If Georgia fully expanded Medicaid with the federal government absorbing 95% of the tab, the state could cover more than 350,000 of the over 400,000 uninsured people living in Georgia,…
In March, Georgia’s Governor and state legislature approved SB 106, legislation that allows the state to pursue an 1115 “waiver” to make changes to Georgia’s Medicaid program and a 1332 state innovation waiver to make changes to private insurance in the state. (Waivers allow a state to set aside or “waive” certain requirements imposed by the federal government and try new models of providing health coverage and care.)
In June, the Governor hired Deloitte Consulting to develop the proposals for Georgia’s Medicaid program and the private insurance market. Five months later, on October 31st and Nov. 4th respectively, Governor Kemp announced the details of his proposed plans.
The Governor’s proposed 1115 Medicaid waiver, called Georgia Pathways plan, would allow Georgians with incomes below the poverty line to enroll in Medicaid coverage but only if they can meet monthly work requirements (at least 80 hours per month of work, school, training, or volunteering per month). The plan would cover only a fraction of those who could be covered by a full Medicaid expansion.
The Governor’s proposal to re-shape the state’s private health insurance market consists of two parts:
- A reinsurance program to lower premiums; and
- A dramatic erosion of the Affordable Care Act’s rules and structures, including provisions that privatize insurance enrollment; cap the financial assistance available to low- and middle-income consumers; and erode consumer protections (like the requirement that health plans cover essential health services).
This plan would result in many Georgians who currently have health insurance becoming uninsured or underinsured.
The announcement of the Governor’s plans kicked off a 30-day public comment period during which Georgians impacted by these proposals, health advocates, health care industry stakeholders, and others could weigh in on the plans.
The Governor’s Medicaid proposal does not go far enough towards closing Georgia’s coverage gap and his plan to dramatically scale back the ACA in Georgia would turn back the clock on Georgians with pre-existing conditions and consumers who need financial help to afford private coverage, among many others. GHF submitted comments to state officials communicating our deep concerns about both plans. You can read GHF’s full comments here: