This is the fourth entry in a series of posts highlighting GCO’s new report – Increasing Access to Quality Healthcare for Low-Income Uninsured Georgians. The first entry provided an overview of the report, the second looked at Georgia’s healthcare safety net, and the third explained the impact of uninsurance. 

Medicaid is the country’s main public health insurance program for low-income families and individuals, including children, parents, pregnant women, seniors, and people with disabilities. A joint federal/state program, the federal government sets mandatory eligibility groups and general guidelines for benefits, while states establish individual eligibility criteria within federal standards.

The Georgia Department of Community Health projects that over 1.8 million Georgians will enroll in Medicaid and PeachCare in 2014 – 18.56 percent of the state population. The Department estimates that the state will spend $2.85 billion on these programs – 15.57 percent of state revenue. The federal government will cover the remaining $6.65 billion for a total expenditure of $9.5 billion. [i]

In 2010, Congress passed and President Obama signed into law the Patient Protection and Affordable Care Act (Affordable Care Act or ACA). The expansion of Medicaid eligibility to all nonelderly adults who make up to 138 percent of FPL is a major component of the law. In 2012, the Supreme Court found the ACA’s Medicaid expansion to be unconstitutionally coercive of states. As a result of the ruling, expanding Medicaid is now optional for states.

Georgia Governor Nathan Deal and the General Assembly have chosen not to expand Medicaid because of the cost to the state and unsustainability of the federal contribution.

An estimated 534,000 uninsured adults in Georgia making less than 100 percent of the federal poverty level fall in the expansion “coverage gap.” These uninsured individuals would be newly eligible for Medicaid under the expansion but will likely continue to have limited access to affordable health coverage without a change in the state’s expansion decision or other health policy changes. [ii]

GCO’s new healthcare access report focuses on identifying sustainable solutions to improve healthcare for these individuals.

[i] Clyde L. Reese III and Jerry Dubberly, “Georgia Medicaid and PeachCare for Kids,” Georgia Department of Community Health, Presentation to Georgia General Assembly Joint Study Committee on Medicaid Reform, August 28, 2013, 11, 33,


[ii] Genevieve M. Kenney et al., “Opting in to the Medicaid Expansion under the ACA: Who Are the Uninsured Adults Who Could Gain Health Insurance Coverage?,” Timely Analysis of Immediate Health Policy Issues, Robert Wood Johnson Foundation and Urban Institute, August 2012, 18,

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