CHICAGO — Consumer representatives praised state insurance regulators for urging Congress to extend the enhanced Affordable Care Act subsidies, and encouraged the regulators to keep up the pressure during a session at the National Association of Insurance Commissioners summer conference on Monday (Aug. 12).

Laura Colbert, executive director of Georgians for a Healthy Future and one of NAIC’s 22 funded Consumer Liaison representatives, and Claire Heyison, senior policy analyst at the Center for Budget and Policy Priorities and one of NAIC’s unfunded consumer representatives, also laid out the consequences of letting the credits end, many of which were also included in National Association of Insurance Commissioners’ (NAIC) July 19 letter to the chairs and ranking members of the Senate Finance and Ways & Means committees.

First enacted under the American Rescue Plan in 2021, the enhanced credits made $0 premium plans available to people earning up to 150% of poverty and lowered the premium contribution for those with higher incomes, including by reducing the maximum rate to no more than 8.5% of monthly income.

Just over one year after it came into effect, Georgia’s alternative to Medicaid expansion is not living up to its promise, according to an Atlanta-based policy research organization.

“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, which partnered with GBPI in criticizing the Pathways program.

Health care researchers and advocates want Georgia to implement new policies across its health insurance system as the state concludes its yearlong process of redetermining eligibility for Medicaid and the Children’s Health Insurance Program.

Ten states—six of them in the South—have not adopted Medicaid expansion as provided under the Affordable Care Act. In Georgia, Gov. Brian Kemp has implemented a conservative alternative that offers government health insurance to people earning up to the federal poverty level—$15,060 for an individual adult—if they can document that they’re working, in school, or performing other qualifying activities. Laura Colbert, executive director of Georgians for a Healthy Future, spoke with Spotlight recently about Kemp’s plan and GHF’s support for more traditional Medicaid expansion. The transcript of the conversation has been lightly edited for length and clarity.

CDC study cites some causes of growing disparity of preventable early deaths between rural and urban residents.

People in rural Georgia and nationwide are more likely to die early than those in urban areas, and the long-term trend got worse during the pandemic, according to a multi-year study released Tuesday by the U.S. Centers for Disease Control and Prevention.

Rural Georgians are less likely to have job-based health insurance, according to the nonprofit Georgians for a Healthy Future. And in Georgia, uninsured poor adults are not automatically covered by Medicaid, as the state is one of 10 mostly in the South that remain opposed to full Medicaid expansion. That lack of coverage “absolutely (is) one of the predictors and one of the bigger problems,” Garcia said.

The idea of expanding Medicaid is gaining momentum in the last holdout states, with eyes on Mississippi as the next potential state to take up the policy.

As of 2024, only 10 states have not expanded their Medicaid programs. North Carolina and South Dakota are the two newest states to provide Medicaid coverage to people earning no more than 138 percent of the federal poverty level.

The renewed interest comes at a time when states can now get a bump in federal dollars for two years if they adopt Medicaid expansion. The incentive was passed as part of the American Rescue Plan Act.

Laura Colbert, the executive director of Georgians for a Healthy Future, said awareness of the program is low and it’s complicated to get enrolled.

“We know about two-thirds of Georgians in this income bracket are in a working household so would presumably qualify, and yet we haven’t seen them enroll in it,” Colbert said. “We think a lot of that is because the enrollment process is difficult and it’s not working for the folks it’s supposedly meant for.”

Over 19 million people are estimated to have been taken off of Medicaid after broader eligibility granted during the coronavirus pandemic expired—but many who were disenrolled may still be eligible for the health program.

Analysis of government data by health policy research organization KFF found that, as of March 26, around 20 percent of the total number of individuals enrolled on either Medicaid or the Children’s Health Insurance Program (CHIP) had seen their coverage removed, while 36 percent still had renewals pending….

Deanna Williams, an enrollment assister at non-profit Georgians for a Healthy Future, told local news outlet WABE on Monday that many of the people she works with were finding out they had lost coverage during visits to the doctor or pharmacy.

“That means they may be without medication for a week or two, or sometimes a month, depending on how long this process is,” she said. Georgia has reportedly taken steps to notify people at risk of losing coverage, and those who are cut off have the ability to appeal.

Over 500,000 individuals in Georgia have lost their Medicaid coverage as the state aggressively pursues Medicaid redetermination, leaving many citizens without crucial healthcare. This unwavering bureaucratic process has unfolded following an end to federal COVID-19 public health emergency regulations, which previously prevented the state from dropping beneficiaries. According to a report by WABE, Georgia is working through the monumental task of reassessing nearly 2.8 million adults and children enrolled in the program, demanding that all reapply to retain their health coverage.

The grind of paperwork and administrative requirements has proven a stumbling block for many. Deanna Williams, an enrollment assister with Georgians for a Healthy Future, expressed the surprise and hardship that her clients face when discovering their Medicaid coverage is no longer active. “It’s typically they’re finding out when they’re either going to a pharmacy or going to a doctor’s office and they’re having that visit,” Williams told WABE. The lapse in coverage has led to people being without medication for potentially weeks at a time.

Georgia has so far dropped hundreds of thousands of people from Medicaid, mostly for administrative reasons such as problems with renewal application paperwork.

The cutoffs are stacking up as the state continues reevaluating everyone’s Medicaid eligibility with coverage after the end of federal COVID-19 public health emergency rules last spring. The nationwide process is known as “Medicaid redetermination” or “Medicaid unwinding.”

Now, to stay covered, everyone in the program has to reapply. In Georgia, that’s nearly 2.8 million adults, as well as children with PeachCare for Kids.

“A lot of them are just not sure what that means,” said Deanna Williams, an enrollment assister at the nonprofit Georgians for a Healthy Future.

She said many of her clients are surprised to learn their coverage is suspended.

“It’s typically they’re finding out when they’re either going to a pharmacy or going to a doctor’s office and they’re having that visit,” she said.

“For them, that means they may be without medication for a week or two, or sometimes a month, depending on how long this process is. So it’s hard to get those calls. I try to take the extra step to see how we can help them during that process and waiting period. That’s how I try to help my clients through it.”

Democratic state lawmakers say they’ll continue fighting to expand Medicaid in Georgia after a majority Republican committee rejected the latest proposal for expansion with a week left in the General Assembly’s legislative session.

The vote followed almost two hours of Senate committee debate on a House bill, the Peach Care Plus Act of 2024…Laura Colbert, executive director at the nonpartisan policy group Georgians for a Healthy Future, spoke before the committee in favor of Peach Care Plus. “Unexpected medical situations can be a big hit, you know, for some of us we can handle an unexpected $500 or $800 medical bill, but these are folks making $20,000 a year. And so that’s a really big hit,” Colbert said.