In December 2019, Georgia’s Governor asked federal officials to approve changes to the state’s Medicaid program. Medicaid is a public health insurance program that currently covers half of Georgia’s children, some low-income seniors and people with disabilities, low- and moderate-income pregnant women, and very low-income parents.
The Affordable Care Act (ACA) gave states the option to expand Medicaid to cover adults making slightly more than poverty-level wages (about $16,700 for an individual and $35,900 for a family of four). Unfortunately, Georgia is one of only 14 states who have so far refused to extend health insurance to these low-income Georgians. That leaves 408,000 uninsured Georgians ineligible for Medicaid, and at the same time, their incomes remain too low to qualify for financial help to buy coverage through the ACA’s health insurance marketplace.
Governor Kemp’s plan to change Medicaid, called Georgia Pathways, will do little to close this coverage gap. The state estimates the plan will cover only about 50,000 low-income Georgians because of the unwarranted complications that it puts in place. The Governor’s plan ultimately leaves thousands of low-income Georgians uninsured and ignores the most cost-effective solution available: Medicaid expansion.
Some low-income Georgians would be allowed to enroll in Medicaid
This change, sometimes called a “partial Medicaid expansion,” falls short of the ACA’s Medicaid expansion which envisioned that states would cover adults making slightly more than poverty-level income. Under the Governor’s plan, 408,000 Georgians could qualify for coverage—if they can meet the stringent requirements described below. Under a full Medicaid expansion, Georgia could cover 567,000 low-income adults.
Georgians would be subjected to illegal paperwork requirements to enroll in coverage
Under the Governor’s plan, Georgia adults who may qualify for coverage must prove they are working or performing certain activities for at least 80 hours a month. Work and qualifying activities include full or part-time employment, community service, vocational readiness, certain education activities, or job readiness. Qualifying activities do not include caregiving and participating in substance use recovery programs; Georgians who are homeless or have limited access to the internet would not be excused from the reporting requirements.
If the Governor’s plan is approved, Georgians would be required to complete bureaucratic paperwork to prove they are spending 80 hours a month participating in an eligible activity before they can enroll in Medicaid coverage. They must continue to prove their work or other activities to Georgia’s government for at least three months. After that, they would be subject to random requests for proof of continued work.
Other states have attempted to implement similarly burdensome “work requirements.” In those states, thousands of qualified people lost their health care coverage because they were unable to successfully report their work due to technology barriers, insufficient notice from the state about the requirements, bureaucratic mistakes, and other issues. As a result, work requirements are currently the subject of a federal lawsuit and have been deemed illegal by three federal courts.
Low-income Georgians must pay premiums and copays to Georgia’s government
The current proposal requires that Georgians making between 50 – 100% of the federal poverty line (between $6300-$12,700 annually for an individual) would be required to pay monthly premiums of $7-$11 per month. If an enrollee misses two months of premium payments, their coverage would be suspended and after three months of missed payments, the person would lose their coverage. When accessing health care services, enrollees would be required to additionally pay copays of up to $30 per visit.
Traditionally, Medicaid members have not been required to pay premiums or co-pays because their incomes are so low. While the state caps enrollees’ cost-sharing at 5% of a person’s income, that could add up to as much as $600 for an individual and $1300 for a family of four per year, who are surviving on poverty-level wages.
The plan eliminates the option for low-income Georgians to get transportation to their health appointments
Under the Governor’s plan, Georgians who enroll in coverage would not have access to some traditional Medicaid benefits like non-emergency medical transportation. Non-emergency medical transportation (NEMT) is a free service that provides transportation to people who are covered by Medicaid who do not have their own way to get to and from health appointments or the pharmacy. The program is especially important for people with disabilities, seniors, rural residents, and people of color.
Adequate transportation is important to the health of Georgians because in most cases people need to go to a location outside of their homes to receive medical care. Without access to reliable, safe transportation, Georgians may be forced to skip health appointments, go without medication and ultimately, experience worse health outcomes.
