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- Rising costs and expiration of enhanced tax credits threaten coverage despite the launch of Georgia Access.
- Georgia Pathways expansion underperforms; administrative requirements and work reporting create barriers to enrollment and affordable coverage.
- Formalize and reimburse Community Health Workers, prevent medical debt via legislation like the Medical Debt Fairness Act, and expand coverage.
Access to affordable healthcare remains one of the most pressing issues facing Georgians today. Across the state, families are navigating rising costs, coverage challenges, and barriers that make it harder to get the care they need.
Through our Consumer Hotline, we hear from people forced to choose between paying for groceries, rent, or their health coverage. These are not isolated stories; they reflect a broader pattern that policymakers must address.
This issue was the focus of a recent conversation our Deputy Director, Natasha Taylor, had with 11Alive reporter Joe Ripley. Natasha shared her perspectives on the current healthcare landscape in Georgia, including affordability challenges, barriers to care, and opportunities for policy solutions.
Affordability Remains a Major Barrier
Even with the successful launch of Georgia’s state-based marketplace Georgia Access in 2024, rising costs are putting coverage further out of reach for many families. Recent projections from the Georgia Health Initiative show that, with the expiration of enhanced premium tax credits, nearly 500,000 Georgians will become uninsured if Georgia does not act to protect affordability.
Georgia’s limited Medicaid expansion program, Georgia Pathways, has also struggled to reach the scale originally projected. While the program was intended to expand coverage for uninsured adults, enrollment has remained significantly lower than expected, leaving many Georgians without affordable healthcare options. Administrative barriers and work reporting requirements continue to create challenges for people seeking coverage.
When care becomes unaffordable, people delay treatment, skip medications, or go without coverage altogether, leading to worse health outcomes and higher costs over time.
In rural communities, provider shortages, hospital closures, and transportation barriers already limit access to care. When affordability is added, these challenges grow, pushing more people to rely on emergency care.
In metro Atlanta, hospital closures and capacity constraints continue to strain safety-net providers, increasing wait times and reliance on emergency services.
Where Georgia Has Made Progress
Recent legislative efforts have:
Additional investments have expanded medical residency slots, increased Medicaid reimbursement rates, and strengthened maternal health programs, including home visiting services for new mothers.
What Still Needs Attention
Community Health Workers (CHWs)
CHWs help people navigate care and connect to resources, but many cannot find stable employment because their services are not reimbursed. Creating a pathway for certification and reimbursement would strengthen this workforce and expand access.
Medical Debt
Even insured individuals face high out-of-pocket costs. Policies like the Medical Debt Fairness Act would help by ensuring patients are screened for financial assistance before bills become unmanageable.
Moving Forward
Building on recent progress will require:
- Expanding access to affordable coverage
- Preventing medical debt and financial barriers to healthcare
- Investing in community-based solutions like CHWs
Ensuring that all Georgians can access and afford care is not just a healthcare issue; it is essential to the health and stability of communities across the state.
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