CMS approves Georgia’s partial Medicaid expansion with work requirement

The federal government approved Georgia’s plan to partially expand Medicaid to an additional 65,000 adults on the condition that they work, job-train, volunteer or pursue education for at least 80 hours a month.

CMS on Thursday green-lighted Georgia’s five-year 1115 demonstration waiver, titled Georgia Pathways to Coverage, to extend Medicaid coverage to uninsured Georgians who are between ages 19 and 64 with incomes at or below 100% of the federal poverty level, which is about $12,760 for a single-person household.

In addition to working, individuals would have to report their qualifying work activities and hours. Most would also be required to pay a monthly premium. The Medicaid expansion is slated to go live July 1, 2021.

Currently, Georgia, which covers about 1.9 million people in Medicaid and the Children’s Health Insurance Program, does not allow non-disabled, childless adults to enroll in the safety-net program. Under the expansion, the state projects 30,000 people will enroll during the first year of the demonstration and nearly 65,000 will enroll over five years.

Critics have argued that Georgia’s plan is too narrow. The Affordable Care Act allows states to expand Medicaid coverage to people up to 138% of the federal poverty level and for states that do, the federal government pays 90% of the total cost of Medicaid expansion.

But in Georgia, CMS said it will not authorize enhanced federal funds to pay for the demonstration, and “will continue the existing policy of providing the enhanced federal match rate when the state covers the entire adult expansion group.”

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Tags: covid-19, pandemic

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