According to the Georgia and Budget Policy Institute, “Cutting out transportation is not likely to significantly reduce state costs but would deeply impact rural Georgians who may live farther away from health facilities. Non-emergency medical transportation is less than two percent of traditional Medicaid spending in Georgia according to GBPI’s budget calculations. A relatively small investment in Medicaid funding could mean a huge difference to Georgians who don’t have reliable access to safe transportation.”
The plan creates a complicated, expensive bureaucracy
The state’s proposed plan creates complicated restrictions and burdens for low-income Georgians. In addition to the paperwork requirements and required cost-sharing, the Governor’s plan would establish a member rewards account and a point reward system for enrollees. Consumers’ monthly premiums would be deposited into their rewards account, which could be used to pay future copays for health services. The point reward system would “reward” individuals for healthy behaviors and add money to the account based on those behaviors.
Indiana initially operated a similar reward system as part of their version of Medicaid expansion. The state saw limited participation and no benefits to beneficiaries’ health because of the complexity of the system, which mirrors Georgia’s in many ways. Ultimately, these kinds of systems are expensive and ineffective at keeping Medicaid enrollees enrolled in coverage, facilitating access to comprehensive benefits, or achieving better health outcomes.
Governor Kemp’s office has not provided an estimate of the costs to the state to operate the rewards systems, track work requirements or collect premiums. The Atlanta Journal-Constitution reported, “Other states that have tried to implement a work requirement reported costs ranging from $6 million to $272 million, according to the federal Government Accountability Office.” The intricacies of Georgia’s plan would require significant spending by the state that is not currently budgeted for in the Governor’s plan.
Georgia would pay three times more per person than needed
The Governor’s plan only expands coverage to Georgians making up to the poverty line, rather than slightly more than the poverty level (138% of the federal poverty level) as intended by the Affordable Care Act (ACA). Because Georgia is not proposing a full Medicaid expansion, the state will have to pay three times more per person to carry out this plan. When states fully expand Medicaid, the federal government covers at least 90% of the costs of the expansion and the state has to pay only 10% of the costs. If Georgia were to full expand Medicaid coverage the state would be eligible for this “enhanced match”. Instead, Georgia will pay 33% of the costs (and the federal government will pay the remaining 67% ) of the Governor’s plan–three times more than needed.
Governor Kemp’s plan to change Medicaid in Georgia does not work for Georgians. It would exclude most low-income, uninsured adults and subject those who can enroll to illegal, complicated, and expensive requirements. At the same time, the plan passes up the most cost-effective option to provide coverage to low-income adults in Georgia.
Our elected officials have the power to ensure that every Georgian, regardless of income, have access to affordable, comprehensive coverage. Leaders of 34 other states have made the choice to expand Medicaid and their states are reaping the benefits. Georgia can join them, but elected officials need to hear from you. Ask Governor Kemp and your state legislators to expand Medicaid.
Matt Hiltman lowered his shoulder as his horse galloped down the windswept field, kicking up clods of earth in its wake. His steel armor gleamed in the bright sun, and the audience on the sidelines roared with anticipation. Two horses and two riders fast approached each other on a collision course. The crowd fell silent as wood crumpled into metal with a loud crunch, and Matt’s lance struck true. The opponent careened off his horse and tumbled to the ground. Cheers burst out across the tournament field. Another victory for a professional jouster.
A lifelong Georgian, Matt is a world-class, full-contact jouster who competed in the sport for five years while also pursuing studies at Georgia State University. “If I had to describe myself, I would say that I’m an adrenaline junky,” said Matt. Beyond scuba diving, hang gliding and other high-octane activities, Matt’s thirst for adventure also inspired him to study diverse fields at college, including geology, chemistry, biology and history. He graduated magna cum laude from Georgia State University with a major in philosophy and minor in psychology, looking forward to a career in law or another field where he could serve the greater good.
“I’ve spent a lot of my life and a lot of time thinking about how I can best help the world,” Matt said, “And I’ve got some ideas that I’d like to share.”
The future was brimming with opportunity when Matt’s life hit an unexpected obstacle. At age 29, Matt was hospitalized due to mental illness. “He had an episode of psychosis, and it became obvious at that point that he had bipolar I,” said his mother, Dianne. In Matt’s words, “It was a major shake to my foundation … to discover that my brain is a tool that can be corrupted.”
