Rep. Marvin Lim Calls for Georgia to Track Medicaid Coverage Losses and Improve Access to Benefits

ATLANTA - State Representative Marvin Lim (D-Norcross), a member of the House Health Committee, is calling for improved Medicaid coverage data, improvements to Georgia Gateway and an assessment of federal changes affecting hospitals following his review of records from the Georgia Department of Community Health (DCH) and the Georgia Department of Human Services (DHS).

Rep. Lim notes that the records concern H.R. 1, the federal law enacted in July 2025. He adds that DCH confirmed it had no statewide forecast of how many people could gain or lose Medicaid coverage. He further notes that while DCH provided estimates for Georgia Pathways and certain newly eligible groups, he emphasizes that those estimates do not account for potential coverage losses or interruptions across the state.

Rep. Lim also notes that DHS records detail preparations for new reporting and verification requirements, including medical-frailty exemptions. He adds that those preparations raise questions for him about how the state will prevent eligible individuals from losing coverage due to paperwork or processing delays. Rep. Lim further notes that federal law will limit certain Medicaid payments to hospitals and other providers and emphasizes that while DCH provided information on the new limits, it did not provide provider-level financial projections or analysis of ways to reduce their impact.

"We have detailed plans for implementing these rules but no statewide estimate of how many Georgians could lose Medicaid," said Rep. Lim. "As a member of the House Health Committee, I think we should have that information before the changes take full effect."

Rep. Lim adds that he found other states have published estimates of potential Medicaid coverage losses and financial effects, which he notes could provide examples for Georgia to follow.

"I encountered a similar issue in my earlier review of Georgia's Supplemental Nutrition Assistance Program," added Rep. Lim. "DHS provided detailed data on caseloads, recertifications and payment errors. The main remaining gap was information on procedural closures, renewal completion and how often households regain benefits shortly after losing them. We need to know not just how many people lose Medicaid coverage, but why. If people are still eligible, we should know whether bureaucracy, including paperwork and delays, is causing them to lose coverage."

Rep. Lim further notes that his concern extends to Georgia Gateway, the state's system for applying for and renewing benefits, including Medicaid and the Supplemental Nutrition Assistance Program.

"I appreciate the changes DHS has made to Gateway so far," said Rep. Lim. "I still hear from constituents who have trouble applying, renewing or getting problems fixed. We've made progress, but people shouldn't have to fight through so much bureaucracy just to get or keep benefits they're eligible for."

Rep. Lim recommends the following five steps:

1. Estimate how Medicaid coverage will change. Rep. Lim is encouraging DCH to publish a statewide projection before the 2027 legislative session, separately estimating coverage gains, losses caused by eligibility changes and interruptions caused by paperwork or other administrative issues. He is also encouraging the department to explain its assumptions and update the numbers as actual data becomes available.

2. Create a public monthly Medicaid dashboard. Rep. Lim recommends that DCH and DHS report applications, renewals, denials, terminations, reinstatements, appeals and processing times. He further recommends that the dashboard distinguish individuals who are no longer eligible from those who lose coverage because of paperwork or other procedural problems and would encourage DCH and DHS to track how many regain coverage within 30, 60 or 90 days.

3. Prevent unnecessary coverage losses. Rep. Lim recommends setting clear deadlines for medical-frailty exemption decisions, addressing delays and protecting eligible individuals from improperly losing coverage while decisions are pending, consistent with federal law.

4. Keep improving Georgia Gateway. Rep. Lim suggests continuing to test system changes, simplifying applications and renewals, improving notices and using feedback from people who use Gateway to identify and fix problems.

5. Show how hospital funding will be affected. Rep. Lim notes that DCH should publish estimates of how federal payment limits and scheduled reductions will affect individual hospitals and other providers, where legally disclosable, including safety-net hospitals. He further notes that DCH should identify specific options to reduce the financial impact.

"With Governor-elect Keisha Lance Bottoms coming in, I hope we can make some of these changes," concluded Rep. Lim. "We need better numbers, a better Gateway experience and a clearer picture of how those federal changes will affect Georgians. We can't change every federal requirement, but we can make sure we're implementing them correctly."

Representative Marvin Lim represents the citizens of District 98, which includes a portion of Gwinnett County. He was first elected to the House of Representatives in 2020 and currently serves on the Agriculture & Consumer Affairs, Appropriations, Appropriations Subcommittee on Public Safety, Health and Retirement committees.

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