by Ty Tagami | May 2, 2025 | Capitol Beat News Service
ATLANTA – The future oversight over Georgia’s multi-billion-dollar Medicaid program is in limbo as companies battle over new management contracts after a lengthy bidding process.
The medical safety net covered 2.5 million children, pregnant woman, low-income adults, seniors and people with disabilities in Georgia last year.
The program totals $17 billion, with $5 billion from the state and the rest mostly from the federal government. The total is slated to rise to nearly $18 billion next year in the budget that lawmakers sent to Gov. Brian Kemp last month.
Georgia used to manage the Medicaid program directly, but about two decades ago the state decided to contract out the work. There have been tweaks along the way, with more companies added through competitive bidding. Then, more than two years ago, the Kemp administration initiated another competitive bid, and it could result in a major overhaul.
Two of the three incumbents — Amerigroup and Peach State Health Plan — lost.
Incumbent CareSource won a new contract, along with three newcomers: Humana Employers Health Plan of Georgia, Molina Health Care of Georgia and UnitedHealthcare of Georgia.
The change is prompting concern among doctors and other medical providers, who worry about service disruptions when their patients must enroll with one of the new management companies.
They remember what happened last year when Medicaid recipients had to undergo eligibility redeterminations after the requirement was waived during the COVID-19 pandemic. Nearly 300,000 lost coverage after enrollment peaked at more than 2.8 million in 2023.
Steven Miracle, CEO of Georgia Mountains Health Services, a non-profit in Blue Ridge with a large Medicaid clientele, thinks the new contracts will have a similar effect as his patients are forced to enroll with a different company.
“If they don’t have the information or if they aren’t able to access the technology that will allow them to sign up or if somehow, some way they miss the deadline, then there will be people who believe that they have insurance coverage that in fact don’t,” Miracle said. “People don’t pay attention, so they’re not going to be aware that that they have to re-enroll.”
Miracle’s organization is among three dozen represented by the Georgia Primary Care Association. Albert Grandy, Jr., the association’s president, drafted an open letter to Georgians in March on behalf of those organizations.
“This shift introduces a heightened risk of disruption to critical health-care services, particularly for those who depend on continuity of care to manage chronic conditions, access mental health services, or receive specialized treatments,” Grandy wrote, adding that colleagues across the state were finding it difficult to negotiate contracts with the new insurers, leaving thousands of patients unclear about whether they could continue with their current medical providers.
“These changes could have devastating consequences for patients. Delays in care, denied claims, and lapses in coverage are not just administrative headaches — they are life-threatening issues for many. Our most vulnerable populations — children in foster care, individuals with disabilities, pregnant women and seniors — cannot afford to fall through the cracks of an uncertain system,” wrote Grandy, CEO of Curtis V. Cooper Primary Health Care in Savannah.
In an interview this week, Grandy said the state might automatically assign existing Medicaid patients to one of the new insurers if they fail to enroll themselves.
So, they would still be insured, but they might find that their current doctors are out of network, he said, adding that labs, radiologists and other specialists might also be out of network and thus inaccessible.
Dr. Samantha D. Manderson, an obstetrician-gynecologist in Cordele, said patients in rural areas could find it particularly difficult to locate new providers.
“I’m especially concerned about expectant mothers who will be forced to change doctors mid-pregnancy,” she said through a spokeswoman. “Many of my rural patients would not have other options close by and would have to travel just to get the care they need, potentially delaying life-saving care.”
After the winning bids were selected, the Georgia Department of Administrative Services initiated what’s known as a protest period, during which the public can raise concerns about the pending contracts.
Kimberly Oviedo, an audiologist in Acworth, sent an email to the agency on March 10 that is among the hundreds of protest-related documents on file. She was concerned about the lengthy process that medical offices must go through to ensure their staff can be reimbursed for service.
UnitedHealthcare was non-responsive, she wrote.
“We were able to start credentialing with Molina Health, Humana, and CareSource. However, UHC says they have no idea of what the contract is that they won in GA,” Oviedo wrote. “We can’t get through to anyone with UHC to start the process. This is alarming as this is one of the largest bids won in GA.”
In an interview this week, nearly two months after she sent that email, Oviedo said she still hadn’t gotten through to UnitedHealthcare.
She said she had an initial email exchange with the company wherein an employee said UnitedHealthcare had no contract to manage Medicaid in Georgia. Although technically true — the contracts are on hold until the protests are resolved — she said the other three bid winners had contacted her to initiate the credentialing process, which she said can take six months.
