Sluggish start to Georgia’s modest expansion of Medicaid reignites debate over health coverage

Caption

Georgia Pathways to Coverage was always expected to take time to ramp up, but the initial numbers represent a slow start in sign-ups.

Credit: Jill Nollins, Georgia Recorder

Fewer than 300 people have been approved for Georgia’s new Medicaid program for some low-income adults who rack up enough hours of work, or other qualifying activity, each month.

The program, which launched July 1, is being closely watched nationally as Georgia becomes the only state to require work or the equivalent for low-income adults newly eligible for the public health insurance program. Thursday offered the first glimpse into how the program is working so far.

Lynnette Rhodes, chief health policy officer for the state Department of Community Health, which administers the Medicaid program, said during a public presentation Thursday that 265 people have been approved for the new program.

“I just wanted the committee to know that there’s still some more work that we have to do for Pathways, but overall, the core functionality is stood up and the program is working,” Rhodes told the Board of Community Health’s care management committee.

Republican Gov. Brian Kemp originally unveiled Georgia Pathways to Coverage in 2019 during his first year in office. His plan was approved late in the Trump administration, but the program’s launch was delayed by the Biden administration, which balked at the work requirement.

Georgians earning less than $14,580 annually would have to complete 80 hours of work, on-the-job training, community service, schooling or other qualifying activity to gain and keep health insurance through the program.

The state has planned for about 100,000 people to gain coverage in the first year, though as many as 345,000 Georgians could meet the income threshold, according to a state estimate. The program was always expected to take time to ramp up, but the initial numbers represent a slow start in sign-ups.

The program is also being rolled out as Medicaid enrollees across the country are going through the process of having their eligibility checked following a pandemic-era federal rule that temporarily barred states from kicking people off the program. State officials have said they are trying to steer those who lose coverage toward Pathways when possible.

In June, nearly 100,000 people lost health insurance coverage during the unwinding, many of them for procedural reasons and not because they were ruled ineligible. Two-thirds of them were children.

Another 68,000 lost coverage last month, according to a preview of July’s report offered at Thursday’s meeting.  

Kemp’s spokesman, Garrison Douglas, sounded an optimistic note Thursday when asked whether the program was seen as being on track to meet enrollment projections for Georgia Pathways. 

“While the federal government has initiated and dictated the process for redetermining current Medicaid recipients, Georgia is the only state in the country simultaneously providing a new pathway to health care coverage and opportunity,” Douglas said. 

“As applications continue to be reviewed, those who will benefit from this new and innovative program will continue to grow,” he added. 

But Georgia Democrats who have long pushed for full Medicaid expansion blasted the governor’s program Thursday. Georgia, which has one of the highest uninsured rates in the country, is one of 10 states that have not expanded Medicaid under the Affordable Care Act.

“At this rate, it would take 28 years for the governor to meet this enrollment estimate of 90,000 people. This program is a loser from Day 1,” said Senate Minority Leader Gloria Butler, a Stone Mountain Democrat.

Supporters of Georgia Pathways have called it a conservative approach that will help lead people to private insurance options, whether on the exchange or through an employer. But Butler dismissed Georgia Pathways as a “half measure” that costs more and covers fewer people than traditional expansion, which could cover about a half million people.

State Rep. Michelle Au, a Johns Creek Democrat, said the combined effect of the new Medicaid coverage option with the unwinding amounts to “one half step forward followed by three huge strides back.”

“No state touting record budget surpluses should tolerate this as a result,” Au said. “Further, no political motivation can excuse the catastrophic reality that, even with Pathways to Coverage in place, hundreds and thousands of low-income children in Georgia will lose their health insurance coverage.” 

More information about Georgia Pathways to Coverage can be found here. To learn more about the Medicaid redetermination process, also known as Medicaid unwinding, visit staycovered.ga.gov. 

This story comes to GPB through a reporting partnership with Georgia Recorder.