State leaders celebrated three years ago when they passed a bipartisan measure designed to step up enforcement of a federal law that requires health insurers treat mental health and substance abuse services the same as physical care.

But more than two years after that law took effect, lawmakers and advocates are voicing frustration with the state of enforcement of behavioral health parity rules passed in 2022 that were intended to improve access to care in Georgia…

Laura Colbert, executive director of Georgians for a Healthy Future, which is a patient advocacy organization, described the implementation of the 2022 law as “uneven” at a parity day event in mid-February.

Colbert said the insurers’ reports to the state are not demonstrating compliance with the law, adding that the reports on private insurance coverage vary in quality. She said the reports on coverage through Medicaid are better, partly because the state Department of Community Health uses a standardized template for reporting.

“For parity to become so real, the onus is on insurance companies. The other portions of this law are very important for holding them accountable, because they certainly will not police themselves, but insurance companies should be doing the work of parity,” Colbert said.

Peter Biello: Welcome to the Georgia Today podcast from GPB News. Today is Thursday, Feb. 20. I’m Peter Biello. This podcast has the latest reports from the GPB newsroom. If there’s something you think we should cover, send us an email. The address is GeorgiaToday@GPB.org. On today’s episode, Georgia Democrats sound the alarm over possible cuts to Medicaid. Lawmakers advance a measure that may make child care slightly more affordable. And as Postmaster Louis DeJoy prepares to step down, Sen. Jon Ossoff looks towards the future of the post office.

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Ellen Eldridge: “The Legislature passed Georgia’s Mental Health Parity Act in 2022. Since then, the Carter Center and mental health care advocates have remembered the day by visiting lawmakers and also holding insurance companies accountable for keeping the state law. Laura Colbert is with Georgians for a Healthy Future. She says it’s not enough that the bill passed.”

Lauren Colbert: “Parity is about both policy and practice. So it’s not just what’s written down for an insurance company. It’s about how, then, when somebody calls and, you know, needs their coverage, that the practice meets that same policy.”

Ellen Eldridge: “Colbert says you can file a complaint if your behavioral health needs are not being met by your insurance provider. For GPB News, I’m Ellen Eldridge.”

President Donald Trump’s return to the White House sent a clear signal about Medicaid to Republicans across the country: Requiring enrollees to prove they are working, volunteering, or going to school is back on the table. The day after Trump’s inauguration, South Carolina GOP Gov. Henry McMaster asked federal officials to approve a work requirement plan. Ohio Republican Gov. Mike DeWine plans to soon follow suit. Republicans in Congress are eyeing Medicaid work requirements as they seek to slash billions from the federal budget.

Even with the proposed changes, some people, including those who work in the informal or gig economy, may not have official records and may be locked out of health coverage, said Laura Colbert, executive director of Georgians for a Healthy Future, a nonprofit consumer health advocacy organization. People caring for older children or aging relatives, older adults who struggle to find work, and those with medical conditions that prevent them from working still wouldn’t qualify for health coverage, she said.

“The Pathways program just doesn’t reflect the reality of how people are working,” Colbert said. “Pathways is a program that has clearly been developed by people who have had salaried jobs with predictable incomes.”

ATLANTA – Advocates seeking health insurance for more low-income Georgians are encouraged that Medicaid expansion is starting to draw support among what for years has been unified Republican opposition.

Although just four GOP state senators joined 17 Democrats when Senate Bill 50 was introduced late last month, it was still a milestone for Laura Colbert.

“This bill is really exciting because it’s Georgia’s first bipartisan legislation that would close Georgia’s coverage gap,” said Colbert, executive director of Georgians for a Healthy Future.

The measure would create PeachCare Plus, expanding Medicaid access for Georgians making less than 138% of the federal poverty level.

Currently, only Georgians who earn at or below the poverty level qualify for coverage. Unlike 40 other states, Georgia has not sought the expanded access – and associated federal money – that has been on the table for more than a decade. 

