MM Curator summary
[ MM Curator Summary]: GA’s planned Medicaid expansion has been stopped by CMS.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
On December 23, 2021, CMS announced that it was rescinding its prior approval of the Georgia Pathways to Coverage demonstration project, which would have required Georgia residents to work as a condition of Medicaid eligibility and allowed the state to charge premiums to a larger class of individuals than permitted under the Medicaid statute. These proposals could have gone into effect as early as next week had CMS not withdrawn its prior approval.
The Georgia Pathways to Coverage demonstration project would have required adults within a certain percentage of the federal poverty level to work at least 80 hours each month to qualify for Medicaid. In addition, the demonstration would have required Medicaid beneficiaries earning between 50 and 100 percent of the federal poverty level to pay monthly premiums.
CMS approved the demonstration project on October 15, 2020. According to the Kaiser Foundation, Georgia was one of eleven states that received approval to impose work requirements under the Trump Administration.
In his first week in office, President Biden signed an executive order directing CMS to review Medicaid work requirements that were approved under the previous administration. Soon thereafter, by letter dated February 12, 2021, CMS informed Georgia Medicaid that it was considering withdrawing its approval of the Georgia Pathways to Coverage demonstration, citing “ongoing disruptions caused by the COVID-19 pandemic.” Georgia agreed to delay implementation of its demonstration project until the end of 2021 while it negotiated with CMS to address the agency’s concerns.
Last week, CMS informed Georgia that it was reversing its prior approval of the Georgia Pathways to Coverage demonstration project. The agency explained that both the work and the premium requirements contained in the demonstration project would restrict Georgian’s access to coverage.
None of the other ten states that received approval from the Trump administration to impose work requirements have done so. Earlier this year, CMS rescinded its past approval of work requirements for South Carolina, Ohio, Wisconsin, Arizona, Indiana, and Utah. And federal courts have blocked the implementation of work requirements in Arkansas, Kentucky, Michigan and New Hampshire.
A copy of the December 23, 2021 CMS letter rescinding its prior approval of the Georgia Pathways to Coverage demonstration project is available here. A CMS press release announcing its decision to rescind its approval of the demonstration project is available here.