White House nixes work requirement in Georgia Medicaid plan

The Biden administration has rejected Georgia’s plan to expand Medicaid coverage on the condition that recipients meet a work requirement.

The U.S. Centers for Medicare & Medicaid Services said Thursday that it was revoking the state’s authority to require work activities or charge Medicaid recipients higher premiums. The Trump administration had approved the work provision.

CMMS cited the ongoing coronavirus pandemic in part for its decision, saying work requirements would “significantly compromise” the effectiveness of Georgia’s plan to boost coverage. 

The decision was a blow to Georgia Republican Gov. Brian Kemp, who had promoted Georgia’s Medicaid plan as a fiscally responsible alternative to a full expansion of Medicaid services under the Affordable Care Act. The plan sought to add an estimated 50,000 poor and uninsured Georgia residents to the Medicaid rolls in its first two years.

The Kemp administration said it planned to fight Thursday’s decision in court. 

“Georgia proposed and received approval to implement an innovative waiver that would expand coverage and access in a fiscally conservative way,” spokeswoman Katie Byrd said in a statement. “We are disappointed the Biden Administration chose to turn its back on a bipartisan group in the Georgia General Assembly that came together to help create a fair and balanced healthcare framework that increases options and lowers costs.”

Under the Affordable Care Act, states gained the option of expanding Medicaid to low-income adults who make up to 138% of the federal poverty level, with the federal government picking up 90% of the cost. More than 10 million people have gained coverage that way.

But Georgia and some other states rejected that option. Kemp said a full expansion would be too costly in the long run.

Democrats have criticized Kemp’s plan for doing too little, saying it would leave at least 350,000 Georgia adults uninsured because they don’t meet the threshold requirements. The issue is likely to be a key one in the state’s 2022 gubernatorial election.