Bipolar disorder is a mental illness that causes intense shifts in a person’s mood, energy and ability to think clearly, according to the National Alliance on Mental Illness. People with bipolar disorder experience debilitating mood swings, known as mania and depression. About 4.4 percent of adults in the United States experience the disorder at some point in their lives, which generally starts showing symptoms when people reach their mid-20s.
Many treatments can help people living with bipolar disorder, including medications, therapy and lifestyle adjustments. People can lead successful lives after finding the right care regimen and combination of treatments, but that usually requires extensive trial and error. Doctors still have a limited understanding of how the brain works and how best to treat mental illness.
Once I’m healthy, I’ll be able to get out there and help people.
“It’s been difficult, it’s been very difficult over the last few years,” Matt said.
For Matt, health insurance has been a major barrier to finding the effective treatments that would allow him to begin recovery. Bipolar disorder caused him to lose his job and his health insurance. Untreated, the symptoms make it nearly impossible to work a full-time position with benefits. Matt doesn’t earn enough money to receive subsidies for individual health insurance, so he can’t afford coverage from the private marketplace. He also doesn’t qualify for Georgia’s current Medicaid program.
Watch Matt share his story in his own words.
“He can’t work ‘til his treatment is better,” said Dianne.
Matt sees hope in an advanced brain therapy called Transcranial Magnetic Stimulation. Unfortunately, he cannot receive this cutting-edge procedure without health insurance. Matt is stranded in his recovery process without any affordable health care options.
“There are several treatments that I don’t have access to because I don’t have health care insurance,” says Matt. “That’s frustrating knowing that I might feel relief . . . knowing that it’s out there, and I can’t get it, is very frustrating.”
While Matt and his family have struggled to access treatment, Georgia lawmakers have repeatedly rejected a policy that would provide affordable health coverage to Matt and almost half a million Georgians: Medicaid expansion. About 25 percent of uninsured Georgians who would qualify for coverage through Medicaid expansion suffer from mental illness or substance use disorder.
“He’s not afraid to work hard,” says Dianne. “He’s not unwilling. He just can’t right now. And there’s not anything we can do.”
A new wave of state leaders will have a fresh opportunity in 2019 to tackle Georgia’s growing health crisis and draw down federal funds to broaden health coverage. By allowing Georgians like Matt to access and afford needed medical services, lawmakers can help thousands statewide to get healthy and stay healthy. The policy is popular with the public as well, with more than 70 percent of Georgians supportive of Medicaid expansion according to recent polls.
He’s not afraid to work hard. He’s not unwilling. He just can’t right now. And there’s not anything we can do.
For Matt, the idea of getting healthy brings him back to his dream of helping others. “Really it just comes down to . . . you know, once I’m healthy, I’ll be able to get out there and help people.”
Before he’s able to help others, Matt will need to find the right combination of tools to treat his mental illness. He and his family continue to pursue every possible lead, including out-of-state research studies and charity care. But without health insurance, Matt’s recovery appears stuck, and a promising future seems just beyond his reach. In the past, Matt’s hard work helped him succeed in the classroom and in the saddle. Now, his future success rests in the hands of the 236 men and women of Georgia’s General Assembly.
“Having affordable health care and health insurance would give me hope. It would give me more access to different treatments. Mostly, it would give me hope.”
If you or loved ones are living with mental illness, please consider visiting the National Alliance on Mental Illness – Georgia or calling their helpline at 770-408-0625 for more information and support.
To show your support for expanding health coverage in Georgia, please consider sending a short e-mail to your state lawmakers through an easy-to-use form.
Health care emerged as the priority issue for voters this election season. Historic voter turnout and engagement have highlighted the universal desire for affordable, quality health care. Every Georgian wants to be able to see a doctor when they get sick. Every community wants to safeguard their hospital and emergency room. Yet too many of Georgia’s rural hospitals have closed in recent years, and too many Georgians can’t afford health care.
