ATLANTA, GA — Georgians for a Healthy Future (GHF) today responded to Thursday’s announcement from Georgia’s Department of Community Health (DCH) that the agency will ask the federal government for permission to change how it funds Pathways to Coverage, the state’s limited Medicaid program for Georgians earning up to 100% of the federal poverty level (FPL).
Because Georgia has not fully expanded Medicaid to cover Georgians earning up to 138% FPL, the federal government currently covers 66 percent of program costs (Georgia’s current Medicaid matching rate).
DCH is requesting an increase to 90 percent, the “enhanced” rate the federal government pays to states that have fully expanded Medicaid to low-income adults with incomes up to 138% FPL. DCH is asking for that funding boost without increasing Pathways’ income eligibility.

To make this request, DCH must formally amend the Georgia Pathways to Coverage Section 1115 waiver, the federal approval that allows Georgia to run Pathways with its own custom rules, including current work requirements, instead of following standard Medicaid rules.

“Every Georgian deserves access to health coverage, and every additional person who gains it is meaningful, even within a program as flawed as Pathways,” said Laura Colbert, Executive Director of Georgians for a Healthy Future. “While the federal requirements do not eliminate the inherent problems with work reporting requirements, the shift away from Pathways’ current structure to the federal version is an opportunity for more Georgians to gain coverage, including family caregivers, adults with serious chronic illnesses like cancer or mental illnesses, and veterans with major disabilities.”

Pathways currently requires enrollees to document at least 80 hours per month of work or another qualifying activity and covers fewer than 20,000 Georgians. Starting January 1, 2027, Georgia must align its work requirements with new nationwide standards under H.R. 1, the federal budget law passed last year that imposes Medicaid work requirements across the country. The new federal rules will include more exemptions than Georgia’s current program, and DCH estimates this could increase Pathways enrollment to 120,000 Georgians.

One year after H.R. 1’s enactment, advocates point to rising premiums, new Medicaid paperwork requirements, and coverage losses across Georgia

ATLANTA, Ga. (July 2, 2026): One year after H.R. 1 became federal law on July 4, 2025, more than 500,000 Georgians have dropped their marketplace health insurance coverage due, in part, to rising premiums. Newly released guidance from the Centers for Medicare & Medicaid Services (CMS) goes further than what is written in H.R. 1 in some cases, and makes accessing high-quality, affordable health care even more of a challenge for everyday Georgians.

Health advocates say the combined effects of marketplace subsidy changes, new administrative requirements, and future federal policy changes have significant implications for both Georgia families, health care providers, and communities statewide.

After Congress declined to extend enhanced premium tax credits under H.R. 1, which priced working-class Georgians out of marketplace coverage, the federal government has finalized a rule for the 2027 marketplace that will increase the paperwork needed for people to enroll in plans and receive financial help, permit unlimited annual out-of-pocket maximums for certain marketplace health plans, and make it more difficult to find in-network care.

Regarding Medicaid, a newly released CMS rule, which is intended to guide states like Georgia in their implementation of H.R. 1, will continue to leave low-income families without access to affordable care. By sharply restricting exemptions to Medicaid work reporting requirements, such as who is considered “medically frail,” and forcing severely ill individuals to navigate complex paperwork systems to keep their coverage, the new federal guidance will only perpetuate existing barriers and Georgia’s health care crisis. Georgia’s Pathways to Coverage program is a cautionary tale of what is to come for other states when the H.R. 1 Medicaid work requirement begins in January 2027: bureaucratic hurdles and suppressed enrollment for individuals with low incomes and high administrative costs covered by taxpayers.

ATLANTA, May 13, 2026 — Following significant declines in funding for health insurance navigator programs, Georgians for a Healthy Future (GHF) today launched its “Getting Georgia Covered” spring campaign to sustain enrollment assistance services for Georgia residents navigating an increasingly complicated health coverage landscape.

Support for marketplace navigator programs has drastically decreased, leaving far fewer trained resources available to help Georgians compare plans, apply for subsidies, and understand their coverage options. The cuts come at a moment of significant instability: the expiration of enhanced premium subsidies drove 2026 marketplace premiums up significantly across the state. As coverage has grown less affordable, hundreds of thousands of Georgians have already disenrolled from ACA plans, and many of those still enrolled are working harder than ever to find plans that fit their budgets, making one-on-one enrollment assistance more critical than it has been in years.

