“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.”

This month, the Poor People’s Campaign, the Georgia Budget and Policy Institute, and Georgians for a Healthy Future hosted a webinar about the unwinding process. The partnerships and corresponding information campaigns are an effort to provide information communities with resources needed to stay covered.

Many rural Georgians are faced with compounding health disparities, such as a lack of job-based medical insurance, long travel times to access medical services and increased rates of chronic conditions, according to Georgians for a Healthy Future.

Andy Lord, who spoke on behalf of both Georgians for a Healthy Future and the Georgia Society of Clinical Oncology, argued there already exists a precedent among private insurance companies to charge smokers for their unhealthy choices.

“If you’re the same age, height, weight, everything, but one’s a smoker and one’s a nonsmoker, the private sector model says we charge the smoker more, right? That’s a business decision,” Lord said. “Higher risk behaviors result in higher premiums. That’s ubiquitous across the insurance industry.”

Laura Colbert is Executive Director of Georgians for a Healthy Future. She has doubts.

“The evidence is very nonexistent that the work requirement would motivate somebody to kind of go out and get a job when they wouldn’t otherwise,” Colbert said.

Why, she asks, would health insurance be a stronger incentive to work than basics like food and shelter?

“Medicaid will not pay your rent, your utility bill or put gas in your car,” Colbert said. “And, you know, it’s not like people get a check for Medicaid. All they get is health care.”

But more importantly, Colbert said that while Pathways will expand coverage, it doesn’t include everyone that needs it.

That’s because lots of people simply can’t work.

“Not only are people with serious mental illness and full-time caregivers going to be left out,” Colbert said, “but there will also be some groups that are disproportionately left behind by the program.”

Like those in rural areas where there aren’t good-paying jobs, or some minorities living in historically disinvested communities, she said.

Colbert, of Georgians for a Healthy Future, said Georgia’s current Medicaid system shuts many people who need health care coverage out of the system.

“Georgia has a very stringent Medicaid program,” Colbert noted. “ Our program is one of the least generous programs in the country. The governor has put forth this program for those folks who fall in a coverage gap because Georgia has not expanded Medicaid. For those folks who fall in that gap, this program is going to be very difficult to get in and stay enrolled in.”

Colbert said those folks who fall through the gap generally are Georgians between the ages of 18 and 40; people in rural areas and other places where higher-paying jobs are scarce; workers in low-paying fields such as food service, grocery, retail and childcare; people with mental health and substance abuse conditions; and people of color. Blacks and Latino account for half of the people in Georgia’s Medicaid coverage gap, said Colbert.

“They haven’t done any checks since March of 2020 so everyone has been able to keep their coverage for that entire period without having to renew,” said Laura Colbert, Executive Director of Georgians for a Healthy Future.

“Now that we know redetermination will begin April 1, 2023, it’s more important than ever for Medicaid and PeachCare for Kids members to make sure their contact information is up to date so we can reach them with critical, timely information, said DHS Commissioner Candice Broce. We want to make sure that eligible Medicaid members do not risk losing their family’s coverage.”

“My last person I [helped] only paid $8 a month health-care coverage for 2023,” Deanna Williams, an insurance navigator who works at Georgians for a Healthy Future, said during a press conference last week. “A lot of people who I’ve helped, especially in my rural area … were shocked to know that they could get a plan.”

And Georgians for a Healthy Future director Laura Colbert said Medicaid expansion is a long shot this session too.

“The governor does not have any meaningful motivation to move forward with Medicaid expansion because he won so decisively in November,” she said, “and because he got the green light on his Pathways waiver.”

Even people who maintain eligibility next year could temporarily lose coverage during redeterminations, said Laura Colbert, director of Georgians for a Healthy Future.

“Often Medicaid members, because they are in low income families, they tend to be harder to reach,” Colbert said. “Because they’re busy, because they live in rural areas, because they move more often.”

Colbert says low-income adults will likely see the largest coverage losses, because they don’t often qualify for Medicaid unless they are pregnant, disabled or have certain cancers.

“Unless our state leaders choose to expand Medicaid,” Colbert said.