Keeping Families Covered: Understanding Implications of the Medicaid Unwinding and the Pathways to Coverage Implementation
Abstract
In 2023, Georgia faces two unprecedented healthcare events: the Medicaid unwinding and a partial expansion of Medicaid through the Pathways to Coverage program. Since the start of the pandemic-era Medicaid continuous coverage requirement, Medicaid enrollment has grown substantially, and over two million Georgians have had uninterrupted access to affordable health care coverage. Starting April 1st, the continuous coverage requirement will begin to unwind, and the state of Georgia will have about a year to re-determine the eligibility of all children and adults covered by Medicaid and PeachCare. During that time, an estimated 545,000 Georgians risk losing healthcare coverage. Children—particularly Black and Latinx children—are at risk of experiencing harmful, temporary gaps in coverage due to procedural denials (e.g., the renewal form gets sent to their house in the wrong language). Parents with very low incomes, young adults aging out of Medicaid or PeachCare, and mothers who are past one-year of postpartum coverage risk losing eligibility and potentially falling into the coverage gap.
Starting July 1st, the state is slated to begin implementation of the Pathways to Coverage plan. This partial Medicaid expansion would provide health care coverage to adults in Georgia making up to 100% of the Federal poverty level (about $18,310 or less for a family of four). In order to gain eligibility, all enrollees would be required to complete a minimum of 80 hours per month of qualifying activities like employment, community service, higher education, etc., and some enrollees would have to pay monthly premium payments. The state has estimated that between 31,000 to 100,000 Georgians could be enrolled in the first year of enrollment.
The presenters will discuss the Medicaid unwinding and the planned implementation of the Pathways to Coverage program and how these two healthcare events impact access to health care for Georgians. The presenters will also highlight the implications of these two seismic shifts for Georgia’s public health system and how public health workers can play a role in helping Georgians stay covered.
Keywords
Medicaid unwinding; health disparities; health care access; policy
Keeping Families Covered: Understanding Implications of the Medicaid Unwinding and the Pathways to Coverage Implementation
In 2023, Georgia faces two unprecedented healthcare events: the Medicaid unwinding and a partial expansion of Medicaid through the Pathways to Coverage program. Since the start of the pandemic-era Medicaid continuous coverage requirement, Medicaid enrollment has grown substantially, and over two million Georgians have had uninterrupted access to affordable health care coverage. Starting April 1st, the continuous coverage requirement will begin to unwind, and the state of Georgia will have about a year to re-determine the eligibility of all children and adults covered by Medicaid and PeachCare. During that time, an estimated 545,000 Georgians risk losing healthcare coverage. Children—particularly Black and Latinx children—are at risk of experiencing harmful, temporary gaps in coverage due to procedural denials (e.g., the renewal form gets sent to their house in the wrong language). Parents with very low incomes, young adults aging out of Medicaid or PeachCare, and mothers who are past one-year of postpartum coverage risk losing eligibility and potentially falling into the coverage gap.
Starting July 1st, the state is slated to begin implementation of the Pathways to Coverage plan. This partial Medicaid expansion would provide health care coverage to adults in Georgia making up to 100% of the Federal poverty level (about $18,310 or less for a family of four). In order to gain eligibility, all enrollees would be required to complete a minimum of 80 hours per month of qualifying activities like employment, community service, higher education, etc., and some enrollees would have to pay monthly premium payments. The state has estimated that between 31,000 to 100,000 Georgians could be enrolled in the first year of enrollment.
The presenters will discuss the Medicaid unwinding and the planned implementation of the Pathways to Coverage program and how these two healthcare events impact access to health care for Georgians. The presenters will also highlight the implications of these two seismic shifts for Georgia’s public health system and how public health workers can play a role in helping Georgians stay covered.
