Why a federal Medicaid overhaul could open door for Georgia

Until Thursday, there was no indication from Washington that Gov. Brian Kemp’s plan to pursue waivers that could lead to a partial expansion of Medicaid had any chance of winning federal approval. 

But that changed when the nation’s top Medicaid official told Politico she is reviewing a policy engineered by President Donald Trump that blocked states from pursuing a limited Medicaid expansion.

Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, told Politico that she wants the states to get more flexibility in deciding how to administer the Medicaid program. 

Said Verma: 

“What I have said to states and to governors [is], ‘Tell me what you want to do, and it’s my job to help you get to where you want to go.’ ... We are changing the partnership between the federal and state government. We are trying to empower states.”

The U.S. Supreme Court in 2012 gave states the right to decide whether to expand Medicaid under the Affordable Care Act, and Georgia was among about two dozen states that have opted out of the program. 

Verma and other Trump officials allied with several Republican governors in 2017 to attempt to let states offer a partial Medicaid expansion, such as covering residents who make up to 100 percent of the poverty line, and still receive the amped-up federal matching funds that full-expansion states get.

The president nixed that proposal back then. But Verma’s decision breathes new life into that idea - and could give the Kemp administration an opening that wasn’t available just days ago.

He unveiled a plan shortly after taking office to seek two separate federal waivers, including one that could pave the way to a partial Medicaid expansion. That measure has passed the Senate and is now pending in the House. 

Kemp’s administration has budgeted $1 million to hire a consulting team to investigate the best option, mine statistical and population data, and begin the bureaucratic work of navigating the process with federal decision-makers in Washington.

If Georgia did a full expansion of Medicaid to all its poor, the state would only pay 10 percent of the cost, and the federal government would match the state’s input 9-to-1. Without the special match, the feds would now pay Georgia about 67 percent of the cost.

 

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About the Author

Greg Bluestein
Greg Bluestein
Greg Bluestein is a political reporter who covers the governor's office and state politics for The Atlanta Journal-Constitution.
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