Georgia clashes with Biden administration over Medicaid waivers

The Affordable Care Act dates to 2010 and gave all states the option to expand Medicaid to their entire poor population, with the federal government paying at least 90% of the cost of the expansion.

Georgia is one of the 12 states that did not fully expand.

Gov. Brian Kemp and Georgia General Assembly leaders instead developed their own plan to increase health care coverage for the uninsured. Known as Georgia Pathways, the program involves the creation of two Medicaid waivers.

One of those expanded Medicaid eligibility to all Georgians living at or below the poverty line so long as they met work, school or volunteer thresholds of 20 hours a week or 80 hours a month. The Biden administration rescinded approval of this waiver earlier this year pending further review.

The second waiver would cover people at up to 137% of the poverty line and involves working with insurance companies. This program remains in federal review.

The U.S. poverty line for one person in 2021 is $12,880, and $26,500 for a family of four.

Kemp and fellow Republicans have touted the proposal as a more narrowly tailored, fiscally responsible alternative to a full expansion of Medicaid. Kemp has estimated Georgia Pathways would add an estimated 50,000 poor and uninsured Georgia residents to the Medicaid rolls in its first two years.

State Sen. Ben Watson (R-Savannah), chairman of the Georgia Senate Committee on Health and Human Services, said the proposed waiver and the work, school or volunteer requirements are not too much to ask. He says Medicaid should be a "revolving door" only used by those in poverty to get out of poverty.

“The thing that everybody ignores or says is too onerous is: if you're not able to work 20 hours a week, or go to technical school, or do the community service for 20 hours a week, or go to college, well, then you're probably more than just in poverty, you probably are disabled. And we have a good federal system that works through disability," Watson said.

“Then if they say, 'No, you're not disabled,' well, then you really need to get a job.”

Democrats take a contrary view, insisting on full Medicaid expansion. They claim Georgia Pathways would leave at least 350,000 Georgia adults uninsured because they don’t meet the requirements.

Sen. Raphael Warnock, who is in Georgia this week, said on Tuesday that he's urging the White House to include a "federal fix" for the issue in the next jobs package that would allow those eligible residents in Georgia and other holdout states to gain health care coverage, Georgia Public Broadcasting reported.

“Our state officials so far have decided to leave billions of dollars on the table, to leave hundreds of thousands of Georgians in the Medicaid gap,” Warnock said on Tuesday outside of Grady Memorial Hospital. “We can cover everybody right now, when instead the politicians are playing games with the people's taxpaying money.”

Warnock did not give details on the program he mentioned but said it would be tied to the still-pending Democratic American Jobs Plan package. Warnock said he and fellow Sen. Jon Ossoff urged the Biden administration to reject Kemp's proposal, calling Georgia's proposed requirements "wrongheaded."

“I’m hoping to introduce legislation soon that will allow Georgians in the coverage gap and those who are low income to get coverage through the federal government while continuing to incentivize the state to finally expand its Medicaid program,” Warnock told reporters.

Watson said he would rather Warnock leave things in the state’s hands.

“What I would like for him to do is let Georgia do what was approved,” Watson said. “That would be the appropriate response.”

Will Peebles is the enterprise reporter for Savannah Morning News. He can be reached at wpeebles@gannett.com and @willpeeblessmn on Twitter.

This article originally appeared on Savannah Morning News: Georgia clashes with Biden administration over Medicaid waivers