Home Heartland Square Georgia Gov. Kemp to seek work requirement for partially expanded Medicaid, subsidized insurance

Gov. Kemp to seek work requirement for partially expanded Medicaid, subsidized insurance


Georgia Gov. Brian Kemp announced a plan Monday that he said will provide health care coverage to tens of thousands of additional residents without the need for a full expansion of Medicaid under the Affordable Care Act.

Kemp’s plan comes with a requirement that participants pay a monthly premium and spend 80 hours a month working, doing community service, pursuing education or training to qualify.

“Today, I am proud to announce Georgia Pathways, our innovation waiver that will help thousands finally afford health insurance,” Kemp said in front of the steps of the state’s capitol. “This plan reflects our priorities and values.”

The ACA gives states the option to raise the income eligibility requirement for Medicaid to open up the taxpayer-funded program to more participants. ACA calls for an income limit of 138 percent of the federal poverty level, or $17,000 for an individual. Georgia’s waiver will extend the Medicaid income eligibility to up to a maximum of 100 percent of the federal poverty line, or a little more than $12,000 annually.

Critics say Kemp’s plan will not solve the state’s health care issues.

“Evidence shows that most people with Medicaid already work & half of America’s uninsured kids live in six states including GA,” Georgia pediatrician Dr. Melinda Willingham wrote on Twitter.

About 3 million Georgians live under 200 percent of the federal poverty line, according to a report by the Kaiser Family Foundation.

A full Medicaid expansion would cover 667,000 Georgians, according to Kemp’s office, with a $1.5 billion price tag for the state over the next five years. The partial expansion will cover around 52,500 Georgians and cost the state $323 million over five years. 

Ninety percent of a full expansion would be covered by the federal government. About 67 percent of the cost will be covered by the feds with the partial expansion plan. Although Kemp said he would seek 90 percent reimbursement. The Trump administration still needs to approve the plan.

Kemp gave the Georgia Department of Community Health the green light to submit two waivers to the federal government through the Patients First Act, passed during the 2019 legislative session.

The governor last week announced plans for the first waiver, Georgia Access. It will reduce federal control over the ACA health care marketplace, cut premium costs and boost the state’s private health care sector, according to Kemp. Kemp’s administration said Georgia Pathways will apply to 408,000 adults by offering them the option that is “more cost-effective” for the state.

Public comment for the program was announced Monday and will close on Dec. 3. 

Officials plan to submit the waivers to the federal government by Dec. 31.

“Together, Georgia Pathways and Georgia Access encompass the entire healthcare delivery system, showcase our priorities, reflect our values, and put patients first,” Kemp said.