Closing the coverage gap is Medicaid expansion.
Many Georgians are living uninsured, without access to affordable health coverage. They work in jobs that don’t offer health insurance, can’t afford private insurance, and make “too much” to qualify for Georgia Medicaid. They live in what is called the “Medicaid coverage gap.” Georgians in the coverage gap earn less than the federal poverty line, approximately $15,000 for a family of two or $25,800 for a family of three.
Medicaid expansion could cover 400,000 – 500,000 Georgians, including 200,000 who currently fall into the coverage gap, and about 200,000 additional low-income Georgians.
Georgia has among the strictest Medicaid eligibility requirements in the country, so very few Georgia parents and adults are able to get covered, even when their incomes are very low.
Understanding Medicaid and Medicaid Expansion
In all states, Medicaid is a health insurance program for low-income individuals and families, including children, parents, pregnant women, elderly people with certain incomes, and people with disabilities. In 41 states (including Washington DC), the program also covers other adults that meet income limit criteria.
In Georgia Medicaid coverage is limited to individuals (residents of the state, US citizens or lawful permanent residents) who meet income limits and fall into very specific eligibility categories:
- Pregnant women
- Children and teenagers under 19 years old.
- Seniors, ages 65 or older
- Individuals who are legally blind
- Individuals with a disability
- People in need of nursing home care
- Adults who meet stringent documentation requirements for work or other activities
Georgia’s stringent Medicaid requirements mean many low-income adults and parents cannot qualify, leaving them without access to necessary health care. They fall in Georgia’s coverage gap.
One way Georgia can close the coverage gap is to expand Medicaid by adjusting our state eligibility criteria by:
- Enable adults with incomes between 0-138% of the federal poverty line ($20,782 a year for a single adult, or $35,630 for a family of 3) to enroll.
- Eliminating the strict documentation and paperwork requirements for adults’ work, school, or other activities.
Why Medicaid Expansion Matters
Medicaid expansion is not just about access to health care; it’s about economic stability, community well-being, and public health. Expanding Medicaid in Georgia can:
- Help individuals get coverage so they can see a doctor when they get sick without having to worry about unaffordable medical bills.
- Create 51,000 new jobs in the health care sector, with more than half of them outside of the health care industry within the first few years of the program.
- Increase the personal incomes of Georgia families by $900 per year.
- Reduce Georgia’s uninsured rate and strengthen our state’s rural hospitals so communities have local care when and where they need it.
- Improve access to mental health and substance abuse treatment so that families can stay together, stay well, and avoid unnecessary losses from drug use, suicide, or other mental health consequences.
- Support women’s health by extending coverage to thousands of uninsured women.
- Provide veterans and military spouses with the health coverage they deserve.
Join us in our mission. Act now — Georgia can’t wait any longer!