The Comprehensive Health Coverage Commission (CHCC) met on Wednesday, October 22, 2025, for the first time in nearly a year. The commission was created to explore solutions for closing Georgia’s health insurance coverage gap and to recommend ways the state could expand access to affordable care. But despite that mission, there has been little progress in advancing actionable solutions, even as Georgia’s coverage challenges have deepened and the health policy landscape has continued to change.
At the Commission’s last meeting of 2024, members reviewed a research plan developed by Ernst & Young (EY) to examine health coverage options for Georgia. Some of the Commission’s recommendations from 2024 were implemented, including efforts to streamline enrollment processes and improve accessibility within the Pathways to Coverage program. These changes reflected the Commission’s early focus on addressing administrative and eligibility barriers. However, since the Commission’s last meeting of 2024, momentum has slowed, and few new policy advancements have emerged to build on those initial steps.
When the commission reconvened this month, the discussion largely focused on procedural updates and the next steps for revising EY’s research plan. While these administrative conversations may move the project forward, they did not address the larger question of how Georgia can respond to looming coverage losses or ensure that affordable health care remains within reach for all residents.
What’s changed since the last meeting
Federal policy shifts threaten to widen Georgia’s coverage gap.
Since the CHCC last met, major federal changes have reshaped the foundation of health care policy. Federal Budget Legislation (HR1) has altered how states fund and operate Medicaid, tightening financial constraints on programs that help families with low incomes access care.
At the same time, the enhanced premium tax credits (ePTCs) that have made Affordable Care Act (ACA) Marketplace plans more affordable are set to expire at the end of the year. If these enhanced credits lapse, thousands of Georgians with low incomes (especially those earning just above the poverty line) will face steep premium increases. For many, monthly costs could double or more, forcing them to drop coverage altogether. The expiration would hit rural areas and communities of color hardest, where more residents rely on these subsidies to keep their plans affordable. Without ePTCs, Georgia’s uninsured rate is expected to climb again, reversing years of progress in reducing the number of people without health insurance.
Together, these changes could leave thousands of Georgians (particularly those with incomes between 100% and 138% of the federal poverty level) without an affordable coverage option. However, instead of using the meeting to discuss how the state could cushion the impact of HR1 or prepare for the loss of ePTCs, the commission’s latest meeting focused mostly on procedural updates and next steps for revising its research plan. By not meeting during the legislative debate over HR1(or immediately following its passage), the commission missed key opportunities to analyze the bill’s implications, explore contingency funding options, or consider short-term solutions to protect coverage gains. While the CHCC is not directly responsible for implementing policy changes, it could have played a proactive advisory role in guiding Georgia’s response.
What was discussed
The meeting focused on updates, not solutions.
During the meeting, Georgia Medicaid Director Stuart Portman outlined HR1’s potential impacts on the state’s Medicaid system. He discussed the law’s impact on provider taxes, caps on hospital payment programs starting in 2028, and new work reporting requirements tied to eligibility.
Portman also shared updates on the state’s Pathways to Coverage waiver, which has been extended through 2026, and said that the state plans to apply for the Federal government’s new Rural Health Transformation Fund. While the presentation covered significant policy updates, the discussion stopped short of addressing how these changes could worsen Georgia’s coverage gap or what steps the state could take to prevent further losses if Marketplace coverage becomes less affordable.
What was missing
The big question went unanswered: what happens when more Georgians lose coverage?
Georgia is on the cusp of major policy shifts that threaten coverage for tens of thousands of residents. Yet, several key issues went unaddressed. There was no discussion of how HR1 and the expiration of ePTCs might expand Georgia’s uninsured population or how the state could respond. Medicaid expansion, the most effective and fiscally sound way to close the coverage gap, was not mentioned.
The Pathways to Coverage program has not met its goals. Even though it has been extended through 2026, the program remains severely underperforming, with fewer than 10,000 Georgians enrolled as of September 30, 2025, far short of its first-year goal of 30,000.
Meanwhile, the success of Georgia Access, the state’s health insurance marketplace, has been largely supported by the ePTCs that make private plans more affordable for most enrollees. Without those subsidies, many individuals just above the poverty line will no longer be able to afford private coverage, putting them at risk of becoming uninsured once again.
Commission member feedback
Members shared ideas, but few addressed the larger issue of affordability and access.
Commission members offered a range of ideas, such as improving data use, streamlining eligibility, strengthening oversight of managed care organizations, and expanding access to cost-saving care models. Several emphasized the importance of coordination between the public and private sectors and revisiting the state’s research plan. However, few of these contributions directly confronted the looming affordability crisis or offered strategies for preventing coverage losses once federal supports expire.
Why this matters for Georgians
Delaying closing the coverage gap means more families fall through the cracks.
Georgia continues to have one of the highest uninsured rates in the nation. As federal funding tightens and state leaders hesitate to take bold action, more families are at risk of losing access to coverage and care.
If the state doesn’t act soon, it means more Georgians will fall through the cracks, especially those who earn too much to qualify for traditional Medicaid but too little to afford private coverage.
The commission was created to explore real solutions to this problem. But after nearly a year of inaction, its work has yet to produce meaningful progress toward closing the coverage gap. And without enhanced federal subsidies, the resulting coverage losses in Georgia Access would undermine Governor Kemp’s argument that Georgia’s health care strategy is working because more residents have private coverage. Those gains were built on federal affordability measures that are now set to vanish, not on state innovation alone.
The path forward
Georgia still has the power to act.
Georgia’s leaders still have options. Fully expanding Medicaid remains the most powerful and cost-effective solution available to close the coverage gap, protect hospitals, and strengthen rural health care systems.
The problem with the CHCC’s long pause and inactivity from our state lawmakers is that even maintaining the status quo was unsustainable—and now, the state is slipping further behind. By not meeting for nearly a year, the commission allowed existing challenges to intensify, leaving Georgia less equipped to manage the financial strain and coverage losses now approaching. As policymakers prepare to brace for the impact of medicaid cuts, they must confront the reality that the status quo is leaving too many Georgians behind.
Cover Georgia will continue to follow the commission’s work and keep advocates and consumers informed. As decisions unfold at the state and federal level, one truth remains clear: every delay to closing the gap leaves more Georgians without the care they need.
It is time for Georgia’s leaders to move beyond procedural discussions and take meaningful steps to ensure that everyone in our state has access to quality, affordable health coverage.
Catch up on the commission’s work. See our recap of key takeaways from last year’s meetings.
Stay informed. Sign up for updates on Georgia’s health coverage efforts.
Learn more. Read how Medicaid expansion could close the gap.