How Medicaid works in Georgia

By Saurabh Datar

Health care bills in both the U.S. House and the Senate have attempted to change the way Medicaid is administered in the country. But how exactly does the federal program work for Georgia?

Over 74 million Americans were enrolled in Medicaid, per May 2017 figures published by the Centers for Medicaid and Medicare Services. Georgia has more than 1.79 million enrolled in Medicaid, according to latest data available with the Department of Community Health. Enrollment has been on the rise since the turn of the century.

Of this, more than half are children and about a quarter are the elderly and people with disabilities.

More than a third of the payments are made to health maintenance organizations and prepaid health plans. A quarter of the payments are made to long-term care facilities. These include nursing homes, intermediate care facilities for the disabled, home health facilities and personal care services.

Medicaid also pays for half the child births in Georgia and nearly 75 percent of nursing homes.

Federal funding for Medicaid in Georgia is currently an open-ended grant depending on how much Georgia spends on its enrollees. Effectively, Georgia gets $2.17 from the federal government for every dollar it spends on Medicaid services, according to an analysis by the Kaiser Family Foundation.

In 2016, Georgia spent more than $9.8 billion on Medicaid — $3.1 billion from the state. This amounts to 16 percent of the state’s revenue spending.

Georgia’s Medicaid expenses have been growing in the past 15 years. But the state is still one of the lowest spenders per enrollee in the country, well below the national average spend per enrollee.