Pandemic could swell Georgia’s Medicaid rolls, numbers of uninsured

Even before COVID-19 struck, Georgia had a high rate of people with no health insurance.

Now, with job losses piling up amid the pandemic, the number of Georgians without coverage is expected to spike.

A new analysis from consulting firm Health Management Associates (HMA) gives estimates for Georgia that are jarring.

HMA projects that if unemployment were to reach 10 percent by midyear, about 100,000 more people in Georgia would be uninsured. And 265,000 new enrollees would join Medicaid, the federal-state program for the poor and disabled.

Those figures represent the low estimate of the state’s insurance fallout.

If the estimate is 17.5 percent unemployment by mid-2020, those increases would be 312,000 more uninsured people in Georgia and 406,000 more on Medicaid, HMA estimates.

The firm also outlines a nightmare scenario, with America reaching a 25 percent jobless figure. The number of Georgians uninsured, in that case, would increase by more than 500,000, with a similar number joining Medicaid.

States that have not expanded Medicaid under the Affordable Care Act, such as Georgia, would fare worse than others in terms of growth of uninsured, the analysis says.

“This will affect states differently,’’ said Matt Powers of HMA, a former Illinois state Medicaid director. “Georgia is heavily populated and a non-expansion state.’’ (Georgia is the eighth most populous state, with more than 10.5 million people.)

Georgia’s uninsured rate in 2018 was 13.7 percent, the U.S. Census Bureau reported, giving the state the nation’s third-highest rate of people without health insurance.

Bill Custer, a health insurance expert at Georgia State University, said he agrees with the thrust of the HMA findings.

“Georgia is likely to see a very large increase in the number of people on Medicaid, but because we didn’t expand [Medicaid] to cover the folks most affected by the virus and the economic downturn, the increase in the uninsured is likely to be much larger,’’ Custer said.

Gov. Brian Kemp, when asked Monday about the pending surge in uninsured in Georgia, talked about the potential for his waiver plans, recently submitted to the feds for approval.

Kemp addressing reporters Monday   Photo credit: Georgia Recorder

Kemp’s Medicaid waiver would add adults earning up to 100 percent of the federal poverty limit to the program. To get that coverage, individuals must meet requirements such as work, enrollment in education, or community service. A second waiver would create a ‘‘reinsurance’’ program, plus a plan to replace the state’s current healthcare.gov website procedure with what officials say would be a more consumer-friendly enrollment process.

Kemp, like his fellow Republicans who control the Georgia General Assembly, has long opposed Medicaid expansion, saying such a move would be too costly for the state. Democrats have argued that many more people could be covered under expansion, in a more cost-effective way, than under the GOP waiver plans.

Georgia is among 14 states that have not adopted Medicaid expansion.

Nationally, the HMA analysis estimated that by midyear:

  • The number of Americans with employer-based coverage could decline by 12 million to 35 million
  • Medicaid enrollment could increase from 71 million to up to 94 million
  • Uninsured numbers in the U.S. could increase to a total of 40 million, “with bigger impacts in non-expansion states.’’
  • Testing is still a weak point

Kemp said Monday that the state has work to do on expanding testing for COVID-19.

“Our testing numbers in Georgia continue to lag,’’ he told reporters, who were scattered according to social distancing guidelines at Liberty Plaza, across from the state Capitol. “The status quo is unacceptable.’’

Georgia has among the lowest rates of testing per capita, the AJC has reported.

Kemp said progress has been made on adding hospital surge capacity. The newly announced facility at the Georgia World Congress Center will have 200 “medical pods,’’ similar to large office cubicles, Kemp said. The facility, aimed at people with mild and moderate illnesses, could expand to 400 non-ICU beds.

Statewide, “as of today, we have 2,617 emergency room beds, 929 critical care beds, and nearly 6,000 general inpatient beds available statewide,’’ Kemp said.

The Georgia National Guard has been deployed to clean long-term care facilities, support medical providers in hospitals, and assist at food distribution sites. “The Georgia National Guard is working day and night to keep Georgia safe,’’ Kemp said.

The peak of the pandemic in Georgia is now expected to be May 1, according to new modeling by the Institute of Health Metrics and Evaluation.

Kemp also said it’s too early to tell when he will start to lift restrictions on economic activity that have been imposed to curb infections. “We need to focus on the mission at hand,” he told reporters.