Medicaid in Georgia: A Look at Where We Stand in 2026
by Cindy Zeldin, VP of Health Policy and Government Affairs
It has been more than sixty years since Congress created the Medicaid program to fill identified gaps in our health care system. In each year since its founding, Medicaid has continued to evolve as an integral part of every state’s health care infrastructure and as a vital source of health coverage for more than 80 million Americans, including 2.2 million Georgians.
Today, Georgia Health Initiative releases our 2026 edition of Insights on Medicaid in Georgia. Therefore, it’s an opportune time to reflect on Medicaid’s role here in Georgia, including all that has changed in just the past year.
In January 2025, we unveiled the first edition of Insights on Medicaid in Georgia as a comprehensive, timely, easily digestible, and sound resource. We’ve seen and heard that this publication has been a useful tool not only for state leaders, nonprofit partners, and journalists steeped in Medicaid policy, but for those who may consider themselves to be “Medicaid novices” as well.
Our 2025 edition came on the heels of Medicaid unwinding following the end of the COVID-19 federal public health emergency (PHE). During the PHE, states received additional federal funds by maintaining continuous enrollment of Medicaid members. This served as a reminder that one of Medicaid’s greatest strengths is that resiliency is built into its program design, as continuous enrollment served the dual purpose of infusing resources into state budgets in a time of crisis, while also stabilizing health coverage for people during a time of heightened risk of illness and death. Medicaid unwinding is now in our rear-view mirror, though there remain a number of lessons that we as a state can learn and apply based on what we encountered during that span of time.
At present, much of the national attention around Medicaid has shifted to understanding the implications of major federal health policy changes enacted in 2025 as part of H.R.1 (legislation also known as the “One Big Beautiful Bill Act”). Medicaid looks different in every state, so the anticipated impacts of H.R.1’s provisions will also differ from state to state. But like every other state, Georgia will have to contend with deep funding cuts and a variety of programmatic changes stemming from H.R.1’s provisions that will result in coverage losses, further strain on health care providers, and negative effects on our statewide economy over the next several years. Medicaid’s resiliency will be tested.
Against this backdrop, the 2026 edition of Insights on Medicaid in Georgia provides updates in the areas of eligibility and enrollment, covered benefits and services, operations and infrastructure, and expenditures and financing. Additionally, the 2026 edition features areas of focus that state agency leaders and officials have identified as priorities for the state. Lastly, we include a national updates section that describes the anticipated impact of H.R.1 on Georgia, providing a high-level overview that complements the more in-depth H.R.1 Policy Report that we published in November 2025. Of particular note, federal policy changes are expected to result in Georgians losing health insurance, which in turn will result in higher levels of uncompensated care. Due to H.R.1’s cuts to State Directed Payments and limits on the use of provider taxes, our state will have fewer tools in the toolbox to shore up these funding losses.
There are many facts and figures in the 2026 Insights on Medicaid in Georgia publication, but we never lose sight of the fact that Medicaid is ultimately about people and communities. We at the Initiative believe it is essential that state decision-makers and those impacted by the decisions made have access to high quality information to make sense of how Medicaid works and how it can be leveraged as a tool to improve health and wellbeing statewide.
It is not yet clear how Georgia policymakers will respond within the next 12 months and beyond to federal policy and funding changes, but a shared understanding of Medicaid’s critical role in our state’s health care system is foundational to this process.
Georgia Health Initiative is pleased to continuously provide a helpful resource to support this quest for shared understanding and looks forward to updating and publishing it in each coming year.
