- Children
- Pregnant and postpartum people
- People with disabilities
- Older adults
- Adults with very low incomes
What HR 1 Means for Georgia
- Less federal funding over time: The law gradually reduces how much the federal government contributes to state Medicaid programs. Georgia will have to either spend millions more from its own budget or cut back on coverage, services, and staff.
- More red tape for families and agencies: HR 1 requires more frequent eligibility checks and strict tracking of income and work activity, but without extra funding or staff. Georgia’s Medicaid system already struggles with backlogs, and these new mandates will likely cause more delays and wrongful coverage losses.
- Nationwide work requirements: The law expands Medicaid work reporting rules nationwide. Georgia’s own work requirement program, Pathways to Coverage, has enrolled just over 8,000 people in two years, far short of the 30,000 projected in its first year, because of complicated applications and narrow eligibility. Expanding this failed approach will only push more eligible people out of coverage.
Why This Matters
- Children losing access to checkups and medicine
- Pregnant people missing critical prenatal care
- People with disabilities going without needed support
- Seniors unable to afford long-term care
Watch: Advocates and Experts on Georgia’s Medicaid Future
Resources from Cover GA Members
Will Washington Roll Back Georgia’s Coverage Gains?
What the House Budget Bill Could Mean for Georgia Access
On May 22, the U.S. House passed a sweeping budget bill, known as the “One Big Beautiful Bill” Act. The budget bill proposes significant changes to the Affordable Care Act (ACA) Health Insurance Marketplace, which is known as Georgia Access in our state. Proponents say these changes will cut costs, but they would also make it harder for many Georgians to enroll in or keep their health coverage.
The Senate is now making its changes to the bill, but what those changes will look like is unclear. As currently written, projections from the non-partisan Congressional Budget Office (CBO) show the House’s changes would reduce overall Marketplace enrollment and increase the uninsured rate nationally and in Georgia. If the budget bill passes as currently written, the combination of Marketplace (including allowing the expiration of the enhanced premium tax credits) and Medicaid changes could lead to an estimated 560,000-940,000 Georgians becoming uninsured.[1] (Notably, some of the marketplace changes presently in the bill are also under consideration by the Centers for Medicare & Medicaid Services (CMS), meaning they could be authorized through federal regulation even without new legislation.)
Medicaid Cuts Are on the Table—and Georgia Could Pay the Price
Congress is pushing proposals that would slash Medicaid funding and shift more costs to states. These cuts would hurt millions of Georgians, especially children, seniors, and rural communities. Learn how work requirements, hospital payment cuts, and other proposals could leave more Georgians uninsured—and what you can do to fight back.
House-Passed Federal Budget Legislation Proposes Historical Medicaid Cuts With Serious Fiscal Impacts for Georgia
The U.S. House passed major tax and spending legislation, entitled the “One Big Beautiful Bill Act.” This measure was advanced through a special legislative process called “reconciliation.” This process is not subject to the filibuster in the U.S. Senate, allowing the majority party to set up a lower simple majority threshold (50-votes plus the Vice President as a tie-breaker) for passage rather than the 60-vote majority usually required. However, the reconciliation legislation must abide by the Senate’s “Byrd Rule,” which prohibits including provisions that do not change spending, tax policy or the debt limit.
National Resources
- Kaiser Family Foundation: How Will the 2025 Reconciliation Bill Affect the Uninsured Rate in Each State? Allocating CBO’s Estimates of Coverage Loss
- Center on Budget and Policy Priorities (CBPP): Tracking Senate Action on Tax and Budget Reconciliation Plan
- CBPP: House Republican Reconciliation Bill Would Force States to Cut Food Assistance, Health Care, and Other Vital Services
Cover Georgia Partners In The News
- Associated Press: Georgia’s experience raises red flags for Medicaid work requirement moving through Congress
- AJC: Congress wants Medicaid recipients to work. Georgia provides a model.
- WSB: Concerns arise about local healthcare impact of “Big, Beautiful” budget bill
- 13 WMAZ (CBS Macon): ‘Huge coverage losses’ | Over 600,000 Georgians could lose health insurance under Republican tax bill
- 11 Alive News: Budget cuts could have devastating impact on Georgia food assistance, Medicaid
- AJC: Medicaid cuts could be disastrous for state, health care advocates say
- Politically Georgia Podcast: Food Stamps and Fiscal Fights
- AJC: What could cuts to food stamps mean for Georgians?
- Georgia Recorder: Advocates warn that proposed Medicaid cuts threaten Georgia’s safety net programs
- GPB News: Georgia’s Medicaid expansion plan is up for federal renewal. Public comment is open through June 1
- The Bulwark: The GOP’s Big Medicaid Idea Was Tried Before—And Failed Badly