As expected, Georgian officials have appealed the new federal position on the state’s Medicaid waiver plan, stating that a possible revocation by the Biden government would be an arbitrary and unlawful switch of bait.
The state health ministry commissioner wrote on March 12, noted that federal health officials last year approved the Georgian approach of requiring low-income adults to meet labor or other licensing standards in order to provide Medicaid coverage to obtain.
These requirements were at the center of criticism by the Biden administration last month of the Georgia plan, which is due to begin July 1.
If the government withdraws the Medicaid waiver plan, “Georgia will contest the decision,” wrote Community Health Commissioner Frank Berry in his letter to officials at the Center for Medicare and Medicaid Services (CMS). He called the work and other admission requirements “core of the waiver”.
The state’s Republican lawmakers have defended the waiver plan sponsored by Governor Brian Kemp.
The Berry letter comes as the federal government creates new incentives for states to achieve much larger increases in enrollments through regular expansion of Medicaid under the Affordable Care Act, which most states have already done.
Medicaid provides health insurance to low-income and disabled residents, including approximately 2 million in Georgia.
As currently written, a person must invest 80 hours per month in a job, educational program, volunteer organization, or other qualifying activity to receive Medicaid coverage.
However, a February letter from CMS criticized Georgia’s policy of “making health insurance dependent on working conditions or other community involvement requirements”.
The federal government’s letter highlighted uncertainties related to the COVID-19 pandemic, including vocational training and other activities to meet work and other requirements, as well as access to transportation and affordable childcare.
Twelve states received federal approval under the Trump administration to enforce Medicaid’s work requirements. However, job requests in Arkansas, Kentucky and elsewhere have been blocked by federal courts and the US Supreme Court is expected to take up a case this month.
In his letter, Berry said state officials “have worked in good faith with CMS to adopt an innovative program that will cover a new category of people and help them build important skills and become more independent and self-sufficient.”
The Berry letter said Georgian officials agreed to allow virus-related exemptions from coverage requirements and the COVID-19 pandemic has now subsided.
CMS officials could not be reached Wednesday for comment on the Georgia letter.
The Trump administration opposed the ACA and supported lawsuits against it and efforts by Congress to overturn it. CMS officials under Trump approved the Georgia waiver as an alternative to a standard Medicaid extension.
However, President Biden is a staunch supporter of the ACA, which came into effect as Vice President.
Sweeten the offer
Georgia is one of 12 countries that have so far chosen not to expand their Medicaid programs, as outlined by the ACA. However, the newly approved COVID-19 Relief Act provides these states with improved financial incentives to launch an expansion.
States that expand the program at this point would receive an additional 5 percentage point increase in their regular Medicaid matching rate for two years. During that time, even after factoring in the cost of implementing the expansion, Georgia would raise $ 700 million under the new incentives, according to the Kaiser Family Foundation.
The Kemp waiver plan now outlined is much less ambitious. According to consumer advocacy group Georgians for a Healthy Future, it would cost $ 75 million in the first year and only cover 31,000 low-income adults. The national game as part of the Kemp waiver plan would make up the regular 67 percent of the costs.
A standard extension would allow Medicaid to service 480,000 to 600,000 people in the state, said Laura Colbert, the group’s executive director. “Medicaid’s expansion has always been the moral and cost-effective choice for Georgia,” she said recently. The new incentive package, she said, “only reinforces that choice.”
Democrats, including Georgia’s newly-elected US-American Sens. Jon Ossoff and Raphael Warnock, have pointed to the state’s potential gains from Medicaid’s expansion, including helping hospitals and other medical providers.
“If Georgia doesn’t expand Medicaid,” Warnock said recently, “we are literally leaving money on the table that could save Georgians’ lives.”