Blog

Medicaid, the federal health insurance program for low-income children and some adults under 65, is essential to the physical and financial health of Georgia families and the state as a whole.  Medicaid covers almost 2 million low-income Georgians (18% of the state’s population), serves as a crucial lifeline for Georgia’s rural hospitals. It also accounted for nearly 20% of the state’s total budget in 2023. 

However, D.C. politicians are currently considering overhauls to Medicaid that would limit the program’s ability to serve Georgians, dramatically reduce its efficiency and effectiveness, and make it more expensive for the state to operate.  

Ultimately,  if Congress cuts Medicaid, Georgia families will pay the price.

Georgia Medicaid by the Numbers

In Georgia, Medicaid covers:

• More than 1.9 million children, older adults, pregnant people, and people with disabilities
• Almost half of all births
• Thousands of seniors in nursing homes and people receiving long-term care
• 40% of babies and kids under 19
• 15% of women of childbearing age

Note: Medicaid demographic data was pulled from this Kaiser Family Foundation Fact Sheet.

Cutting Medicaid would undermine care, increase costs for Georgia, and make the program more vulnerable to waste, fraud, and abuse  

To offset the costs of tax breaks for the wealthy that Congress wants to maintain, they have proposed significant cuts to existing health and social programs. To try to hide their drastic cuts to a program that most voters support, Congressional leaders say the Medicaid cuts will curb perceived waste, fraud, and abuse in the program. But that’s a smokescreen.

The truth is simple: Congress is going too far, too fast. They are pushing through massive changes to Medicaid that would reduce health coverage and access to care for the Georgians who need it most. These cuts will result in less health care for millions of children, seniors, people with disabilities, and working families. They won’t make Medicaid more efficient; they’ll make it harder for people to get care when they need it most.

Medicaid is already one of the most efficient health care programs in the country. It’s a complex system with strong safeguards and oversight mechanisms that ensure program integrity and protect taxpayer dollars. What’s really on the table isn’t about waste, it’s about shifting costs to states, slashing services, and leaving families without the coverage they rely on.

The following harmful proposals are currently under consideration as methods to reduce federal Medicaid spending:

Work Requirements (Red Tape That Takes Health Care Away)

Some members of Congress want to impose or expand work requirements for Medicaid in every state. This proposal ignores reality: Most adult Medicaid enrollees are already working, and those who aren’t often face serious health, caregiving, or transportation barriers. These rules only create red tape and cause eligible people to lose coverage.

Pathways to Coverage, Georgia’s Medicaid program with work requirements, underscores the ineffectiveness of work requirements and the administrative burden that these kinds of policies place on enrollees. The program has enrolled only 7,000 of the 240,000 Georgians who likely qualify since July 2023. Even though most of the 240,000 Georgians are working or live in working families, the administrative hurdles that they must navigate to prove they meet the requirements have kept enrollment very low. Plus, work requirements are expensive, wasting Georgia’s taxpayer dollars on unnecessary paperwork and overhead costs.

Eliminating State-Directed Payments (Pulling the Rug Out From Under Georgia Hospitals)

Another dangerous proposal Congress is considering would restrict or eliminate State Directed Payments (SDPs): a crucial Medicaid tool that Georgia uses to stabilize its hospital systems. SDPs allow our state to require Medicaid insurers to pay providers like hospitals, nursing homes, and physicians at rates that better reflect the real cost of care. These payments help offset the financial strain caused by chronically low Medicaid reimbursement rates.

In Georgia, the GA-AIDE SDP program has been especially important for supporting Grady Health System, the state’s largest Medicaid provider, and redistributing funds to keep rural hospitals afloat. If federal policymakers eliminate SDPs, Georgia’s hospitals could face devastating budget shortfalls, resulting in reduced access to vital services like maternity care, trauma response, cancer screenings, and behavioral health. The result? Longer wait times, fewer providers, and increased risk of closure for the hospitals that serve our most vulnerable neighbors. Congress must protect SDPs to safeguard the stability of Georgia’s health care infrastructure, not restrict or eliminate them.

Limiting or Eliminating Provider Taxes (Cutting a Critical Lifeline for State Medicaid Funding)

Almost every state uses provider taxes to fund a significant portion of their Medicaid programs. Provider taxes, paid by hospitals and other health care providers to states, help states draw down billions in federal matching dollars to fund Medicaid services. Limiting or eliminating states’ ability to use these taxes would force Georgia and other states to decrease their Medicaid spending. This would save the federal government money, but Georgia would face serious budget gaps, forcing painful choices. That could mean cutting people off coverage, slashing payments to providers, or gutting essential benefits like nursing home care and services for children with disabilities.

Per Capita Caps (Limits That Shrink Coverage as Needs Grow)

Currently, the federal government pays for ⅔ of all of Georgia’s Medicaid costs, no matter how much care our kids, seniors, pregnant moms, and people with disabilities need. A per capita cap would place a per-person limit on how much the federal government helps pay for Medicaid. Implementing per capita caps would restrict the amount of money that Georgia receives per Medicaid enrollee. Per capita caps are a dangerous shift that fails to account for rising health care costs, public health emergencies, or changes in state needs.

Under per capita caps, Georgia would receive less federal support over time, especially as our population ages and health care costs increase. This would force state leaders to make impossible choices: cutting coverage, reducing benefits, or limiting who qualifies for care. 

Undermining Medicaid Expansion (and Georgia’s Chance to Close the Coverage Gap)

Right now, the federal government covers 90% of the cost to expand Medicaid to low-income adults. That “enhanced match” has been a powerful incentive that makes expansion affordable for states. But it’s been suggested that Congress will eliminate or weaken that commitment.

If the enhanced federal match is taken off the table, Georgia could lose its best chance to expand coverage to 240,000 uninsured adults in the coverage gap (earning too much for traditional Medicaid, but not enough to afford private insurance). That would be a devastating setback for families who are one illness or accident away from financial ruin.

Without expansion, thousands of Georgians will continue to fall through the cracks, unable to see a doctor, fill a prescription, or manage chronic conditions simply because they can’t afford it.

---

The bottom line: Whether through work requirements, reduced federal funding, or payment caps, these proposals all lead to the same outcome: fewer Georgians covered, more families at risk, and greater strain on our health care system.

Georgia’s Health Care Infrastructure is Already Under Strain

Cuts would be especially harmful now, as Georgia’s health infrastructure is already facing  challenges:

• More than 1.2 million Georgians are currently uninsured (Source: Kaiser Family Foundation)
• Over 16,000 Georgia Pathways applications remain unprocessed due to staffing shortages and system failures (Source: 11Alive).
  • Thousands of additional applications for Medicaid, SNAP, and TANF are also delayed.
• Georgia hospitals provided $2.5 billion in uncompensated care in 2022 (Source: WSBTV)

These facts demonstrate that Georgia’s most essential programs are underfunded, and Georgia families are already struggling to access the care they need. If Congress adds deep federal cuts or shifts more health care costs to our state, even more Georgians will be forced to go without the health care we need and deserve.

Medicaid Must Be Protected

Congress should be working to make it easier for Georgians to afford health care and be healthy. Medicaid provides health care for millions of Georgians, including our children and most vulnerable. Georgia’s Medicaid program must be strengthened and protected, not weakened and stretched to a breaking point in order to afford tax cuts for wealthy billionaires. Here’s how you can help:

• Share your story if Medicaid helped you or someone you love.
• Stay connected by signing up for alerts from Georgians for a Healthy Future.