Georgia’s newly elected leaders will have the opportunity in 2019 to embrace a bold solution that would put health insurance cards in the pockets of almost half a million Georgians: Medicaid expansion. While elections come and go, the health care crisis confronting Georgia remains. Seven rural hospitals have closed in Georgia since 2013, and more than half of our remaining rural hospitals are financially struggling. Georgia’s uninsured rate of 14.5 percent is one of the highest in the country, and the uninsured rate in rural Georgia could to climb to 25 percent within the next few years. Substance use disorder and the opioid crisis are devastating communities statewide, demanding a sustained, concerted response.
A strong majority of Georgians support Medicaid expansion. At least seven in ten Georgians think our state should expand Medicaid eligibility, according to polls from the Atlanta Journal-Constitution and 11Alive. Every day Georgia refuses expansion, our state loses $8 million in federal funding for health care.
Although Election Day has passed, the civic responsibility to educate leaders and engage neighbors continues. Send a quick email to your lawmakers about the importance of Medicaid expansion and why you care about this issue. Then share your support for Medicaid expansion with media outlets in your community through a letter to the editor. Visit the tools page for information to guide your thoughts and continued engagement on this important issue.
Teresa began working as a teacher for the Headstart preschool program in 1994 but retired in 2010 because multiple health conditions made it difficult for her to work. Now her family’s only source of income is her husband’s monthly disability check, which is too high to allow him to qualify for Medicaid and too low to allow them to qualify for financial help to purchase private insurance through the Affordable Care Act. (Teresa cannot qualify for Medicaid no matter how low her income is because she does not have a disability or a child under the age of 18.) Both of them fall in Georgia’s coverage gap.
Teresa and her husband are just two of 197 of the Georgians in Clay County that are uninsured because Georgia’s decision makers have not extended health insurance coverage to low-income adults in Georgia (those making less than $16,000 annually for an individual or $20,780 for a family of three.)
Teresa struggles to manage multiple health conditions, the worst of which is a jaw condition that has caused her teeth to rot. Because Teresa has not had health coverage since 2009, she has had to find alternative, insufficient treatments for her jaw condition. She would have to pay $5000—almost four months of income—to receive the necessary medical remedies to alleviate her pain and stop the dental deterioration. If Georgia were to close the coverage gap, Teresa would be able to see her doctor on a regular basis without having to forgo appointments and services that would otherwise be too costly.
Georgia’s Governor and legislature have so far rejected the option to close the state’s coverage gap, leaving people like Teresa and her husband uninsured. Until Georgia’s policymakers extend health insurance to all low-income Georgians, Teresa, her husband, and 240,000 other Georgians will likely continue to skip health care appointments and forgo needed care because they have no pathway to coverage.
Georgians across the state are being asked to decide how they will cast their votes in November for positions such as Governor, Insurance Commissioner, state senator and state representative. The decisions made by voters about these elected positions will directly impact critical consumer health issues in Georgia like access to health care, affordability of health insurance, the opioid crisis, and the sustainability of the rural health care system.
As candidates crisscross the state or their districts asking for support, voters will consider their stances on a number of important issues including health care. To help voters make their decisions, we put together this list of questions for voters to ask of candidates about five timely and pressing consumer health care issues.
These questions can be used at town halls and candidate forums or posed to candidates via social media or in one-on-one conversations.
Closing the coverage gap
- Over 240,000 Georgians make too little to receive financial help to buy private health insurance but do not qualify for Medicaid, meaning they fall into the Medicaid coverage gap. Many of the families who fall in the gap are hard-working people who work in industries that make up the backbone of our state: trucking, food service, and childcare. Do you support using federal funds to close the Medicaid coverage gap and offer affordable health coverage to these 240,000 Georgians while boosting the Georgia’s economy? Please explain.
- A 2016 Department of Health and Human Services study showed that marketplace premiums were on average 7 percent lower in states that extended Medicaid to low-income residents. Do you support closing the Medicaid coverage gap as one method to reduce health care costs and lower the uninsurance rate for consumers in Georgia? Please explain.
Georgia’s health insurance marketplace
- Health insurance premiums for Georgia consumers will rise by as much as 15 percent in 2019 due to the repeal of the individual mandate by Congress and the elimination of cost-sharing reductions, among other things. If elected, what improvements would you make to our health care system to ensure your constituents have access to high quality, comprehensive and affordable health insurance?
