Health, News

HHS Chief Questions Medicaid Work Requirements During Atlanta Visit

In this June 10, 2021, file photo, Health and Human Services Secretary Xavier Becerra testifies before the Senate Finance Committee on Capitol Hill in Washington. Comments Becerra made during a visit to Atlanta Monday cast doubt on whether Georgia's limited Medicaid expansion plan will be allowed to proceed.
In this June 10, 2021, file photo, Health and Human Services Secretary Xavier Becerra testifies before the Senate Finance Committee on Capitol Hill in Washington. Comments Becerra made during a visit to Atlanta Monday cast doubt on whether Georgia's limited Medicaid expansion plan will be allowed to proceed.
Credit J. Scott Applewhite / AP Photo
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The Biden administration’s top health official says his agency is working as quickly as possible to review Georgia’s request for a limited Medicaid expansion with a work requirement.

But comments Health and Human Services Secretary Xavier Becerra made during a visit to Atlanta Monday cast doubt on whether the plan will be allowed to proceed.

“We don’t want work to become an impediment to getting your care,” he told reporters at a roundtable at the Southside Medical Center. 

“It seems kind of ironic that if you’re trying to make sure you’re taking care of your family and also trying to look for good work that you might find yourself losing Medicaid because of requirements relating to work.”

The Biden administration has been reviewing Georgia’s program since February after the Trump administration approved it last year. It’s been a cornerstone of Gov. Brian Kemp’s health care agenda.

Created using a mechanism called a waiver that allows states to sidestep some requirements of the Medicaid program, Georgia’s plan would provide an estimated 50,000 low-income residents access to health coverage if they can work or volunteer 80 hours a month.

In a letter to state officials, federal regulators said that requirement was “infeasible” because of the COVID-19 pandemic.

We don’t want work to become an impediment to getting your care”

That kicked off a series of exchanges between state and federal officials. In one, the then-commissioner of Georgia’s Department of Community Health, which oversees the state’s Medicaid program, threatened to challenge any decision that ultimately blocks Georgia’s plan.

It’s not clear if that’s the fate Georgia’s plan faces. HHS has recently blocked work requirements for Medicaid in other states.

“It’s the obligation of the federal government to always make sure that if a state is doing something different than the way it’s supposed to, that it’s doing it right and that it’s actually fulfilling the mission of Medicaid to give better coverage to more people at lower cost,” Becerra said. 

Democrats and healthcare advocates in Georgia have long called on Republican state leaders to fully expand Medicaid to all low-income residents.

They argue doing so would cost less money than Kemp’s plan and ultimately cover more people in the so-called “coverage gap.” Hundreds of thousands of Georgians make too much money to qualify for traditional Medicaid and not enough money to qualify for subsidized plans offered under the Affordable Care Act.

The Biden administration put new financial incentives in the American Rescue Plan to entice Georgia and other states to fully expand Medicaid. But, so far, state leaders seem uninterested.

Last month, Georgia U.S. Sens. Jon Ossoff and Raphael Warnock pitched a different path to expand coverage: a federally run Medicaid look-alike program.

The senators say the plan wouldn’t cost Georgia anything. Unlike traditional Medicaid, which requires states to cover some of the costs for enrollees, their plan would have the federal government pick up the entire tab.

Ossoff and Warnock say they hope their workaround makes it into the Biden administration’s spending plan being negotiated in Congress.

Becerra thanked the senators for introducing the proposal and said his agency was open to any plan that resulted in covering more Georgians.

“If you tell me you’re going to provide a way to get people covered through Medicaid whether it’s through a workaround or whether it’s through expanding Medicaid that already exists, I will simply say, ‘How high must we jump at HHS to make it possible for Georgians to get access to that coverage?'”