Medicaid and PeachCare provide almost 2 million Georgians with access to health care, including 1.3 million children. About two thirds of Medicaid enrollees are children statewide. Another quarter are elderly, blind or disabled.

Created in 1965, the Medicaid program provides health insurance coverage to low-income residents through a partnership between states and the federal government. PeachCare for Kids provides coverage for children in families who earn too much to qualify for Medicaid. Half of Georgia’s children are covered by Medicaid.

Children Represent Majority of Medicaid Enrollees in Georgia

Medicaid is Major Source of Payment for Key Health Services in Georgia

Medicaid is a critical source of coverage for many health services in Georgia. Medicaid is the primary payer for 75 percent of Georgia’s nursing home patients and also covers more than half of all childbirths in the state. And Medicaid funds are a critical lifeline for rural hospitals and community health services statewide.

Medicaid is primary payer for 75% of Georgia’s nursing home patients

Medicaid pays for more than half of all births in Georgia

Medicaid and PeachCare Provide Access to Health Services for 1.98 million Georgians, including 1.3 million children. 

Medicaid a Good Deal for Georgia

Medicaid Provides Access to Care

Medicaid provides access to care for Georgians throughout the state. About 88 percent of Medicaid enrollees have a usual source of care, compared with 90 percent of people with employee-sponsored insurance plans.

About 88 percent of Medicaid enrollees have a usual source of care, compared with 90 percent of people with employee-sponsored insurance plans.Medicaid Gives a 2-to-1 Return

Medicaid provides a stellar return on investment for Georgia. For every 1 dollar Georgia invests in Medicaid, the federal government matches with more than 2 dollars.

Medicaid Gives a 2-to-1 ReturnMedicaid Controls Costs Efficiently

Medicaid provides coverage efficiently by spending less on administrative costs. Private insurance companies can spend up to 20 cents of every dollar on administrative costs, but Medicaid spends less than half of that: just six cents per dollar on administrative overhead.

Medicaid’s efficiency helps explain how the program’s spending has grown more slowly than private insurance. Since 2007, Medicaid’s spending per enrollee has grown 1.1 percent, compared with 4.4 percent for private insurance providers.

Enrollees Meet Strict Income Eligibility Standards

Georgians must meet specific criteria to enroll in Medicaid. Eligibility levels are based on household income and assets, with thresholds that vary for different groups. Adults without dependent children are not eligible for Medicaid in Georgia.

Group Eligibility
Parents with children under age 19 Annual income up to $6,600 for a family of three
Pregnant women Annual income up to $44,900 for a family of three
Children ages 6 to 19 Annual income up to $32,700 for a family of four
Blind, disabled or over age 65 Annual income up to $8,800 for an individual or $13,200 for a couple

Medicaid Helps Millions of Georgians

It is important to know the facts about how effective and wide reaching the Medicaid program is across Georgia to understand how painful shrinking it might be. Medicaid pays to treat some of the most vulnerable people in the state. About two-thirds of Georgia Medicaid enrollees are children from low-income families. Nearly half of the children in Georgia are covered by Medicaid and PeachCare. Plus, Medicaid is a major source of payment for health services, which helps a financially-strapped health care system avoid even more dire straits. Medicaid is especially important for rural and safety net hospitals that serve disproportionately more vulnerable patients and rely on Medicaid for a larger percentage of their revenue.

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Laura Harker
Laura Harker joined GBPI in 2016 as a health policy analyst. She is responsible for researching and reporting on Georgia’s health policies and related spending. She holds a master’s degree in public health policy from Emory University and a bachelor’s degree in health policy and management from the University of North Carolina at Chapel Hill. Laura can be reached at (404) 420-1324 x 103.

1 COMMENT

  1. HI Laura: I don’t know how you can review Georgia Medicaid and fail to note that 1.3 million of the state’s 1.9 million Medicaid enrollees have been in managed care for ten years, which drives the state’s spend efficiency. The annual trend rate for managed care members is significantly lower than unmanaged FFS, leading to a net cumulative state benefit (cost savings plus incremental tax revenues) approaching $3 billion dollars.

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