Georgia Medicaid plan fails to meet health care needs of thousands

Newest health care proposal will still bar hundreds of thousands of Georgians from coverage

On Monday, Nov. 4, Gov. Brian Kemp announced his administration’s proposal for a Section 1115 waiver, which allows states to make changes to the Medicaid program. The proposed plan takes a first step in extending health coverage to more Georgians by expanding Medicaid to those earning up to 100 percent of the federal poverty line, approximately $12,000 per year for an individual. However, this plan does not adequately leverage funding options to expand coverage to all of the approximately 500,000 that could be covered under federal law, and it proposes costly and burdensome work requirements.

“While it is encouraging to see more Georgians may soon get covered, early estimates show only a tiny fraction of those who could qualify for care will qualify under this plan,” said Laura Harker, senior health analyst at the Georgia Budget and Policy Institute. “Full Medicaid expansion remains the best option to provide affordable health care options to those who need it, better support rural hospitals and help address Georgia’s maternal mortality problem. This proposal leaves billions of federal dollars on the table that could cover hundreds of thousands more Georgians and requires premium payments and work reporting that will incur unnecessary costs while barring Georgians from access to care. State leaders must reassess this proposal to create a health care plan that is truly people-first.”

“While every additional person who gains coverage is an important victory, this plan leaves too many Georgians uninsured. Georgia leaders should set aside partisan ideas that have failed in other states and instead pursue an evidence-based solution,” said Laura Colbert, Executive Director at Georgians for a Healthy Future. “Study after study demonstrates that Medicaid expansion results in improved health outcomes for adults who get covered, fewer financial struggles and more stable housing for low-income families, and stronger finances for community health centers and rural hospitals. Georgians deserve a healthier, financially vibrant future. Unfortunately, this plan does not move the state in that direction.”

The plan fails Georgians because:

1. It does not expand Medicaid to the full extent allowed under federal law. Under the Affordable Care Act (ACA), states can expand Medicaid to people earning up to 138 percent of the federal poverty line, approximately $17,000 a year for an individual. The federal government pays 90 percent of this “full” expansion. Georgia’s partial expansion plan only extends coverage to 100 percent of the poverty line, roughly $12,000 per year for an individual.

2. It does not take advantage of federal funds available and puts more burden on the state to cover fewer people. Georgia initially believed it could receive 90 percent funding, but the Trump administration recently said it would not provide full funding for anything below full expansion. Now the state is moving forward with a plan that would cover fewer Georgians and would receive far less federal funding.

3. This plan also includes requirements to work to maintain Medicaid eligibility. Numerous studies show this is a costly and ineffective approach to getting more people connected to employment. It costs Tennessee $34 million per year to maintain work hour reports. In Arkansas, 18,000 people lost coverage in the six months follow its work requirement implementation. In the past two weeks, Arizona and Indiana suspended work requirements for their Medicaid programs.

4. Finally, the plan requires premiums for enrollees whose earnings are above 50 percent of the federal poverty line. Medicaid traditionally does not allow states to charge premiums and permits only small co-payments. This creates a difficult cost burden for families who we know cannot afford coverage, and could lead to some recipients being disenrolled.

Georgia lawmakers still have the opportunity to choose a better path forward. Legislators can amend the Patients First Act to allow for full expansion to cover as many Georgians as possible and receive more federal funding to fix the state’s health crisis.

The Cover Georgia coalition urges all Georgians to take part in the public comment period about the administration’s proposal. In the coming days, Cover Georgia will release a portal to help Georgians submit public comments. “During the public comment periods, Georgians have the unique opportunity to speak directly to state leaders about their health needs and the needs of their communities. We urge Georgians to take action and speak up!” said Laura Colbert on behalf of the Cover Georgia coalition.

For more information about how 1115 waivers could be used to benefit Georgians and the Cover Georgia coalition’s principals for 1115 waivers: Opportunities for Georgia to Best Leverage Medicaid Waivers by Laura Harker, Georgia Budget and Policy Institute

What You Need to Know about Waives and Medicaid Expansion by the Cover Georgia coalition

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Georgians for a Healthy Future and the Georgia Budget and Policy Institute co-lead the Cover Georgia coalition, which is a coalition made up of dozens of community stakeholders and advocates from all across Georgia that works to ensure that all Georgians regardless of income get the health coverage and care they need. The Cover Georgia coalition has been monitoring the Patients First process to assess its impact on Georgia families and individuals, especially those who are low-income and those from communities that are under-resourced. More information at

About the Georgia Budget & Policy Institute – GBPI is a nonpartisan nonprofit that provides thoughtful analysis on the state’s budget, taxes and policies to advance responsible solutions that expand economic opportunity and well-being for all Georgians. More information at

About Georgians for a Healthy Future –GHF is a non-partisan, non-profit consumer health advocacy and policy organization with a mission to build and mobilize a unified voice, vision, and leadership to achieve a healthy future for all Georgians. More information available at


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