- The federal government has expanded insurance companies’ ability to sell short-term plans that do not cover key services like mental health treatment or prescription drugs. These plans will increase health care costs and roll back consumer protections that many families in our state depend on. How do you think Georgia should regulate these plans?
Opioid/substance use crisis
- In 2016, about three Georgians died each day from drug overdoses and thousands of Georgians live with substance use disorders regularly. To slow this crisis, a broad spectrum of strategies will be needed from prevention and early intervention to expanded access to treatment. If elected, what would you do to address the state’s substance use crisis?
Communities left behind
- Seven rural hospitals in Georgia have closed since 2010. Rural hospitals are often the largest employer in the area and are the economic engines that help to support local small businesses (like the flower shop or pharmacy). If elected, what will you do ensure that rural communities have adequate access to quality, affordable health care?
- People of color in Georgia have shorter life expectancies, higher rates of chronic disease, and are more likely to be uninsured and live in medically underserved areas. The causes of these outcomes are complex and linked to reduced access to quality education, fewer economic opportunities, discrimination, and other social and economic factors. As (Governor/Insurance Commissioner/other position title), how would you address the health disparities experienced by people of color in Georgia?
Defending health care gains
- Over the past two years Congress has repeatedly attempted to repeal the AffordableCare Act (ACA) and slash federal Medicaid funding that our state relies on, despite the fact that 74 percent of the public view the Medicaid program favorably. If elected, will you support/continue to support the program in the face of threats? Please explain.
Did you ask one of these questions to a candidate? Let us know! We want to know which questions were most helpful and how candidates are responding. Email Michelle Conde at email@example.com your feedback.
You can help spread the word about Medicaid expansion on social media and through your networks! Leverage the resources below, tag social media posts with #coverga and link to https://coverga.org to help your network take action.
Now is the time for Georgia lawmakers to support struggling rural hospitals, address the opioid crisis and provide health care access to 470,000 Georgians by expanding Medicaid. #coverga https://coverga.org
We can’t afford to wait
State lawmakers can help 470,000 Georgians access affordable health care by expanding Medicaid.
Now is the time for Georgia lawmakers to support struggling rural hospitals, address the opioid crisis and provide health care access to 470,000 Georgians by expanding Medicaid eligibility.
Georgia has refused more than $12 billion federal dollars meant to put health insurance cards in the pockets of Georgia families. We can’t afford to keep waiting to expand health coverage.
Georgia is turning down $8 million a day —$3 billion per year—in money we could be using to help hardworking Georgians access health care.
Georgians can’t afford another year of turning down billions of federal dollars that could be coming back to the state to stabilize struggling hospitals, create thousands jobs and provide health coverage to working Georgians.
As taxpayers, Georgians have already invested in boosting access to health care. If we don’t accept this opportunity in Georgia, the federal government simply keeps our tax dollars.
About 240,000 Georgians make too little to get financial help to buy health insurance and don’t currently qualify for Medicaid. These Georgians are stuck in the coverage gap with no affordable insurance options. Why? State leaders keep turning down money meant for health coverage.
Many people in the coverage gap work low-wage jobs where they’re not offered health benefits.
The majority of people who would be covered by expanding Medicaid are working. Many of these workers are in some of Georgia’s most important economic sectors: construction, transportation, education and retail.
Strengthen rural communities
Expanding health coverage would support Georgia’s rural hospitals, economic anchor institutions for rural communities across the state.
Closing the coverage gap would create at least 12,000 new jobs and $1.3 billion in new activity in Georgia’s rural communities each year.
Support behavioral Health
About 25% of uninsured Georgians who would qualify for Medicaid expansion coverage suffer from mental illness or substance abuse.
States that expanded Medicaid connected treatment services to more people with mental illness or substance abuse disorder.
Help women access care
Closing Georgia’s coverage gap would extend health insurance to more than 155,000 uninsured women in Georgia.
Georgia ranks among the bottom five states for women’s health insurance coverage.