Oviedo said she sent her correspondent at UnitedHealthcare links to articles about the company’s winning bid but said she never heard back. She said a large portion of her practice serves children in foster care, adding that UnitedHealthcare won that portion of the bid. She worries that her patients won’t have access to insurance and that it will affect her business.
“You can’t call anybody there. You have to go through their chat system. And then their chat person says, ‘Sorry, we don’t offer that contract,’ ” Oviedo said. “So that’s very frustrating.”
She said she made a lucky guess at an email address that worked, until the company stopped responding.
“You can sometimes reach somebody that way, but they don’t make it easy, where like Molina, you can call the rep — her phone number’s right on the email she sent saying, ‘Hey, we’re reaching out to credential you.’ “
As of late Friday afternoon, UnitedHealthcare had not responded to emails sent by Capitol Beat a week earlier seeking a response.
Among the protest documents are more serious allegations from the losing bidders, for instance that a state evaluator lowered her scores for one company after meeting with her boss, suggesting that the boss influenced the outcome; or that state employees and their consultant working on the procurement didn’t all fill out the required conflict of interest disclosures.
Both losing incumbents leveled what is possibly the most serious charge: a direct conflict of interest for CareSource.
They assert that the company hired away a Georgia Department of Community Health official during the bidding process, a woman they said had helped to write the state’s procurement competition, formally known as an “electronic Request for Proposals,” or eRFP.
That department is the agency responsible for the state’s Medicaid program and the management contracts.
She “undoubtedly would have been privy to confidential information about the development of the eRFP that would have been helpful to CareSource in preparing its proposal,” a lawyer for Peach State wrote in a protest document filed last month. At best, this creates an appearance of impropriety, the protest says, and at worst reflects “an improper effort by CareSource to gain an unfair competitive advantage.”
The protest says CareSource should be disqualified.
A spokeswoman for CareSource said the company had no comment “at this time per the RFP requirements.”
The protests have apparently delayed the new contracts. Peach State’s contract was set to expire June 30, which would have required the new contracts to be in place July 1.
But Grandy, the president of the Georgia Primary Care Association, said he heard the contract date was pushed back, initially to next summer and then to the start of 2027.
That’s fine by Miracle and his medical office in Blue Ridge.
“A longer lead time is better,” he said. “Because we’ve got to get providers credentialed with the new insurance companies. We’ve got to get the organizational relationships set up so that we can do billing collections. I mean there’s a lot that has to happen. You can’t just say, ‘Okay we’ve got a new company.’ Health care is much more complex than that.”
by Ty Tagami | Apr 30, 2025 | Capitol Beat News Service
ATLANTA – Georgia’s former governor has thrown his clout behind the environmental movement to protect the Okefenokee Swamp, a move observers say will have political ramifications even though the legal impacts are probably minimal.
Sonny Perdue, a cabinet member during President Donald Trump’s first term, sent a letter to the U.S. Department of the Interior two weeks ago urging support for a years-long effort to get the national wildlife refuge designated as a United Nations World Heritage Site.
Perdue, who became chancellor of the University System of Georgia after serving as agriculture secretary for Trump, sent the message on Board of Regents letterhead, as reported by The Atlanta Journal-Constitution Wednesday.
The April 17 letter to Interior Secretary Doug Burgum cites a study by an environmental conservation group that said the designation would be an economic boon for the area around the Okefenokee.
“This effort represents an extraordinary opportunity to preserve a national treasure while also delivering incredible economic benefits to the state of Georgia,” Perdue wrote.
The letter did not mention the controversy surrounding one of the world’s largest freshwater ecosystems: draft permits the Georgia Environmental Protection Division has given to Alabama-based Twin Pines Minerals for a titanium mine along the southeastern border of the swamp.
The company has said the project would not damage the refuge, but opponents cite research showing it would threaten water levels, increase the risk of wildfires, harm wildlife and pollute the water with toxins.
Twin Pines President Steve Ingle said in response to Perdue’s letter that World Heritage designation by the United Nations Educational, Scientific and Cultural Organization would not affect the company’s bid for a mining permit.
“The application for World Heritage designation does not have any bearing on our permit application, nor does it impact our plans to mine for titanium and zirconium in Charlton County,” Ingle said in a statement issued through a spokesman. He said the company’s “exhaustive, comprehensive” studies show that the proposed operations nearly three miles from the refuge would not harm the Okefenokee “or surrounding environs.”
But mine opponents said Perdue’s letter carries political weight that could influence the state’s permitting decision, as Trump considers rolling back conservation on public lands.
