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Georgia seeking to postpone limited Medicaid expansion
Medicaid

ATLANTA – State health officials are asking the federal government’s permission to delay the implementation date of a limited, Georgia-specific expansion of Medicaid for at least a month.

In a letter dated June 24, state Community Health Commissioner Frank Berry cited a decision during the early weeks of the Biden administration to withhold approval of a Georgia Medicaid waver application then-President Donald Trump’s administration signed off on last year.

Biden’s Center for Medicare & Medicaid Services (CMS) objected to provisions in the proposed Georgia Pathways program requiring Medicaid recipients to work, attend school or volunteer at least 80 hours a month. CMS officials argued recipients would have a particularly hard time complying with a work requirement during the pandemic.

Berry disagreed with the federal agency position’s in a letter he sent to CMS in March.

“Georgia Pathways provides a wide range of qualifying activities in which individuals can engage,” the commissioner wrote. “Moreover, there is also a temporary ‘good cause’ exception if, after enrolling in Medicaid through Georgia Pathways, an individual or immediate family member experiences a hospitalization or serious illness or needs to quarantine due to COVID exposure.

“If anything, the COVID-19 crisis makes the qualifying hours and activities — which include work, job training, education, or volunteering—more important, not less. CMS must allow this program to begin as planned and authorized.”

With the program set to take effect July 1, Berry’s letter asks for more time while discussions between the state and CMS continue.

Gov. Brian Kemp rolled out the limited Medicaid expansion plan early in 2019 as an alternative to the Affordable Care Act then-President Barack Obama steered through a Democratic Congress in 2010. The General Assembly passed legislation later in 2019 authorizing the governor to submit two waiver applications to the feds.

Besides the Medicaid waiver, a second waiver would substitute a private-sector alternative to the federal government’s healthcare.gov insurance exchange.

CMS is also revisiting that second waiver, which the Trump administration approved last fall. Earlier this month, the agency ordered the state to revisit the data used to justify the new approach, taking into account changes in federal law and policy that have occurred since Biden took office.

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