Just one medical bill can send you into bankruptcy when you’re uninsured. Hardworking families in Georgia need health coverage to get care when they need it without facing huge medical bills or going into bankruptcy.
Georgia has refused $12 billion federal dollars meant to put health insurance cards in the pockets of Georgia families. Contact your reps and ask them: why? https://coverga.org
Six Georgia rural hospitals have closed since 2013 and many more are struggling. But Speaker David Ralston “isn’t in the mood” to expand health coverage and stabilize rural communities. https://coverga.org
Instead of expanding health coverage, Lt. Gov. Cagle spent a year studying the state’s biggest health care problems. His solution? More research. How long do we have to wait? https://coverga.org
Thousands of Georgians are stuck without any affordable options for health insurance because state leaders repeatedly reject billions of dollars meant to pay for coverage. About 240,000 workers, students, veterans and other Georgians make too little to get financial help to buy health insurance and do not currently qualify for Medicaid. The majority of these Georgians are working in low-wage jobs where they are not offered health benefits.
Georgia is one of 18 states yet to expand Medicaid eligibility to cover more low-income residents. The map below shows the number of uninsured Georgians who could get coverage if Georgia lawmakers voted to fully expand Medicaid. The federal government covers up to 90 percent of the cost for states to expand income eligibility. This amounts to about $3 billion each year in federal dollars coming back to the state to pay for health care services.
Georgia is home to the fifth-highest rate of uninsured people in the country. Accepting the federal money can help hospitals struggling to stay open and cover the costs of caring for a high number of uninsured patients. Georgia would save an average of $200 million each year from lower costs of providing care to the uninsured.
To find out how a state decision to expand health coverage can benefit your community, browse the map below. Click a county to see detailed data and download specific county resources.
Number of Georgians that Could Gain Health Coverage by Expanding Medicaid
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Georgia (statewide), Appling, Atkinson, Bacon, Baker, Baldwin, Banks, Barrow, Bartow, Ben Hill, Berrien, Bibb, Bleckley, Brantley, Brooks, Bryan, Bulloch, Burke, Butts, Calhoun, Camden, Candler, Carroll, Catoosa, Charlton, Chatham, Chattahoochee, Chattooga, Cherokee, Clarke, Clay, Clayton, Clinch, Cobb, Coffee, Colquitt, Columbia, Cook, Coweta, Crawford, Crisp, Dade, Dawson, Decatur, DeKalb, Dodge, Dooly, Dougherty, Douglas, Early, Echols, Effingham, Elbert, Emanuel, Evans, Fannin, Fayette, Floyd, Forsyth, Franklin, Fulton, Gilmer, Glascock, Glynn, Gordon, Grady, Greene, Gwinnett, Habersham, Hall, Hancock, Haralson, Harris, Hart, Heard, Henry, Houston, Irwin, Jackson, Jasper, Jeff Davis, Jefferson, Jenkins, Johnson, Jones, Lamar, Lanier, Laurens, Lee, Liberty, Lincoln, Long, Lowndes, Lumpkin, Macon, Madison, Marion, McDuffie, McIntosh, Meriwether, Miller, Mitchell, Monroe, Montgomery, Morgan, Murray, Muscogee, Newton, Oconee, Oglethorpe, Paulding, Peach, Pickens, Pierce, Pike, Polk, Pulaski, Putnam, Quitman, Rabun, Randolph, Richmond, Rockdale, Schley, Screven, Seminole, Spalding, Stephens, Stewart, Sumter, Talbot, Taliaferro, Tattnall, Taylor, Telfair, Terrell, Thomas, Tift, Toombs, Towns, Treutlen, Troup, Turner, Twiggs, Union, Upson, Walker, Walton, Ware, Warren, Washington, Wayne, Webster, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, Worth
Georgia’s Health Coverage Gap
- State lawmakers can put an insurance card in the pockets of 473,000 Georgians by bringing home money from the federal government to pay for coverage.
- About 240,000 Georgians make too little to get financial help to buy health insurance on the Marketplace and don’t currently qualify for Medicaid. These Georgians are stuck in the coverage gap with no affordable health insurance options.