“Sonny is basically putting his imprimatur, for whatever it’s worth, on a very popular issue in his home state and he’s putting it into a global context,” said veteran Georgia environmental lobbyist Neill Herring. “And he’s basically telling the president, ‘Don’t go there.’ “
Perdue’s letter comes after fellow Republican U.S. Rep. Buddy Carter of Savannah joined Democratic members of the state’s congressional delegation in sending a similar letter to the Interior Department in February.
Josh Marks, President of Georgians for the Okefenokee, which opposes the mining permits, praised Perdue’s stance and said he hoped it would influence the administration of Gov. Brian Kemp.
“It’s time for Governor Kemp to stand up for the Okefenokee by saying no to mining and yes to World Heritage Site listing,” he said, adding that a mine could jeopardize World Heritage designation “because external threats are a key factor in the evaluation process, and the scientific community universally says mining will damage the swamp.”
by Ty Tagami | Apr 29, 2025 | Capitol Beat News Service
ATLANTA – Georgia’s lottery-funded pre-kindergarten program used to be the envy of the nation, offering high-quality schooling for free.
But the program peaked in 2019 as enrollment started to fall, a trend that accelerated during the pandemic.
“Ominously, some states that have been leaders in universal preschool continued a long-term decline in enrollment, including Florida, Georgia, Oklahoma, and Wisconsin,” the National Institute for Early Education Research said in a press release this week that sums up its latest annual report.
The quality of Georgia’s program, long a source of pride for state leaders, ranked below other states during the last school year, according to the institute’s just-released study, “The State of Preschool in 2024.”
The institution, based at Rutgers University, gave Georgia a score of eight out of 10 on its benchmarks for quality, dinging the state for relatively large class sizes.
The organization notes that its report doesn’t cover the current school year, when $97 million in new state funding took effect. That money is meant to boost pre-k teacher pay and reduce class sizes and student-teacher ratios. This presumably will result in a perfect score on the institute’s next report, said W. Steven Barnett, founder and senior director at the institute.
He suspects this year will mark a turning point for Georgia, with a return to national leadership in preschool excellence.
But enrollment will remain a challenge. Some states have maintained high enrollment rates, with four out of five eligible children attending public preschool, Barnett said. Georgia used to have over 60% enrollment, but that is down to 55%, according to the institute’s new report.
“Georgia is on its way back up, putting quality first, putting more money into the program,” he said. “But you’re still at 55% enrollment, and when you have states up over 80%, then that’s not a leading position.”
A host of studies have clarified the value of preschool, with children who attended quality pre-k programs finding an easier path to success in elementary school and after. Barnett said long-term studies have found the experience increases the odds of attending and graduating from college, tends to boost income and even correlates with better health and longevity.
Quality is key, and Barnett credited Georgia for its focus on that. The state has hit his institution’s eight benchmarks for good curriculum, teacher preparation, health screenings and use of data for program improvement. He noted a fundamental conundrum on the two benchmarks Georgia didn’t meet: by decreasing the number of students in each classroom to reduce class sizes and student-teacher ratios, the state will reduce capacity at each facility, which won’t help enrollment rates.
Amy Jacobs, commissioner of the Georgia Department of Early Care and Learning, acknowledged the shortage of seats but said the state is working on it. Lawmakers updated the state’s education funding formula to let schools count 4-year-olds in their enrollment numbers. Enrollment dictates how much money each school district gets, so that change will lead to capital funding to build more pre-k capacity in coming years, she said.
Jacobs said there remains a perplexing mismatch of supply and demand around the state, with some parents unable to find an open pre-k classroom for their child while seats in other areas go empty.
Enrollment used to hover around 80,000 but it’s dropped to around 70,000, she said, and it’s unclear why.
“We know the birth rate is down. It continues to be down in Georgia. I think that’s part of it,” Jacobs said. She added that the remote work and hybrid schedules that are a legacy of the pandemic have probably changed how parents approach child care and preschool.
Georgia is not alone on this. Although some states such as Iowa and West Virginia have maintained high enrollment rates, others have seen their numbers drop, Barnett said, especially in low-income neighborhoods. He thinks the de-emphasis on in-person attendance during the pandemic may have led some parents to devalue schooling in general. Maybe they’re dropping their kids off at the neighbor’s house where they’ll watch TV all day, he said, rather than driving their kids to pre-k.
by Ty Tagami | Apr 28, 2025 | Capitol Beat News Service
ATLANTA – Transgender students born male can no longer participate on female teams in Georgia’s schools and colleges now that Gov. Brian Kemp has signed a ban passed by the General Assembly.
On Monday, Kemp inked his signature on seven bills, including the Riley Gaines Act of 2025. It is named after a Kentucky college swimmer who lost to a transgender competitor at an NCAA competition held at Georgia Tech three years ago.
