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Statement from GHF’s Executive Director on the approval of Georgia’s 1115 Medicaid waiver & pending approval of 1332 private insurance waiver

Today Governor Kemp and the Centers for Medicare & Medicaid Services announced the approval of Georgia’s 1115 Medicaid waiver & pending approval of 1332 private insurance waiver. Laura Colbert, Executive Director of Georgians for a Healthy Future has issued the following statement:

“In the midst of a once-in-a-century health crisis, Georgians need & deserve bold action from their leaders. Unfortunately, the Governor’s health proposals miss that mark. The plans approved today are insufficient and ill-advised. Georgians deserve better.

“When both of these proposals are rolled out, it is likely that more Georgians will lose health coverage than gain it in the first year.[1] When health insurance is more valuable than ever for the access to care and financial protections that it provides to families, state leaders would leave more Georgians uninsured.

“Under the proposals agreed to by Governor Kemp and federal officials today, individuals and families will have a more difficult time getting covered and staying covered. The Georgia Access plan would eliminate the option for people to easily compare health plans and enroll at HealthCare.gov, as tens of thousands do each year. It would also increase opportunities for insurers to take advantage of consumers. The Governor is touting lower premiums, but lower premiums are only beneficial if Georgians actually have health insurance.

“At the same time, the Medicaid proposal fails to extend coverage to all of the low-income Georgians who need coverage while leaving Georgia’s tax dollars on the table.

“Unfortunately, those who live in rural areas and people of color are the biggest losers under these proposals, further exacerbating the disproportionate burden they have carried during the COVID-19 pandemic.

“With a similar investment of state dollars and some political bravery from state leaders, more than half a million Georgians could gain health coverage under a full Medicaid expansion. That number would continue to grow with a modest outreach & enrollment program that helps middle-income families find affordable, private insurance through the ACA marketplace.

“What’s clear is that state and federal officials did not take seriously their responsibility to the 1.4 million uninsured Georgians and their families as they considered these waiver proposals. Georgians who commented on Governor Kemp’s Medicaid plan opposed it by a 9-to-1 margin.[2] Nearly 1000 Georgians weighed in during the state comment period late last year and yet Georgia leaders submitted their plan with few changes to federal officials only three weeks later.[3] Just as concerning, Gov. Kemp chose not to reevaluate this plan, even as COVID-19 emerged and changed everything.

“Similarly, the final public comment period for the Georgia Access proposal closed just three weeks ago on September 23rd. More than 1800 comments were recorded—the most ever on this type of health proposal.[4] The overwhelming majority of those comments were in opposition and came not only from Georgians but from a wide array of respected organizations, like the American Medical Association and the Black Mamas Matter Alliance, as well as the American Academy of Pediatrics and the United Way. Despite this, Georgia has just earned one of the fastest approvals for the proposal.

“Everyone in our state should be concerned about the speed at which state leaders pursued these proposals, even in the face of steep opposition and compelling evidence that they will harm more Georgians than they will help. At every turn in this process, the most cost-effective, evidence-based, equitable, and practical solutions have been ignored. If Georgia leaders fully expand Medicaid to cover low-income adults and invest (even modestly) in local outreach & enrollment help, Georgians would be better off than they will be under these proposals.”

[1]Coverage gains expected in the first year of 1115 Medicaid waiver: 25,028 (Georgia “Pathways to Coverage” Section 1115 Demonstration Waiver application, Pg. 10)

Coverage losses expected in the first year of 1332 private insurance waiver: 25,000-35,078 (Estimates from Tens of Thousands Could Lose Coverage Under Georgia’s 1332 Waiver Proposal, endnote #24, Center on Budget & Policy Priorities, and Georgia’s latest 1332 proposal continues to violate the ACA, Figure 1., Brookings Institute)

[2] Georgians for a Healthy Future, May 12, 2020. Outnumbered.

[3] Georgia Department of Community Health, Dec. 23, 2020. Georgia “Pathways to Coverage” Section 1115 Demonstration Waiver application, Pg. 10

[4] https://www.cms.gov/CCIIO/Programs-and-Initiatives/State-Innovation-Waivers/Section_1332_State_Innovation_Waivers-


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