- Rural Georgia is struggling. Six rural hospitals have shuttered since 2013 across the state, and more than half of Georgia’s remaining rural hospitals are financially vulnerable to closure.
- Opioid abuse and unmet mental health needs are decimating communities statewide, exacerbated by high uninsured rates among working Georgians who simply can’t afford access to care.
- The problem is only getting worse. Georgia’s uninsured rate of 12.9 percent is fifth worst in the country. In rural Georgia, the uninsured rate could climb to more than 25 percent by 2026.
- Georgians are already paying taxes toward closing our coverage gap, but state leaders have refused billions in federal health care dollars meant to pay for Georgians’ health coverage and stabilize struggling rural hospitals.
Hardworking Georgians need health coverage to stay healthy
- Working Georgians who could gain coverage earn income below 138 percent of the federal poverty level: about $16,750 for an individual, $22,715 for a family of two and $28,675 for a family of three.
- The majority of people who would be covered by expanding Medicaid are working but often not offered health benefits through their job.
- Closing Georgia’s coverage gap would extend health insurance to more than 155,000 uninsured women in Georgia. Georgia ranks among the bottom five states for women’s health insurance coverage.
- Closing the coverage gap could extend health insurance to nearly half of Georgia’s uninsured veterans, expanding coverage to 32,000 uninsured veterans and military spouses in our state.
Now is the time for state lawmakers to expand health coverage
- Most other states have already put insurance cards in the pockets of hard-working families, helping them afford to see a doctor when they get sick. Georgia is one of only 17 states to not close the coverage gap by expanding Medicaid.
- State leaders have delayed offering serious solutions for Georgia’s worsening health care crisis for years, waiting on Congress to provide a solution that hasn’t come.
- As Georgia leaders refuse to close the coverage gap, the federal government simply keeps our tax dollars. Each year we wait, our state misses out on $3 billion federal dollars meant to pay for Georgians’ health coverage. That’s more than $8 million each day.
- Georgia has already missed out on $12 billion federal health care dollars. Georgia can’t afford to keep waiting.
Closing coverage gap yields big economic benefits for state
- For every dollar the state spends on closing the coverage gap, Georgia receives up to $9 in federal funding.
- Closing the coverage gap could create 56,000 jobs in Georgia each year and boost the state’s economic output by $6.5 billion annually.
- Closing the coverage gap would create at least 12,000 jobs and $1.3 billion in new economic activity in Georgia’s rural communities each year.
Stabilize struggling rural hospitals by closing the coverage gap
- Many Georgia hospitals are struggling because they treat so many patients who lack health insurance and can’t afford high out-of-pocket costs. Closing the coverage gap opens up an important revenue stream to ensure rural communities have access to health care.
- Taxpayers end up paying a share of the cost for uninsured people who show up in emergency rooms. Closing the coverage gap would allow people to go to their doctor instead of the emergency room when they get sick.
- Other states have seen significant reductions in uncompensated care after closing their coverage gaps: Arkansas experienced a 56.4 percent decrease, and Kentucky saw a 59.7 percent decrease.
Strengthen mental health, substance use treatment by expanding health coverage
- Closing the coverage gap can significantly strengthen behavioral health treatment and services in Georgia. About 25 percent of uninsured Georgians who would qualify for Medicaid expansion coverage suffer from mental illness or substance abuse.
- States that closed their coverage gap expanded treatment services to more people with mental illness or substance use disorders. Kentucky saw a 700 percent increase in Medicaid beneficiaries using substance use treatment services after the state expanded eligibility in 2014.
Georgia can afford to close the coverage gap
- Georgia can afford to close the coverage gap, but state leaders have so far chosen to spend tax dollars in other ways, like $309 million for insurance company tax breaks. State leaders could also increase Georgia’s bargain-basement tobacco tax to raise hundreds of millions of dollars a year.
- Closing the coverage gap would extend health coverage almost half a million Georgians, support struggling hospitals, create 56,000 jobs and bring in $3 billion from the federal government. The net cost to Georgia would be $136 million a year on average.
