(The Center Square) — Critics continue to say the Georgia Pathways to Coverage program falls short of expectations, but proponents say Georgia’s cumulative approach puts more people on private health insurance plans.
State officials initially indicated roughly 345,000 Georgians could qualify for the program. However, officials later said the estimated adoption rate would reach around 90,000 to 100,000 by 2025.
Less than 4,500 Georgians enrolled in Georgia Pathways to Coverage as of mid-June.
“Every Georgian deserves access to affordable health care,” Laura Colbert, executive director of Georgians for a Healthy Future, said in a recent announcement. “Unfortunately, the Pathways to Coverage program is falling far short of that vision for our state.
“Unfair paperwork requirements and other bureaucratic hurdles are keeping hard-working Georgians from getting covered,” Colbert added. “It’s time to remove these barriers to health coverage for uninsured Georgians, and to look at broader solutions to closing the coverage gap.”
In remarks this week, Republican Gov. Brian Kemp said Georgia Pathways and Georgia Access, a state-based exchange where Georgians can shop for health insurance, provide health coverage to more than 714,000 Georgians who earn less than 138% of the federal poverty level.
Georgia’s Office of the Insurance and Safety Fire Commissioner launched Georgia Access on Nov. 1, 2023, as a state-based exchange on the federal platform ahead of Open Enrollment 2024. Last week, state officials said the Centers for Medicare and Medicaid Services confirmed approval for Georgia to transition to a state-based exchange.
Citing September 2023 U.S. Census Bureau data, Georgia Access’ website indicates that 1.2 million Georgians do not have health insurance. According to remarks provided by his office, Kemp said that “through Georgia Access, 400,000 Georgians who were previously on Medicaid now have private sector insurance that provides better coverage, with more options, while saving taxpayer dollars.”
“To be clear, the rosiest projections for traditional Medicaid expansion estimate 500,000 people under 138 percent of the federal poverty limit would be eligible. Not actually enrolled – just eligible,” the governor added.
What’s more, analysts note that care and coverage are not the same.
“When we discuss Medicaid, it is important to remember that coverage does not mean care,” Chris Denson, Georgia Public Policy Foundation’s director of policy and research, recently told The Center Square via email. “Medicaid is a fundamentally flawed program. In Georgia, providers are paid, on average, 80 cents on the dollar for every Medicaid patient they see. As such, only 60% of Georgia physicians accept new Medicaid patients.
“The promise of Georgia Pathways comes from providing an opportunity for these enrollees to transition one day to commercial health insurance while receiving Medicaid coverage in the interim — by engaging in 80 hours each month of work, educational opportunities, or community service,” Denson added. “Even expanding Medicaid under the Affordable Care Act would only cover Georgians up to 138% of the federal poverty level.
“In Georgia, we provide fully subsidized coverage on the health insurance exchange for individuals up to 200% of the federal poverty level. Which provides a better deal for patients and providers alike.”
