Georgia will Continue to Receive Additional Federal Funding to Cover Medicaid Enrollees Through End of 2023

In exchange for keeping Georgians continuously enrolled in Medicaid since the pandemic started, Georgia has received an enhanced Federal Medical Assistance Percentage (FMAP). Medicaid is a partnership between the state and federal government, and the FMAP determines the amount the federal government pays to the state for providing Medicaid services. The federal government gradually began decreasing the pandemic-related enhanced FMAP in April. Although the Medicaid unwinding period extends through May 2024, Georgia will go back to its standard FMAP of about 66% in January 2024. Medicaid unwinding is likely to result in significant declines in enrollment and, in turn, decreased total Medicaid spending. As the process unfolds, further adjustments to the budget will likely be needed to balance enrollment reductions and FMAP cuts.

July

October 1 –

December 31, 2023

*Assumes adjusted base Medicaid FMAP of 65.89 percent and PeachCare FMAP of 76.12 percent starting October 2023.

Source: Federal Consolidated Appropriations Act, 2023.

Investments in the Governor’s Health Care Expansion Plan for Low-Income Georgians

In 2019, the passage of the Governor’s signature health care legislation, the Patients First Act or SB 106, paved the way for Georgia to seek federal approval for three new programs:

• The Georgia Pathways to Coverage program, which proposes to partially expand Medicaid eligibility to low-income adults who meet work or other monthly reporting requirements;

• The Georgia Reinsurance Program, which establishes a claims-based reinsurance program to help offset costs of enrollees in the individual health insurance market who have large medical claims; and

• The Georgia Access Model, which would remove the state from the federal marketplace (often referred to as HealthCare.gov) without a statebased alternative. With the passage of SB 65 during the 2023 Legislative Session, the state has pivoted away from the original Georgia Access Model plan and moved toward a state-based health insurance exchange. Going forward, the program will be funded by user fees rather than state General Funds.

Overall, the state has made a significant investment in all three programs. The Pathways to Coverage Program and Georgia Access Model’s statebased exchange are set to launch in 2023, and the Reinsurance Program launched in 2022. It will be important to track the impact of these investments on increasing access to affordable, high-quality health care.

About $424 Million Invested Since 2021 to Launch Health Care Programs Established by the Patients First Act of 2019

Cumulative State Spending on Patients First Act of 2019 by Program, AFY 21 - FY 24

Yearly State Spending on Patients First Act of 2019 by State Agency, AFY 21 - FY 24

Office of the Commissioner of Insurance

Department of Human Services

Department of Community Health

Office of the Commissioner of Insurance

Department of Human Services

Source: GBPI analysis of Georgia’s 2021 Amended Fiscal Year Budget (HB 80), 2022 Fiscal Year Budget (HB 81), 2022 Amended Fiscal Year Budget (HB 910), 2023 Fiscal Year Budget (HB 911), 2023 Amended Fiscal Year Budget (HB 18), 2024 Fiscal Year Budget (HB 19), signed by the Governor.

Department of Community Health