ATLANTA — A new study estimates more than 1.4 million Georgians may be without health insurance after as unemployment numbers have hit record highs during the COVID-19 pandemic.

The Kaiser Family Foundation released a new report last week, estimating nearly 27 million people in the U.S. have potentially become uninsured after losing employer-based health coverage. Georgia is one of eight states that has at least a million impacted residents.

The nonprofit, nonpartisan health policy organization looked at the potential loss of insurance among families based on unemployment numbers from March 1 to May 2 and mapped out eligibility for the Medicaid and marketplace subsidies.

Of the more than 1.4 million Georgians estimated to have lost their insurance, the report says, 376,000 would be eligible for Medicaid and 775,000 eligible for subsidized plans on the Affordable Care Act marketplace.

But 268,000 are potentially left ineligible for any assistance at all — due to their citizenship status or income levels — and 24,000 will find themselves left in the gap below the federal poverty line but above Medicaid eligibility. The state estimates 408,000 Georgians already fall into this category.

Bill Custer, a health insurance expert and associate professor at Georgia State University, said nationwide a majority of people get their health insurance through their employer — and Georgia is no exception.

Georgians have a few other options for coverage through the longtime federal COBRA program or private insurers, he said. But those options may still be too expensive for someone who just lost a job.

“What's going to happen in Georgia is that there's going to be a fairly steep increase in the number of people without health insurance,” Custer said. “Each of those individuals and families are essentially taking a risk or playing the odds that they will need health care until the economy improves.”

Some won’t be eligible for Medicaid, the state is unable to fall back on it as a “safety net,” as in some other states, for people who lose health insurance coverage, Custer said.

According to the Georgia Department of Labor’s most recent numbers, since mid-March, the department has processed 1,840,365 regular initial unemployment claims and paid out $2.4 billion in combined state and federal unemployment benefits.

The flood of claims has put the department in an “impossible situation,” Commissioner Mark Butler told CNHI in April, with only about 1,000 employees trying to field upward of 80,000 calls a day.

Laura Colbert, executive director of the advocacy group Georgians for a Healthy Future, said the mass health insurance loss “spotlights a real weakness in our health system.”

“On the other hand, the vast majority of those Georgians are now eligible for coverage through Medicaid and the Affordable Care Act marketplace,” Colbert said in a statement. “These health insurance programs are the backstops when massive uncertainty and upheaval hit our health and employment systems, keeping families safe, healthy and financially whole.”

If the state chose to further expand Medicaid, she said, Georgia’s “safety net would be a lot more complete.”

The expected increase in the uninsured population, Custer said, will put a strain on the state’s already financially vulnerable community hospitals.

Jimmy Lewis, chief executive officer of Hometown Health, a network of hospitals, said before the pandemic, many of the hospitals across the state were already in trouble because of a change in their patient payer mix. Then, when elective surgeries were put on hold for safety, revenues dropped drastically.

No one has an exact hold on how much the uninsured patient population will rise yet, Lewis said, but the number of Medicaid patients has already increased.

“We are at a point where we know it’s coming,” he said.

Last fall, updated U.S. Census Bureau data ranked Georgia as the state with the third highest uninsured population in the country.

Custer said the shift in the health insurance landscape happened so quickly, no one asked what the unemployment numbers would do to the uninsured rate.

“We are going to get more uninsured that's clear,” he said. “What we don’t know is how many people are going to be able to access the marketplace and use that kind of coverage — at least in the short run.”

Gov. Brian Kemp’s proposed Georgia Access Medicaid waiver still under federal review, would help some if it can be implemented quickly, Custer said. A lot more Georgians are eligible now for the waiver and Medicaid coverage than before.

However, the governor's office estimates only about 50,000 will be enrolled in the program after five years while full Medicaid expansion has the potential to cover more than 486,000 Georgians by 2022.

An analysis of public comments on the waiver proposals put together by Georgians for a Healthy Future and Cover Georgia — both groups advocate for full Medicaid expansion — revealed out of the more than 2,700 comments submitted, nine out of 10 people opposed the plans.

With many health officials predicting the pandemic is still in its early stages, unemployed Georgians will have to weigh their insurance options.

“Right now, it’s going to be more important than ever to have coverage,” Custer said. “Especially if you have any health issues at all.”

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