ATLANTA — Georgia Pathways to Coverage launched on July 1, 2023, to provide low-income residents access to healthcare.
It’s the only plan in the country that requires recipients to show they’ve worked, volunteered, or taken classes for 80 hours each month.
The state’s application for Pathways estimated 25,000 people could enroll in its first year, but the numbers are well below that.
As of July 2024, the Georgia Department of Community Health (DCH) reported that 4,300 recipients were registered for the program. 11Alive confirmed those numbers with the agency and the governor's office following a roundtable discussion about milestones tied to health insurance programs under the Patients First Act.
"We had to fight the Biden Administration for two years to be able to do this. We had to go to court in the first place to get part of this program started. We've had to deal with redetermination, which many of you have criticized us over the last couple of years, even though it was mandated by the federal government that we do that. So we're in a really good place now," Gov. Brian Kemp said.
Kemp says Pathways' goal is to support residents on their journeys to financial independence and eventually transition them to private coverage.
How to qualify for Georgia Pathways to Coverage
- To qualify, you must be a Georgia resident between the ages of 19 and 64 and have a household income up to 100% of the federal poverty level.
- That’s about $15,000 a year for one person and $25,820 per year for a family of three. Right now, of that group, more than 240,000 uninsured Georgians are potentially eligible for Pathways.
- To see the full list of qualifications and if you meet the income requirements, click here.
What critics of the program say
On the other hand, critics say this program won’t work because of the job requirement. They say it doesn’t take into account people who don’t have a traditional job, those who can’t work because they’re taking care of loved ones or people who don’t have a computer to upload their information at all.
“We also know that it could be folks who are in full-time residential treatment for an addiction that they're struggling with. They're also not able to meet those requirements, but they still critically need access to that lifesaving healthcare coverage," Director of Health Justice for the Georgia Budget and Policy Institute (GBPI) Leah Chan said.
According to a 2024 fiscal note produced by the state auditor’s office, under full expansion, over 500,000 people would enroll in Year 1, and over 1M would enroll in Year 2. However, it’s important to note that only about 290,000 of those folks would be newly insured (i.e., the coverage gap).
Check out the interactive graph for the breakdown below:
States that opted not to expand Medicaid
Georgia is one of 10 states that opted not to expand Medicaid. Other states include Alabama, Florida, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.
So, if we were to fully close the coverage gap, we would get a 90% federal match on healthcare costs for all of those mainly eligible enrollees. Chan said we would also get that over $1 billion signing bonus for the first two years after we closed the coverage gap.
Gov. Kemp has long rejected full Medicaid expansion, arguing it would cost Georgia too much in the long run.
When pressed about how the state plans to enroll more people through Pathways, the Department of Community Health says that as of Aug. 1, it launched a $10.7 million marketing campaign to promote the program.
DCH admits that while Georgians' eligibility for the 80-hour work requirement is verified when they initially apply, the department currently does not have a system in place to verify the hours monthly.
How to apply to Georgia Pathways to Coverage
- To apply to the program, you can do so in person at your local Division of Family & Children Services (DFCS) office. To find the location and business hours of a DFCS office, click here.
- You can also apply by mail to your local DFCS office or by phone at 1-877-423-4746.
- If approved, coverage starts on the first day of the month after you get approved.
For additional information on the Georgia Pathways to Coverage program, click here.