One-Year Anniversary of Georgia’s Pathways to Coverage Program Highlights Need for Reform

This statement was released in partnership with Georgians for a Healthy Future. Read more at healthyfuturega.org.

July 1st marked the first anniversary of the Pathways to Coverage program. Advocates are urging state leaders to acknowledge that the current design has not met the critical needs of Georgia's uninsured population.

Initially expected to enroll between31,000to 100,000Georgians in its debut year, the program has 4,323individuals actively enrolled as of mid-June 2024. This shortfall highlights the gap between the program's objectives and its actual impact on the community's health care access.

Data indicate that the complexities of the program's administration, along with the backlog generated by the Medicaid unwinding, may have contributed to its underperformance-with about 38% of applicants still awaiting processing. The cumbersome enrollmentand monthly reporting process and the substantial state and federal taxpayer funds directed towards managing the online enrollment and eligibility portal-almost $12 million from July 2023 to March 2024 alone-reflect a misalignment of priorities and resources.

Furthermore, Pathways to Coverage's work and other qualifying activity requirements may have limited the program's reach and effectiveness. Only 20% of the applications processed have resulted in coverage, and about 21% of denials are due to stringent qualifying hours and activity requirements.

By eliminating arbitrary requirements and streamlining bureaucratic hurdles, Georgia stands to improve healthcare access and bolster our economy. According to an economic impact analysis by REMI, a more inclusive system could unlock economic benefits, including creating over 51,000 jobs and increasing the state's GDP by $5.5 billion.

With Pathways to Coverage up for renewal in September 2025, the state has an opportunity to revise and expand the program. Georgia could leverage lessons learned from the first year of Pathways to Coverage implementation and pivot to a program that fully closes the health insurance coverage gap while boosting the state's economy.

Leah Chan, GBPI's Director of Health Justice, emphasizes the urgency of the situation: "The Pathways to Coverage program was a step forward for Georgia, but the stark figures after one year signify a missed opportunity for expanding health access in our state. With less than 2% of the eligible population reached, and countless Georgians still outside the healthcare safety net, it's clear that we need a more inclusive and streamlined approach. Regardless of next steps, taxpayers deserve transparency and accountability regarding the significant investment they've made in this program so far."

"Every Georgian deserves access to affordable health care. 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," said Laura Colbert, Executive Director of Georgians for a Healthy Future."It's time to remove these barriers to health coverage for uninsured Georgians, and to look at broader solutions to closing the coverage gap."

About the Georgia Budget & Policy Institute:

The Georgia Budget and Policy Institute strives to be an anti-racist research and advocacy organization that advances lasting solutions to expand economic opportunity and well-being for all Georgians. We examine the state's budget, taxes and public policies to provide thoughtful analysis and responsible solutions that address inequities in our state. We educate the public about complex issues confronting Georgia. We activate Georgians to call for policy solutions that put people first. We aim to inspire informed debate and decision-making, advancing our vision of a fair and inclusive Georgia where everyone can prosper.

About Georgians for a Healthy Future:

Georgians for a Healthy Future collaborates with communities and partners to lead policy change that advances health equity for all Georgians. Our vision is of a day in which all Georgians have equitable opportunities to achieve their highest level of health.We do this by delivering actionable health policy information to policymakers and advocates; providing resources to help consumers become strong advocates, and elevating the consumer experience to inform policy change. Georgians for a Healthy Future provides administrative and technical support for Cover Georgia. Read more at healthyfuturega.org.

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Leah Chan

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