In a setback for Georgia’s attempt to tie public health insurance benefits to employment, the Republican-led initiative has faced sluggish enrollment numbers since its launch in July. Governor Brian Kemp’s expectations of 31,000 enrollees in the program’s first year have fallen significantly short, with only 1,800 people signing up in the initial four months.
Critics attribute the slow adoption of the program to its perceived complexity and the formidable hurdles it poses for low-income individuals. According to Chris Pope, a senior fellow at the conservative think tank Manhattan Institute, the demanding paperwork and burdensome nature of the program may be deterring potential participants.
While Democrats have advocated for Medicaid expansion in red states, the Biden administration offered additional federal funding in 2021 as an incentive. However, many GOP officials, including Governor Kemp, have been hesitant to accept the offer unless tied to employment requirements.
The sluggish uptake in Georgia’s program has not alleviated the state’s high uninsured rate, among the highest in the U.S. Moreover, it raises concerns about the potential impact on other red states, such as Alabama, Mississippi, and South Carolina, considering similar measures. The healthcare industry is pressuring these states to expand government-run health insurance programs.
Some in Georgia argue that it’s premature to draw conclusions about the program’s success, suggesting that awareness may still be lacking.
“I’ve got my fingers crossed it’s going to be a good solution,” said Georgia State Representative Lee Hawkins, a Republican who chairs the House health committee. “Getting the word out is always difficult with any new program.”
Georgia is unique in having a Medicaid work requirement, with other states, like Kansas and Arkansas, considering similar measures. The Trump administration had initially planned to overhaul Medicaid with work requirements, but legal challenges and the Covid-19 pandemic disrupted the implementation. Georgia, however, won a federal court challenge in 2022, allowing partial Medicaid expansion with work requirements.
Governor Kemp, despite winning elections in 2018 and 2022, opted for a limited expansion of coverage for adults up to the federal poverty line. However, coverage is contingent on documentation of employment, study, or volunteer hours.
Republicans in Georgia urge patience, attributing the low enrollment to the state Medicaid agency’s busy review of eligibility for millions of people post-pandemic.
“For those on the right who have long wanted to limit Medicaid, the low enrollment numbers are proof that too many people are content to rely on government help that they don’t need instead of finding employment or going to school,” said Jonathan Ingram, vice president of policy and research at the Foundation for Government Accountability.
Despite bipartisan acknowledgment of low awareness contributing to low enrollment, concerns persist about the potential discouragement of employment. While some Republicans advocate for patience and education, liberals hope Georgia’s experience serves as a cautionary tale for similar initiatives in the future.
