Analysis: Fewer than 4,500 enrolled in Georgia’s Medicaid alternative

(The Center Square) — Fewer than 4,500 people are enrolled in Georgia’s Medicaid alternative that launched a year ago, well below enrollment estimates.

The number of 4,323 Georgians enrolled in Georgia Pathways to Coverage as of June 15 is from the Georgia Budget and Policy Institute, which reviewed estimates the Department of Community Health provided to the media. The state agency did not immediately confirm the numbers on Friday.

The state launched the Pathways program on July 1, 2023, to provide Medicaid to Georgians between 19 and 64 in households with incomes up to the federal poverty level who are not eligible for regular Medicaid. Participants must perform at least 80 hours of “qualifying activities per month,” such as full- or part-time employment, vocational educational training or community service.

“The Pathways to Coverage program was a step forward for Georgia, but the stark figures after one year signify a missed opportunity for expanding health access in our state,” Leah Chan, Georgia Budget and Policy Institute’s director of health justice, said in a statement. “With less than 2% of the eligible population reached, and countless Georgians still outside the healthcare safety net, it’s clear that we need a more inclusive and streamlined approach. Regardless of next steps, taxpayers deserve transparency and accountability regarding the significant investment they’ve made in this program so far.”

Kyle Wingfield, president and CEO of the Georgia Public Policy Foundation, said the enrollment question is a complex one. The state’s Medicaid eligibility redetermination, increased personal income, a fluctuating poverty rate and sparring between the administrations of Democratic President Joe Biden and Republican Gov. Brian Kemp are among the factors that could have contributed to the slow enrollment.

“It’s unfortunate that Pathways got started so much later than anticipated, because the intervening years have been quite volatile and introduced all these factors — and many more — into the equation,” Wingfield said via email. “The point of a demonstration waiver is to figure out if there’s a better way to administer Medicaid. These waivers are designed with the information available at the time, and as we can see, a lot of the circumstances have changed. So it’s hard to know if this was a faulty policy design, an idea that was overtaken by events, or something that was poisoned by partisanship.”

On Thursday, Kemp told the Georgia Hospital Association that Georgia Pathways and Georgia Access, Georgia’s program for residents to shop for and enroll in health insurance, provides health coverage for over 714,000 people under 138% of the federal poverty limit, according to prepared remarks his office provided. The governor said that is “a far greater number of Georgians covered than any estimate for traditional Medicaid expansion to cover the exact same population.”

“There’s a lot of people who don’t want a common-sense, conservative, free-market solution,” Kemp said, according to the prepared remarks. “Many just want the government to throw more and more money at another ineffective bureaucracy.

“…But instead of allowing us to build on that progress and launching Georgia Pathways, the Biden administration unfortunately fought us at every turn, delaying us for over two years,” Kemp added.