Every year on November 1st, healthcare.gov and state-specific health insurance marketplaces open so that Americans who don’t have job-based health insurance or other coverage can shop for and enroll in health insurance. In 2024, 1.3 million Georgians enrolled in coverage in this way, and this year their marketplace will look a little different. Here’s what Georgians need to know about the changes. 

Since 2013, Georgians have used healthcare.gov to view health insurance plans, qualify for financial help to lower their costs and enroll in the health plan of their choosing. In 2023, Georgia lawmakers moved to change that. The state legislature and Governor Kemp passed a new law that allows Georgia to create its state-based marketplace (SBM). Since then, the Georgia Department of Insurance has been working to create and launch Georgia Access (GeorgiaAccess.gov). Georgia Access launches November 1st. 

As Georgians prepare to cast their votes in this year’s elections, the importance of health care policy has never been clearer. From the future of affordable coverage to the persistent gaps in access for communities around our state, the stakes are high. Georgia’s on-going health challenges highlight the need for candidates who prioritize health and wellness. Georgians need elected leaders who will make decisions that ensure access to affordable, high-quality health care, especially for communities who have historically had more difficult barriers to accessing and affording care.

With this in mind, we’ve developed a set of questions for voters to ask state and local candidates on key health care issues affecting communities around our state. These questions can help guide your conversations with candidates at town halls, forums, or on social media.

Georgia is one of 10 states that has not yet expanded Medicaid. Our leaders’ in action leaves thousands of low-income Georgia adults without health insurance.

Instead of expanding Medicaid, Governor Kemp created a new program called Georgia Pathways to Coverage. This program will cover some low-income adults, but it has a lot of rules and requirements.

To qualify for Pathways, you must meet all of these four requirements:

• Be a U.S. citizen or a qualified permanent resident
• Be between the ages of 19 and 64
• Have an income below the poverty line. (If you don’t know if your income is below the poverty line, use the chart below.)
• Be working or doing other qualifying activities for at least 80 hours per month.

If you are uninsured and meet these requirements, you can apply for Pathways. You can apply online at gateway.ga.gov or by phone at 1-877-423-4746.

If you need assistance with your application, GHF’s enrollment assisters are here to help! Click here to ask for their assistance. 

What does this mean for Georgians?

Pathways is a complicated program with many rules and restrictions, so we expect only a fraction of eligible Georgians will get covered through the program. The Governor and his administration have estimated that between 31,000-100,000 Georgians will be able to enroll in Pathways. (Full Medicaid expansion would cover more than 400,000 Georgians.)  

Some people who are likely to be left out include:

• Stay-at-home parents
• Caregivers for aging family members or children with a disability
• People in mental health or addiction recovery programs
• Rural residents and people of color who live in areas where good jobs are hard to find
• People who do not have reliable internet access or a car

These folks may not meet the requirements for Pathways or won’t be able to keep up with the tedious monthly reporting. They will likely be left behind. 

Medicaid expansion: an easier, better solution

Pathways is a broken bridge that lets too many Georgians and too much money fall through the cracks. Because of its complications and restrictions, thousands of Georgians will remain uninsured, and our state’s tax dollars–which are meant to help families access health care and keep hospitals open–will sit unused in Washington, D.C. 

Georgians deserve better. We deserve access to affordable, quality health care regardless of how little money is in our wallets. We deserve healthy hospitals whose doors are open to care for their communities. We deserve to visit the doctor when we’re sick and fill a prescription without worrying about whether to pay our rent or the medical bill.

Luckily Georgia leaders can replace Pathways with a program that is simpler, covers more people, costs less per person, and meets our state’s needs: Medicaid expansion! 

How you can help

Here are some things you can do to get Georgians covered and keep up the calls for Medicaid expansion:

• Spread the word about Pathways. Tell the uninsured Georgians in your life about the program and encourage them to apply. Here is some helpful information to print and share:
  • Uninsured in Georgia? flier
  • Information about Pathways from the Georgia Department of Community Health
• If you apply for the Pathways program, tell us about it! We want to know if you got covered or were turned away. Record your story and enter a monthly $100 give away, sponsored by our partners at Vocal Video! GHF is committed to directly compensating select storytellers with electronic gift cards!
  • If you are helping people enroll in Pathways, we want to hear from you too! 
• Speak up for Medicaid expansion! Ask the Governor and our state legislators to expand Medicaid when they return to the state Capitol in January 2024.
  • Don’t know what to say? We’ve got you covered. Here are some fast facts about Medicaid expansion that you can use to write or call your state leaders. 