Democrats in the state legislature are making another attempt this session to extend health insurance to more Georgians under Medicaid coverage — and this time, four Republicans have already signed on, despite Gov. Brian Kemp making clear he does not back full Medicaid expansion.

“We believe that this bipartisan legislation can get passed,” Senate Minority Leader Harold Jones told reporters at a Tuesday press conference.

Using a mix of state and federal funds, Georgia would enroll patients into plans purchased on the private insurance market. Arkansas is the only other state with a similar model, and it has drawn interest from some Georgia Republicans.

“This is the first bill by Republican cosponsors that would also fully close Georgia’s coverage gap,” says Laura Colbert, who directs the group Georgians for a Healthy Future.

While Colbert’s organization supports traditional Medicaid expansion, which she maintains would be cheaper for Georgia taxpayers, she says PeachCare Plus would cover many more people than Georgia Pathways.

A number of organizations will set the stage for likely bills to watch during the 40-day legislative session that wraps up in early spring. Each winter, a variety of Georgia nonprofits and business interests host breakfasts, suppers and other events to explore some of the issues awaiting lawmakers and to make the case for their legislative priorities.

The first week of the 2025 session also features a pair of legislative preview breakfasts starting on Jan. 14 with the nonprofit Georgians for a Healthy Future and Georgia Chamber of Commerce’s Eggs and Issues that attracts a who’s who of Georgia politics and business.

Jan 14: Georgians for a Healthy Future will host an event at The Freight Depot in downtown, its annual Health Care Unscrambled event, where a bi-partisan panel of state lawmakers and experts will explore health care policy and public health issues. The 2025 event’s keynote speaker is Hemi Tewarson, executive director of the National Academy for State Health Policy.

Georgia officials haven’t invested enough in the state agency that processes public benefits applications, said Laura Colbert, executive director of Georgians for a Healthy Future, a nonprofit policy advocacy organization. The problem is exacerbated by staffing shortages, high staff turnover, and outdated technology, she said.

In November 2023, the U.S. Department of Agriculture notified state officials that Georgia was “severely out of compliance” with timeliness standards for processing SNAP applications. A recent progress report details the scope of the issues: a system that incorrectly prioritizes applications, not enough staff to handle a backlog of nearly 52,000 new applications, and no system to promptly reassign applications when staff are off.

“These delays create real hardship, forcing families to make choices between paying for medicine, food, or rent while they wait for the support they’re entitled to,” Colbert said.

More than a year after the state launched the Pathways to Coverage program, offering Medicaid in exchange for work or other state-approved activities, advocates say the program is too difficult for many applicants to navigate. A new report is recommending changes to Pathways as it faces renewal next year.

Enrollment in Pathways to Coverage has been sluggish, with numbers far below the state’s initial forecasts. Estimates suggest that tens of thousands of Georgians could potentially qualify, with just over 4,200 people signing up during Pathways’ first year.

“Georgia could leverage lessons learned from this first year of Pathways to Coverage implementation and really pivot to a program that fully closes the health coverage gap while boosting the state’s economy,” said Knetta Adkins with the organization Georgians for a Healthy Future, a group that favors full expansion.

Enrollment in Georgia’s year-old limited Medicaid expansion program is well below expectations because of a cumbersome enrollment process and restrictive eligibility criteria, an Atlanta-based public policy group reported Tuesday.

Only 4,231 low-income Georgians were enrolled in the Georgia Pathways program as of the end of last month, well below the 25,000 the state Department of Community Health (DCH) had projected for its first year and even further behind the 240,485 individuals ages 19 through 64 with incomes below 100% of the federal poverty level, according to U.S. Census data from 2022.

Deanna Williams, a health insurance navigator for the nonprofit Georgians for a Healthy Future, said Georgia Pathways enrollees sometimes run afoul of the work requirement because their hours may differ from week to week, which can put them temporarily above the income-eligibility limit.