The passage of the reconciliation package known as the “One Big Beautiful Bill Act” means that many Georgians—particularly those who rely on social safety nets like the Supplemental Nutrition Assistance Program (SNAP) and Medicaid—could face hardship in the coming years.
To prepare for these challenges, an understanding of the contents of the bill is essential.
“This law essentially makes deep cuts to programs that are the foundation of health, food security, and economic stability for hundreds of thousands of Georgians,” says Anthony Hill, Strategic Communications Manager at Georgians for a Healthy Future. “It’s easy to talk about these programs in terms of numbers and budgets, but behind every number is a family. So, at the core of this conversation are those families and what we can do to protect their health and their dignity at a time when the programs that they depend on are at risk.”
A broad swath of Georgia society will be impacted by the budget allocations in the reconciliation package. This could include patients who rely on hospitals and public health systems, as well as the healthcare providers who’ve built their livelihoods around them. More families may struggle to feed their children, a hardship that will also impact farmers and grocers. And people who’ve been able to purchase affordable health insurance through Georgia Access may face higher premiums or even lose their coverage.
GEEARS has cultivated internal expertise as well as trusted partners to help clarify different facets of this sweeping legislation.
Medicaid Changes Will Harm Georgia’s Youngest Children—Callan Wells, Senior Health Policy manager, GEEARS
With a heart-wrenching story, Callan Wells illustrates how the changes to Medicaid could harm a young child and her family: “Last year in Gwinnett County, a baby girl was born with stage five renal disease,” she recalls. “She spent months in the hospital before her family learned about and applied for Katie Beckett Medicaid, which helps children with complex medical needs. Medicaid covers medical bills incurred in the three months prior to application, coverage that protected this family from overwhelming debt and made it possible for her to continue the therapies she still needs to grow and thrive.”
The new law shortens the program’s retroactive coverage window from three months to two, which means parents could now be on the financial hook for more of their children’s complicated treatment.
It also delays requirements for states to streamline Medicaid applications and renewals, which would have made the process easier for families to execute. The change could have meant that fewer children experienced interrupted or disrupted care during their first, and most developmentally critical, years.
A weakened Medicaid program could also mean hospital closures, Wells observes. “This bill has far-reaching implications for children, not just because it could harm them directly, but also because children live in families and communities,” she says. “Children rely on the adults around them—parents, teachers, neighbors, extended family—to keep them safe, healthy, and fed. While the bill may exempt parents of young children from work requirements, it does not shield the broader network of caregivers who help raise them. In other words, when adults lose access to healthcare, children also experience that loss.”
The Financial Implications of Medicaid Changes for the State of Georgia—Leah Chan, Director of Health Justice, Georgia Budget and Policy Institute
Medicaid changes—like freezing provider taxes and restricting how the state can pull down supplementary payments for safety net providers—will also impact the state economy, says Leah Chan.
“Shifting costs to the state,” she explains, means an estimated loss of $8 billion in federal funds over the next decade. “So, the state could be forced to make changes to who gets covered and what kind of benefits they receive.
“Rather than allowing us to progress and expand access to care to all Georgians,” she continues, “the healthcare provisions in the bill really threaten the health and economic security of Georgia’s low-income families and really pushes Georgia’s rural healthcare system to the brink. So, we are likely to see reductions in access to health care coverage; pressure on household financial security for lower income Georgians and greater risk of medical debt; financial strain on safety net health providers and increased risk of hospital closures, particularly in rural areas; and stress on our state and local economy with job losses and reduced economic output.”
“Disguised Cuts” to SNAP—Ife Finch Floyd, Director of Economic Justice, Georgia Budget and Policy Institute
At the heart of predictions for families who rely on SNAP is this fact, reported by Ife Finch Floyd: “SNAP is one of the most effective and efficient anti-hunger programs we have in this country. SNAP reduces food insecurity by about 30% and improves health and economic security across the board. It reaches about 1.4 million Georgians, or 700,000 households.”
Currently, SNAP benefits are funded completely by the federal government. However, this bill makes an unprecedented change. Starting in federal fiscal year 2028, if states cannot reduce their administrative payment errors below a certain level, they will be required to pay between 5% to 15% of SNAP benefits. Based on current levels of spending, this could mean that Georgia could have to cover between $162 million to $487 million.
“If Georgia leaders believe they cannot afford the new cost because they cannot or do not want to use available reserves, raise revenue, or cut other state programs,” Finch Floyd says, “they may reduce access to the SNAP program by increasing the administrative burden to access the program or they could opt out of the program entirely.”
Expanded work requirements, she observes, will also curtail access to SNAP benefits. Currently, “Recipients who are aged 18 to 54, with no children or without a verified disability, are required to work for 20 hours a week for an average of 80 hours a month. The new law increases the age from 54 to 64 and includes parents, grandparents, and caregivers with children who are between the ages of 14 and 17 years old. Research study after research study finds that work requirements do not increase wages significantly or increase access to quality jobs that will improve economic security. Instead, work requirements do a better job of simply cutting people off of basic assistance programs.”
In Georgia, more than 150,000 people live in households at risk of losing at least some of their SNAP benefits if an adult cannot meet a harsh work requirement.
Other changes to SNAP, Finch Floyd reports, include ending access to SNAP for legally present immigrants who are refugees and people granted asylum, freezing future increases to SNAP benefits, and eliminating the National Education and Obesity Prevention Grant Program, also known as SNAP-Ed, which provides nutrition and obesity prevention education throughout the state.
Sweeping Changes to Georgia’s Affordable Care Act Marketplace—Whitney Griggs, Director of Health Policy, Georgians for a Healthy Future
Griggs sets the scene by explaining the current state of Georgia Access, our state’s Affordable Care Act (ACA) marketplace: “Georgia has the second largest state-based marketplace in the country. This year over 1.5 million Georgians enrolled in health insurance through Georgia Access. Over 90% of those enrollees receive financial assistance to help lower the cost of their monthly premiums and since 2022, there have been additional enhanced tax credits in place to help lower those monthly premiums even further. And many Georgians have fully subsidized coverage, so they’re paying nothing for their health insurance at the moment.”
Here are the changes Griggs predicts:
- The enhanced premium tax credits that allow people with low incomes to qualify for fully subsidized health coverage will expire at the end of the year. That will mean premium increases for many.
- More people will fall into the gap between Medicaid (they’ll earn too much to qualify) and the ACA marketplace (they’ll earn too little to afford premiums) and become uninsured.
- Reduced funds for Georgia’s reinsurance program, “which is essentially insurance for insurers,” Griggs says, could endanger the stability of the marketplace overall.
- The end of auto-renewals for those who qualify for tax credits could create administrative burdens and prevent more Georgia families from getting health coverage.
These experts’ messages, supported by irrefutable data, are sobering, but in their deep understanding of these policies and the challenges to come, there is also power. Our information and partnership can arm organizations, individuals, and allies as they embark upon a new advocacy journey. We hope you’ll join these ranks by using GEEARS’ action alerts to contact your representatives about upcoming state and federal budget legislation.
All the experts quoted above recently collaborated on a press conference to share these resources. To watch it in its entirety, click here.
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