postponed renewals all came due at once. That catch-up process is the unwinding.

If you are looking for how to renew your Georgia Medicaid today, this is not that page: the current renewal process (annual reviews, the renewal packet, deadlines, and how to respond) lives in our Georgia Medicaid recertification and renewal guide. This page explains the historical event, the numbers it produced, and what to do if it cost you or a relative their coverage.

Why coverage froze, then thawed: the federal timeline

The continuous-enrollment condition came from Section 6008 of the Families First Coronavirus Response Act (FFCRA), enacted in March 2020. In return for the 6.2 percentage-point increase in the federal match, a state could not terminate most enrolled beneficiaries through the end of the COVID-19 public health emergency, except when a person moved out of state or asked to be removed.3 Enrollment grew sharply across the country and in Georgia as a result.

The thaw came from the Consolidated Appropriations Act, 2023 (CAA, 2023). It separated the continuous-enrollment rule from the public health emergency and ended it on March 31, 2023. It then phased down the extra federal funding over the rest of 2023 (5 percentage points from April through June, 2.5 points from July through September, and 1.5 points from October through December) before the increase expired at the end of 2023. To keep the funding, states had up to 12 months to initiate, and 14 months to complete, a renewal for everyone on the rolls.4 Georgia used that full window, running its renewals from April 1, 2023 to June 30, 2024.

The Georgia Medicaid unwinding by the numbers

Here is what Georgia's unwinding produced, drawn from the Georgia Department of Human Services, the KFF Medicaid Enrollment and Unwinding Tracker, and CMS.1

The headline is the more than 802,000 people who lost Medicaid.1 A "procedural" termination means the state could not complete the renewal (returned mail, no response, or missing documents) rather than finding the person ineligible. CMS's renewal-outcomes data for June 2024, Georgia's final unwinding month, shows 220,737 Georgians due for renewal, of whom 133,134 (60.3%) were renewed and 78,217 (35.4%) were terminated; 20.6% of everyone due for renewal was terminated for a procedural or administrative reason, which works out to roughly 58% of that month's terminations. Nationally in the same month, 65.3% of all terminations were procedural.2 Those percentages describe renewals due in June 2024 only, not the unwinding as a whole; Georgia has not published a cumulative procedural share. Many of the people in that column still qualified and simply did not get through the paperwork in time.

Why so many lost coverage over paperwork, not income

A procedural disenrollment is a loss of coverage caused by a breakdown in the renewal process, not by a determination that the person earns too much or otherwise no longer qualifies. The most common triggers during the unwinding were a renewal packet mailed to an old address and returned undeliverable, a packet that arrived but was never returned, and a packet returned without the required pay stubs or documents.

Federal rules are designed to prevent exactly this. Under 42 CFR 435.916, a state must first try to renew eligibility automatically, on an "ex parte" basis, using data it already has (tax, wage, Social Security Administration, and SNAP records) before it asks a beneficiary for anything. Only when the agency cannot confirm eligibility from that data may it send a renewal form.7 When states leaned harder on ex parte renewal, fewer people fell through; when they relied on mailed paperwork, procedural losses climbed. That difference in approach is most of why disenrollment rates varied so widely from state to state.

What the unwinding left in place permanently

The unwinding is over, but several protections that were strengthened around it are now permanent federal law and continue to govern Georgia renewals today.