GHF is one of only a few organizations in Georgia providing enrollment assistance across both Medicaid and the Georgia Access marketplace, serving residents regardless of which program they qualify for.

The campaign runs May 13 through 19. Funds raised support GHF’s enrollment assistance operations, which serve Georgia families year-round.

GHF launches first-of-its-kind tool to monitor insurer compliance with state and federal mental health parity laws

ATLANTA — This week, Georgians for a Healthy Future (GHF) released the Georgia Mental Health Parity Dashboard, a new tool that allows consumers and policymakers to track how well health insurers are complying with laws intended to ensure equal access to mental health and substance use disorder care.

The Georgia Mental Health Parity Dashboard tracks compliance with Georgia’s Mental Health Parity Act (HB 1013) and the federal Mental Health Parity and Addiction Equity Act (MHPAEA) across state-regulated private health plans and the public health insurance programs Medicaid and PeachCare for Kids. It examines the rules and processes that most directly affect whether people can get the care they need, including how insurers define medical necessity, set cost-sharing requirements, and apply prior authorization and other utilization management tools.

ATLANTA — Georgia lawmakers return to the Capitol this week as higher health insurance premiums strain family budgets in Georgia and push more Georgians toward becoming uninsured. Congressional procrastination has already made Georgia Access coverage more expensive for many families; now Congress is actively debating whether and how to restore the enhanced premium tax credits that helped keep premiums affordable. 

While the outcome and timing in Washington remain uncertain, a potential federal fix would not relieve Georgia’s lawmakers of the need to adopt a state-level affordability plan.

The question is whether state leaders will use the tools available to protect residents from avoidable coverage losses now and build a more stable and affordable health insurance marketplace for the years ahead.

With the final 2026 Georgia Access enrollment deadline just days away, Georgia is already seeing warning signs. Georgia Access has lost more than 190,000 enrollees in the first phase of 2026 enrollment, according to the Atlanta Journal-Constitution. January 15 is the last day to enroll in a 2026 plan through Georgia Access. 

New projections from the Georgia Health Initiative show the stakes if Georgia does not act to protect affordability. By 2034:

• Nearly 500,000 Georgians will become uninsured
• $10.5 billion increase in uncompensated care costs for Georgia health care providers
• Tens of thousands of health care jobs at risk
• Rural hospitals and underserved communities hit hardest

“Georgia does not have to sit on the sidelines while Congress debates next steps. We can determine our own fate,” said Laura Colbert, Executive Director at Georgians for a Healthy Future (GHF). “Because Georgia operates its own health insurance marketplace, state leaders can take practical steps to keep coverage affordable for our families and prevent Georgians from becoming uninsured. Those state tools matter even if Congress acts, because federal action may be delayed, temporary, or structured in ways that still leave many Georgians behind.”

Congress’s failure to extend enhanced premium tax credits leaves Georgia families exposed

ATLANTA, GA — Georgians for a Healthy Future released the following statement after Congress failed to extend the enhanced premium tax credits, a decision that is likely to result in the expiration of these affordability protections in 20 days and result in higher health insurance costs for many Georgia families.

The enhanced premium tax credits are the primary tool that help families purchase comprehensive coverage on the health insurance marketplace and keep monthly premiums affordable for nearly all (95%) Georgia Access enrollees. The vote comes just days before the December 15 deadline for Georgians to enroll in health plans that begin on January 1. The failed vote creates uncertainty during a critical period when many families are making final decisions about their 2026 coverage and relying on these credits to keep premiums affordable.

Statement from Georgians for a Healthy Future Director of Health Policy Whitney Griggs:

“Congress’s failure to extend the enhanced premium tax credits leaves Georgia families exposed to steep and avoidable premium increases in 2026. Average premiums for subsidized Georgia consumers are expected to nearly triple, rising from 275 dollars to 814 dollars per month. For families with incomes below 250 percent of the federal poverty level, premiums are projected to jump more than 500 percent. These increases are simply unaffordable for many households, especially in rural communities where options and resources are already limited. Without these protections, up to 460,000 Georgians could lose their coverage, and rural hospitals and clinics will face even greater financial strain.”