Federal government rejects work requirement in Georgia Medicaid overhaul

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“Although they tried to hide behind the holidays by announcing two days before Christmas, we plan to challenge their flawed – possibly political – decision in court,” she said.

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Governor Brian Kemp and Seema Verma, then administrator of the Centers for Medicare and Medicaid Services, celebrate after signing a healthcare measure at the Georgia Capitol in October 2020. The federal government approved Kemp’s plan to reshape Medicaid and the Individual insurance in Georgia under the Affordable Care Act. Kemp’s plan would have allowed as many as 50,000 poor, uninsured adults to be added to Medicaid lists in two years. Yet his office estimated that more than 400,000 people would not meet Medicaid requirements and be uninsured. (Hyosub Shin / [email protected])

Credit: HYOSUB SHIN / AJC

Governor Brian Kemp and Seema Verma, then administrator of the Centers for Medicare and Medicaid Services, celebrate after signing a healthcare measure at the Georgia Capitol in October 2020. The federal government approved Kemp's plan to reshape Medicaid and the Individual insurance in Georgia under the Affordable Care Act.  Kemp's plan would have allowed as many as 50,000 poor, uninsured adults to be added to Medicaid lists in two years.  Yet his office estimated that more than 400,000 people would not meet Medicaid requirements and be uninsured.  (Hyosub Shin / Hyosub.Shin@ajc.com)
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Governor Brian Kemp and Seema Verma, then administrator of the Centers for Medicare and Medicaid Services, celebrate after signing a healthcare measure at the Georgia Capitol in October 2020. The federal government approved Kemp’s plan to reshape Medicaid and the Individual insurance in Georgia under the Affordable Care Act. Kemp’s plan would have allowed as many as 50,000 poor, uninsured adults to be added to Medicaid lists in two years. Yet his office estimated that more than 400,000 people would not meet Medicaid requirements and be uninsured. (Hyosub Shin / [email protected])

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

Kemp made the plan his response to Democratic calls to expand Medicaid, touting it as a “budget conservative” way to add more needy recipients to Georgia’s lists.

At a press conference last year, the governor said “the status quo is simply unacceptable” citing the high costs of state premiums and the high number of uninsured people – the second worst in the world. country.

This would have allowed perhaps up to 50,000 poor and uninsured adults to be added to Medicaid lists in two years. Still, Kemp’s office estimated that more than 400,000 people would not meet Medicaid requirements and be uninsured.

Health care groups and Democrats have long described the governor’s proposal as a further step and called for a full expansion of Medicaid for the state’s very poor, as provided for in the Affordable Care Act.

More than three dozen states have expanded their Medicaid programs, a step the governor called too expensive and too rigid. Some Republicans privately hoped Kemp would embrace a full expansion in 2022, though that idea always seemed infeasible in a polarizing election year.

House Speaker David Ralston was among Republicans who attacked the White House for both the decision and the timing of its announcement.

“It is shameful that President Biden has denied thousands of Georgians medical coverage,” he said. “Like the Grinch, he stole hope from so many families in need, just over Christmas.”

Biden’s signature policy proposal, the Build Back Better Act, would provide a workaround for the federal government to extend Medicaid to all poor adults without state approval. This bill is blocked in the Senate, and it is not yet known whether the provision will remain intact.

A separate Kemp waiver program approved by the Trump administration last year also faces an uncertain future.

This proposal is tantamount to a “reinsurance” plan aimed at reducing premium prices for those who take out individual insurance. If this proposal goes ahead, Kemp plans to inject public money into the private insurance market with the aim of lowering premiums for some Georgians.

The Biden administration has pushed to scale back this proposal and asked for further public comment from Georgians, who can submit comments until January 9.


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