“Ideally, a state-based marketplace will allow for a more tailored experience for consumers and allow the state to innovate,” said Laura Colbert, executive director of Georgians for a Healthy Future, which supports the ACA. “I have some concerns about whether the state has the vision for that.”

Colbert said the work on the new marketplace comes as the state is simultaneously working on two other health priorities. The state is preparing a first-of-its-kind limited Medicaid expansion; and Georgia, along with other states, has also just begun a post-pandemic re-evaluation of all 1.3 million Medicaid enrollees, thousands of whom are expected to be dropped from Medicaid and will need to enroll in ACA plans.

“I have seen the state agencies, both DCH and DHS, come forward with really good-faith efforts to plan as best they can,” Laura Colbert, executive director of Georgians for a Healthy Future, said. “The trickiest part of this seems to be maybe staffing for both DHS and DCH … hiring enough Medicaid eligibility workers. Making sure they are trained properly and prepared to do that job over the next 12 to 14 months is going to be very difficult in this work and labor environment.”

“There will be far fewer uninsured folks as a result of this Medicaid renewal process in states with Medicaid expansion. Georgia is not one of those, so we will see very large coverage losses,” Laura Colbert, executive director of Georgians for a Health Future, which is a nonpartisan patient advocacy group, said during a recent Protect Our Care program.

Colbert said the state agencies have made “really good faith efforts to plan as best they can,” but noted that it falls to the governor and lawmakers to ensure they have the resources they need.

Due to this, Georgia is likely to see some of the most extensive coverage losses in the country, said Georgians for a Healthy Future Executive Director Laura Colbert.

“Some of those coverage losses are going to be among kids who are still eligible for Medicaid. And they may lose that coverage just because of the bureaucracy of the renewal process,” she said. “Some adult coverage losses that we see are really going to be because Georgia has not yet opted to cover low-income adults and really make the Medicaid program complete.”

“I have seen the state agencies, both DCH and DHS, come forward with really good faith efforts to plan as best they can,” said Laura Colbert, executive director of Georgians for a Healthy Future.

“The trickiest part of this seems to be maybe staffing for both DHS and DCH … hiring enough Medicaid eligibility workers. Making sure they are trained properly and prepared to do that job over the next 12 to 14 months is going to be very difficult in this work and labor environment.”

State budget hearings earlier this year highlighted the labor shortages and high turnover rates most state agencies face.

Many adults will lose coverage because Georgia is one of 10 states that have not fully expanded Medicaid, Colbert said.

Some children also may lose coverage because of the complexity of the bureaucratic process, she added.

“Some folks are going to be ineligible for Medicaid and not eligible for anything else,” Colbert said. “We will see very large coverage losses.”

Other adults who lose coverage may be able to enroll in Affordable Care Act plans available on the Healthcare.gov marketplace. Those who lose coverage will be able to apply for Healthcare.gov plans as early as 60 days before their Medicaid/PeachCare coverage ends and up until July 31, 2024.

However, only those Georgians who earn 100% or more of the federal poverty level ($13,590 for a single person) will qualify.

Those who earn less than the federal poverty level will be able to seek coverage through a new Georgia program, called Georgia Pathways, that launches on July 1.

Under that program, Georgians who work, volunteer, or enroll in educational programs for at least 80 hours per week can also qualify for the state Medicaid program. Estimates of how many people will be eligible for that program vary.

“There may be upwards of 200,000 members already on Medicaid that would qualify for [Pathways],” DCH Commissioner Caylee Noggle told lawmakers in January. “They will be transitioned to that [program] during their eligibility redetermination if they’re eligible.”

But the number could be much lower, said Colbert of Georgians for a Healthy Future.

“It’s likely then that fewer than 100,000 folks are going to gain coverage because of really difficult bureaucratic work requirements and premiums that are not standard for the Medicaid program,” Colbert said this week.

Colbert noted that the process has only been underway for less than a month, so it’s difficult to pinpoint trouble spots.

“We are hearing some people think that it’s disinformation or that it’s a scam, that it’s an effort for some unknown actor to try to get people’s personal information,” Colbert said. “It’s more important than ever that Georgians really understand the importance and the impact of Medicaid.”

This year’s mental health law addresses the needs of people transitioning between homelessness, the emergency room and prison, said Whitney Griggs, health policy analyst for Georgians for a Healthy Future. They are people with severe and persistent mental illnesses who fall through the cracks of the system, she said.

She added that not a single system – the housing system, the health care system, the justice system – is really designed to meet the needs of these individuals.

The populace that HB 520 sought to help, so-called “familiar faces,” gobbles up a huge chunk of state resources and state dollars, Griggs said, which is why it’s important to address the system that causes those faces to cycle through those three locations.

She said the bill “did things like banning local housing companies from not providing housing to someone because they had a criminal background”.

And proponents insist that early intervention is the best way to proactively take care of Georgians’ health.

“As the Medicaid unwinding unfolds, doctors, pharmacists and community members are likely to see an increase in the number of uninsured children and adults. These Georgians may be newly unable to access care or have difficulty filling a prescription,” according to a Georgians For a Healthy Future report.

The nonprofit group estimated that nearly 550,000 Georgians will lose coverage, either because they are no longer eligible or for administrative reasons. These could include problems, such as a letter being mailed to the wrong address, lack of home internet or language barriers.

This year’s mental health bill addressed the needs of people who cycle between homelessness, emergency rooms and jail, said Whitney Griggs, the health policy analyst for Georgians for a Healthy Future.

“[Those] who have really severe and persistent mental illness and are just kind of falling through the cracks in the system,” she said. “And no one system — the housing system, the health care system, the judicial system — are really designed to meet their needs.”

“I’m nervous,” said Laura Colbert, executive director of Georgians for a Healthy Future, a health care advocacy nonprofit.

“This is going to be the biggest coverage event since the implementation of the Affordable Care Act,” she said. “Our state agencies are historically not well resourced and can struggle to fulfill their mission… I’m concerned for Georgia families that policymakers have not invested enough resources, and as a result won’t be successful.”

However, Colbert added, “I’ve also seen evidence that people with the state are being thoughtful, so that gives me some optimism as well.”