Georgia delays Medicaid expansion after pushback from Washington

In October 2020, Governor Brian Kemp and Seema Verma, Centers for Medicare and Medicaid Services Administrator under the Trump administration, announced the federal government intended to approve two "waivers" for Georgia health insurance.  One would expand Medicaid coverage to some poor Georgia adults, if they meet specific activity requirements.   (PHOTO by Hyosub Shin / Hyosub.Shin@ajc.com)
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In October 2020, Governor Brian Kemp and Seema Verma, Centers for Medicare and Medicaid Services Administrator under the Trump administration, announced the federal government intended to approve two "waivers" for Georgia health insurance. One would expand Medicaid coverage to some poor Georgia adults, if they meet specific activity requirements. (PHOTO by Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

Georgia will delay the rollout of its limited Medicaid expansion, originally planned for July 1, until at least August 1, according to a letter the state Department of Community Health sent to Washington dated Thursday.

The delay comes after the plan has come under scrutiny by the Biden Administration because of the state’s requirements that beneficiaries either work or attend school or engage in other qualifying activities. In several other states, the administration has already revoked Medicaid work requirements, citing the pandemic and economic environment and saying such rules present barriers to those lacking access to transportation or child care, among other issues.

Georgia’s plan now faces likely legal challenges, and the Biden Administration has moved its status from approved to “pending” on the federal website.

Gov. Brian Kemp’s administration in turn has told federal officials that any attempt to rescind approval for the requirements would be “arbitrary, unreasonable, and unlawful.”

The delay spelled out in the letter this week adds time for Georgia to negotiate with Washington over their differences.

Georgia has the nation’s third-highest rate of uninsured people, behind Texas and Oklahoma.

The Affordable Care Act gave all states the opportunity to expand Medicaid to their entire poor population, with the federal government paying at least 90% of the cost of the expansion. Georgia is among 12 states that did not fully expand.

Instead, the Kemp Administration worked with the Trump Administration to craft its plan and seek a waiver of parts of the federal law to implement the limited expansion with work requirements. Such waivers are allowed so that states can experiment with ways to tailor programs to their individual needs.

The Trump Administration approved the waiver in its final weeks.

Kemp’s aides estimated that the plan would eventually extend Medicaid coverage to about 50,000 of the state’s 400,000 uninsured low-income adults. Among those who would not qualify are those taking full-time care of an aging relative, for example.

The aides maintain that the requirements are not just about work but other specified activities that would help people lead healthier lives and eventually afford private insurance.