Big changes are on deck for Medicaid, the state-federal health insurance program for poor children and some poor adults. In Georgia, people have four more days to comment on an especially big change being sought for the state.

The U.S. Centers for Medicare & Medicaid Services is accepting public comment until Friday on Gov. Brian Kemp’s Medicaid waiver proposal.

Kemp’s proposal would open Medicaid to more poor adults without fully expanding the program the way other states have done. Kemp and other Georgia leaders have said that could be too expensive for the state’s budget.

Instead, Medicaid would be offered to any poor Georgian who can perform certain approved activities for 80 hours a month. That includes working at a formal job or registered nonprofit or getting a higher education. It doesn’t include informal work such as caretaking for a baby or a family member with dementia.

Kemp’s aides estimate that perhaps 50,000 more of Georgia’s 408,000 uninsured poor would receive health insurance as a result of the proposal.

People who already receive Medicaid would remain covered, including children and people federally designated as disabled.

The aim of the proposal — which will require federal approval before it’s implemented — is to get people covered first through Medicaid and then, if they get jobs, move them to employer insurance.

The link to comment on the proposal, called an 1115 waiver or Georgia Pathways to Coverage, is posted on the U.S. Medicaid website. Click this link and then click the “Answer Questionnaire” button:

For more information, The Atlanta Journal-Constitution published a front-page story on the 1115 waiver Nov. 5. Here's a link to that story: Kemp's Medicaid plan would cover thousands, but not most, of Georgia's poor

And the AJC published a story with more details on the front of the Metro section Dec. 4. Here's a link to that: Kemp's health care waivers a matter of perspective

Kemp has an additional proposal to reshape the state’s Affordable Care Act exchange and individual health coverage, but that has not been opened for comment yet.

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