By working together, we can make sure that all Georgians–regardless of how much or little money they have–have health coverage and the access to care that comes with an insurance card.

​​Every person who calls Georgia home deserves to live healthy and thrive. While Georgia has made recent strides to improve the health of our residents, we haven’t yet reached that goal according to Georgians themselves and our state’s health data.

To help state and community leaders make effective and informed decisions about the health and well-being of Georgians, Georgians for a Healthy Future created the illustrated What the health, Georgia guide. This publication is intended to be a reference that decision makers can go back to again and again as they consider new health laws and policies and determine how to invest public funds in health care and public health.

Download a copy of What the Health, Georgia here! 

Legislative update: Sine Die

Thank you for your continued readership and support during the 2021 legislative session! The GHF team is proud to deliver timely, accurate updates to you on health care happenings at the Capitol. We hope that they have helped you stay informed and connected. If you have enjoyed reading each week’s edition, please consider supporting our work with a donation today. Thank you very much!

In this week’s update:

• Our priorities: “Express lane” Medicaid, telehealth, and prior authorization
• Status update: Which bills continue to the Governor’s desk and which ones were left behind
• GHF’s got you covered this session!

Legislative update: Week 8

The GHF team prides itself on delivering timely and accurate updates to you on health care happenings at the Capitol. We hope that you enjoy reading our weekly legislative updates and that they help you stay informed and connected. If you enjoy them, please consider supporting our work with a donation today. Thank you for your continued support!

In this week’s update:

• Action alerts: Ask the House Rules Committee to prioritize mental health & substance use recovery today!
• Bills likely to receive a House or Senate vote today
• Approved last week: Emergency services, prior authorization, & the FY22 big budget
• Advocacy events this week: HIV decriminalization & Medicaid expansion advocacy day!
• U.S. Senate approves COVID-19 relief including extra Medicaid expansion funding for Georgia
• GHF’s got you covered this session!

Legislative Update: Week 4

Thank you for your readership and enthusiasm for GHF’s weekly legislative updates! The GHF team enjoys putting these updates together to keep you in the loop. We work hard to deliver this service to you in a complete and accurate way every week of Georgia’s legislative session. If you rely on these updates to keep you connected to the health happenings under the Gold Dome, please consider supporting our work with a donation today. Thank you very much!

In this week’s update:

• Take action to reduce the number of uninsured children in Georgia
• Legislation on vaccine administration, lead poisoning in children, prior authorization, and a Medicaid public option!
• Advocacy events for your calendar
• GHF’s got you covered this session!

Legislative Update: Week 1

The 2021 legislative session has begun

Last week, the Georgia General Assembly convened for the first time in 2021. The first four days of the 2021 legislative session were held with additional COVID-19 safety protocols in place. The attentions of legislators were mostly taken up with committee appointments, (including a change in leadership for the Senate Insurance Committee from Sen. Burt Jones to Sen. Dean Burke), Governor Kemp’s third State of the State address, and other annual traditions, including GHF’s own Health Care Unscrambled. 

This week will be primarily dedicated to budget hearings for the current (FY 2021 Amended) and next year’s (FY 2022) state budgets. The General Assembly will reconvene on Tuesday, January 26th for the fifth day of legislative session.

Ramatu lives in Gwinnett County with her four children for whom Medicaid helps to meet their unique health needs. Medicaid provides a lifeline for Ramatu’s family and helps ensure that her children receive the health care they need. According to the Kaiser Family Foundation, 54% of Georgia children with special health care needs are covered by Medicaid. 

“Two of my kids are on straight Medicaid because of the severity of their disability. The other two, they are on what is called care services.”  –Ramatu

Both of Governor Kemp’s health care proposals were approved by federal health officials in the last two weeks. Unfortunately, both proposals fall short of the bold, evidence-based action that Georgians need their state leaders to take. These plans may impact you or people you know. While some details of the plans are still being sorted out, we have tried to answer some of your early questions here. As we learn more and these plans roll out, GHF will keep you updated with the information you need to get covered, stay covered, and help your loved ones do the same.