State health coverage commission begins work

ATLANTA – A newly created state commission looking for ways to improve health-care access and quality for low-income uninsured Georgians held its kickoff meeting Thursday.

The nine-member Georgia Comprehensive Health Coverage Commission was authorized in legislation the General Assembly passed this year overhauling Georgia's "certificate-of-need" (CON) law governing hospital construction and new medical services.

The panel includes a broad range of health-care executives, academics, and advocates from across the state.

"There's no silver bullet that will solve all of our issues," Caylee Noggle, president and CEO of the Georgia Hospital Association and the commission's chair, told members of the panel. "But there are numerous options to consider."

The commission received a briefing on the current status of Georgia Medicaid, a joint state and federal program that serves low-income families, pregnant women, children, newborns and aged, blind, and disabled adults.

About 2.3 million Georgians are enrolled in either Medicaid or PeachCare for Kids. Enrollment peaked at 3.1 million during the COVID pandemic but has declined since the COVID-related public health emergency ended in May of last year.

The federal government prohibited disenrolling any Medicaid recipients for three years after COVID-19 struck the nation four years ago. When the public health emergency ended, states went through a "redetermination" process to reassess eligibility for those on Medicaid.

"Medicaid is really the safety-net program for those who have no other options," Noggle said.

Legislative Democrats have pushed for years for Georgia to expand Medicaid coverage through the federal Affordable Care Act (ACA) to people with incomes up to 138% of the federal poverty level. Republican legislative leaders assured Democrats during this year's debate on the CON bill that Medicaid expansion would at least get consideration.

Republican Gov. Brian Kemp has opposed "full-blown" Medicaid expansion under the ACA, citing the cost. Instead, he pushed a limited version of expansion through the General Assembly – Georgia Pathways – capping eligibility at 100% of the poverty level and including a work requirement. However, enrollment in the program since it took effect a year ago has been disappointing.

State Insurance Commissioner John King said his agency is aggressively marketing another alternative championed by Kemp called Georgia Access, a state-based health-insurance portal created in 2022 to direct people seeking health coverage to private insurers and brokers.

"We are not relying on one method of engagement," King said. "We're spending a lot of time on the education piece."

The law that created the commission gave it two years to make recommendations.

Noggle said she would like the panel to meet every four to six weeks. Its first interim report is due Dec. 1.