Last week, Virginia became the latest state to expand health care coverage to low-income adults when the Virginia legislature voted to close the its coverage gap and Governor Northam signed the new budget. More than 400,000 Virginians are expected to gain coverage as a result, and the state anticipates declines in uncompensated care costs for hospitals, an increase in people receiving needed health services, and greater financial security for those set to gain coverage. The vote comes after years of advocacy and engagement from constituents and advocates who worked to convey to legislators the importance of health coverage and the impact the change would have on the lives of hundreds of thousands of Virginians.
Unlike Virginians, 240,000 hard-working Georgians cannot yet look forward to putting a health insurance card in their pockets. These friends and neighbors make too little to get financial help to buy health insurance and don’t qualify for Medicaid in Georgia, leaving them stuck in the state’s coverage gap.
Georgia remains one of 17 states that is still refusing billions in federal health care dollars to provide health coverage to low-income adults in the state. As in Virginia, Georgia’s Governor and state legislature can choose to close the coverage gap at any time, and here are five reasons they should do so as soon as possible:
Thousands of Georgians would gain health coverage–240,000 Georgians would gain the peace of mind, access to care, and financial protection that insured Georgians have. These Georgians make less than $12,140 a year or $20,780 for a family of three. Most are working in sectors like retail, child care, construction, and food service, low-paying jobs that do not come with benefits.
Georgia’s rural hospitals are economic anchor institutions–rural communities need their hospitals to provide accessible healthcare, sustain well-paid jobs, and facilitate economic stability. Closing the coverage gap would create at least 12,000 new jobs and $1.3 billion in new activity in Georgia’s rural communities each year.
The resulting job growth is greater than what the state would gain by attracting Amazon’s HQ2–extending health coverage to more Georgians would create 56,000 new jobs across the state, more than the 50,000 jobs that Amazon is promising at its second headquarters. Even better, the new jobs would be scattered across the state rather than concentrated in and around Atlanta.
Georgia’s tax dollars are currently sitting unused in Washington, D.C.–By refusing to extend health insurance to low-income Georgians, the state is missing out on $8 million per day ($3 billion dollars per year). Instead of giving up hard-earned tax dollars, Georgia’s policy makers could bring that money back to the state to help low-income parents, veterans, and workers put health insurance cards in their wallets.
It is the biggest step Georgia can take to slow the substance use crisis —One quarter (25%) of Georgians who fall in the coverage gap are estimated to have a mental illness or substance use disorder. If they were covered by health insurance, treatment and recovery services would be within reach, allowing them to resume full, healthy lives. As a result, 36,000 fewer Georgians each year would experience symptoms of depression and the state could make significant progress in addressing its ongoing substance use crisis.
After five years of delay, Virginia’s leaders made the right decision and as a result, 400,000 Virginians will see healthier futures. Now is the time for Georgia’s decision makers to follow suite by putting 240,000 insurance cards in wallets all across the state.
Susie is the sole caretaker of her young granddaughter, but she has a hard time caring for herself because she is stuck in Georgia’s coverage gap. She makes more than $6300 annually, so she doesn’t qualify for Medicaid coverage as a caregiver, and she doesn’t make enough to receive financial help to buy health insurance through the Marketplace. Susie is currently undergoing treatment for cancer but because she lacks health coverage, Susie is only able to receive cancer treatments from a doctor that allows her to make low monthly payments. Susie has other chronic health issues that need to be managed but finds it difficult to receive consistent care without insurance. Because Georgia’s elected officials have not extended Medicaid to cover caregivers like Susie, she struggles to care for herself while working to ensure her young granddaughter receives the care and support she needs to grow up healthy and thrive.
Medicaid provides access to needed health care services for low-income soon-to-be-moms, new mothers, and very low-income parents of minor children. For mothers, Medicaid makes being a mom a little easier by ensuring that their children have access to the health care services they need to grow and stay healthy. For others, Medicaid would help them get or stay healthy so they can best fulfill the responsibilities of being a mothers or caregivers. Over 150,000 uninsured women like Susie would gain health insurance if Georgia’s decision makers extended Medicaid to cover low-income adults (those making less than $16,000 annually for an individual or $20,780 for a family of three).