• Twelve-month continuous eligibility for children. Section 5112 of the Consolidated Appropriations Act, 2023 requires every state to keep children under age 19 enrolled in Medicaid and CHIP for a full 12 months at a time, regardless of mid-year income changes, effective January 1, 2024. A child enrolled in PeachCare for Kids stays covered for the year even if the family's income rises.5
• Permanent 12-month postpartum coverage. The American Rescue Plan Act of 2021 created a state option to extend postpartum Medicaid from 60 days to 12 months, and the Consolidated Appropriations Act, 2023 made that option permanent.5 Georgia adopted it effective November 1, 2022 and covers pregnant members with budget-group income at or below 220% of the Federal Poverty Level for the rest of the pregnancy and a full 12 months after it ends. One carve-out: a woman approved for Emergency Medical Assistance is not automatically eligible for the 12-month extended postpartum period.8
• Ex parte renewal as the default. Georgia must attempt an automatic renewal from existing data before sending any paperwork.7
• A reasonable opportunity period for citizenship and immigration status. If the state cannot promptly verify a person's declared citizenship, U.S. national status, or satisfactory immigration status, it must give a reasonable opportunity period to provide documents, and during that period it may not delay, deny, reduce, or terminate benefits for someone it has determined is otherwise eligible. The period runs until the state verifies the status or 90 days after its notice, whichever comes first, though it can be extended past 90 days for someone declaring a satisfactory immigration status who is making a good-faith effort to obtain documentation.9

For step-by-step help using these protections at your own renewal, see our Georgia Medicaid recertification and renewal guide.

The Pathways to Coverage complication

Georgia Pathways to Coverage launched on July 1, 2023, in the middle of the unwinding. Pathways is a Section 1115 demonstration that offers Medicaid to adults aged 19 to 64 with household income up to 100% of the Federal Poverty Level who complete at least 80 hours per month of qualifying activities such as work, school, or community service.10

For many adults losing continuous-enrollment coverage, Pathways was the only Medicaid door still open, because Georgia has not adopted full Medicaid expansion. But it added its own reporting requirements on top of an already difficult renewal season, and the handoff from continuous enrollment to Pathways frequently broke down. If Pathways is your situation, our Georgia Pathways to Coverage guide covers eligibility, the activity requirement, and how to stay enrolled.

What is changing next: 6-month renewals in 2027

The renewal landscape is shifting again: for renewals scheduled on or after January 1, 2027, federal law requires states to recheck eligibility every 6 months (instead of every 12) for the Medicaid expansion adult group and waiver coverage equivalent to minimum essential coverage, which in Georgia includes Pathways to Coverage.5 The new cycle, who is excepted, and how to prepare are covered in our Georgia Medicaid recertification and renewal guide, which owns current and upcoming renewal rules; this page remains the record of the 2023-2024 unwinding itself.

What to do if you lost Medicaid in the unwinding

If you or a family member was dropped during the unwinding and you believe the person still qualified, act on the strongest option that still applies.

• Reapply through Georgia Gateway. The fastest route back is a new application at Georgia Gateway, by phone to the Georgia Division of Family and Children Services at 1-877-423-4746, or in person at a county DFCS office. Most unwinding terminations are now well past the 90-day window, so a fresh application is usually the path.6
• Ask about reconsideration if your termination is recent. When coverage is ended for failing to return a renewal form, federal rules require the agency to reconsider your eligibility without a new application if you send the renewal form back within 90 days of the termination date. That requirement covers people whose eligibility is figured using MAGI income rules; if you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, federal law lets a state offer the same window but does not require it, so ask DFCS whether Georgia does.7 Reconsideration means DFCS re-decides your case on the late renewal instead of making you start over. It does not by itself guarantee that coverage is restored back to the termination date: whether reinstatement is retroactive or restarts with a gap is a state-level question, so ask DFCS what applies to your case.
• Submit citizenship or immigration documents if that was the issue. Federal rules give you a reasonable opportunity period to produce proof of citizenship, U.S. national status, or satisfactory immigration status, and the state may not terminate an otherwise-eligible person while that period is still running.9 If your period has already closed, submitting the documents with a reconsideration request or a fresh application is the route back.
• Appeal if you disagree with the decision. You can request a fair hearing before the Georgia Office of State Administrative Hearings. For how appeals and "aid pending" work, see our Georgia Medicaid appeals and fair hearings guide.
• Get free help. Legal aid and navigators can walk you through reinstatement. See the contacts below.

Where to get help

Use these contacts to reapply, ask about reinstatement, appeal a decision, or get free navigation help.

Learn More

Find personalized help navigating Georgia Medicaid at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.