“This commonsense legislation is about what is fair and safe for our children,” Kemp said.
House Speaker Jon Burns, R-Newington, said the issue is not partisan. Rather, he said, “it’s about right and wrong.”
The House of Representatives backed a similar bill, but Senate Bill 1 emerged as the final version. Burns and the top Republican on the Senate side, Lieutenant Gov. Burt Jones, made it a top priority. Jones, a potential candidate for governor, did not attend the bill signing ceremony, but said in a written statement that Georgia lawmakers had kept a promise to female athletes, “Just like President Trump is delivering on promises made in D.C.”
In early February, Trump signed an executive order affecting schools and transgender athletes. His “Keeping Men Out of Women’s Sports” order withholds federal funding from schools that do not “oppose male competitive participation in women’s sports … as a matter of safety, fairness, dignity, and truth.”
Critics contend Georgia’s Senate and House measures were overkill, a massive effort against rare instances of transgender participation in sports. But proponents, including Frontline Policy Action, a fundamentalist Christian advocacy group that helped draft them, argued that allowing transgender students born male to compete against females was both unfair and dangerous, given the variance in physical strength.
Despite hours of testimony, no evidence was presented of instances in Georgia’s elementary or high schools where a significant problem was caused by transgender participation. Critics noted that lawmakers named their legislation after a college athlete from another state.
Georgia now joins more than two dozen states with a similar prohibition.
The law applies to any competitions that involve public schools and colleges and includes participating private schools and colleges. It allows the state to financially punish institutions that willfully fail to comply, including withholding direct funding as well as funds for scholarships, loans and grants. It also allows lawsuits and monetary damages against such institutions.
The law also prohibits transgender athletes born female from participating on male teams, though there was no significant testimony about problems caused by their participation in sport.
Kemp also signed House Bill 268, a sweeping school safety measure that requires that routinely updated digital campus maps be shared with first responders, that schools equip staff with mobile panic alerts and that student records be transferred within five business days of a student’s change of schools. It would also allow children ages 13-17 accused of committing a terroristic act on campus to be tried as an adult, with potential prison time and convictions that would go on their records for life.
Kemp also signed House Bill 81, to enter an interstate compact on licensing school psychologists; House Bill 235, to give school staff time off to donate organs; House Bill 307, for screeners and support plans for students with dyslexia; Senate Bill 82, to encourage school districts to authorize charter schools, and Senate Bill 123, to address chronic absenteeism.
by Ty Tagami | Apr 24, 2025 | Capitol Beat News Service
ATLANTA – A federal judge in Atlanta said she will decide by month’s end whether the government must extend the visitor status of 133 current and former college students who were suddenly revoked for no apparent reason.
Judge Victoria Marie Calvert heard oral arguments Thursday in the case involving at least 26 foreign nationals attending a Georgia college or university or doing post-graduate work. Another 106 are in other states, but the students’ lawyers argue their cases should be bundled together in the U.S. District Court for the Northern District of Georgia to reduce the workload on the court.
It’s a core issue that Calvert must consider before she decides on the preliminary junction sought by the students. Calvert already issued a temporary restraining order against the federal government on Friday, ordering that the students’ visitor status be restored.
But her order expires May 1, and a preliminary injunction would secure the students’ status under the Student and Exchange Visitor Program until the trial concludes.
Their lawyer, Charles Kuck, argued that the U.S. Department of Homeland Security failed to follow its own rules when it revoked his clients’ visitor status without providing a reason.
Assistant U.S. Attorney R. David Powell argued that a preliminary injunction could allow the international visitors to stay past the original expiration dates of their visitor status. He asked that any preliminary injunction be tailored to each plaintiff’s expiration date.
The case may be the largest of its kind in the country, but numerous others have been filed, including two class action lawsuits, one in Washington and another in New Hampshire.
On Wednesday, Judge Leigh Martin May, who serves in the same courthouse as Calvert, denied a temporary restraining order sought by three foreign students whose visitor status had been revoked.
But Kuck said the trend favors students. He said judges nationwide have issued 17 temporary restraining orders in similar cases.
Powell acknowledged the impact, saying U.S. Immigration and Customs Enforcement has been busy restoring students’ status.
“More orders are coming out every week and every day,” he said. “Sometimes multiple per day.”
Kuck said after the hearing that he hopes the government backs down, but he said he doubts President Donald Trump will allow that to happen. He said he is prepared for a fight that could go on for “a long time.”
The immigration attorney said his office has been bombarded with calls and emails from nearly 700 students nationwide whose visitor status has been revoked.
“We’re going to file a class action (lawsuit),” he said. “This is a disaster.”
