Georgia gets Trump approval for Medicaid work requirements, partial expansion

The Trump administration has given Georgia the green light to partially expand Medicaid without federal support, and to impose work requirements on Medicaid beneficiaries.

The plan announced by Gov. Brian Kemp (R) Thursday stops short of the full-scale Medicaid expansion supported by Democrats, which would cover thousands more low-income adults regardless of their employment status.

Kemp’s plan, called “Pathways to Coverage,” would cover adults who meet the work requirements and who earn no more than 100 percent of the federal poverty level — $12,760 a year for an individual.

Kemp said his plan can help reduce the state’s high uninsured rate. 

The plan will cover about 65,000 additional people, far fewer than full expansion, which advocates argue would cover an estimated 600,000 people. 

Partial expansion is also projected to cost more money. An estimate last year pegged the cost of full expansion at about $150 million in the first year and $200 million annually in following years. 

On Thursday, Kemp said full expansion would cost $547 million annually, but did not disclose where the estimate came from. 

In order to qualify, Medicaid beneficiaries must complete at least 80 hours of work, community service or other qualifying activities per month.

Most individuals who earn between 50 percent and 100 percent of the poverty level will also be required to pay monthly premiums.

The approval comes as the U.S. is mired in the middle of a pandemic that shows little signs of abating. COVID-19 infections are rising across the country, and Americans are enduring record levels of unemployment. 

Kemp announced the plan inside the state Capitol, flanked by Centers for Medicare and Medicaid Services Administrator Seema Verma and Sen. Kelly Loeffler (R), who is in the middle of a tight reelection race. 

During his press conference, Kemp took a swipe at the idea of full Medicaid expansion, calling it a “clever bumper sticker plan.”

“A full expansion of Medicaid costs too much, and it will completely undermine the access to quality care,” Kemp said.

Yet Georgia will undertake its partial expansion without any federal support. The Trump administration denied the state’s request to receive full federal funds for only partial expansion. 

Under ObamaCare, the federal government pays for 90 percent of the cost of states that wish to expand Medicaid. Georgia asked to receive the same level of federal funding while covering only a fraction of the people. 

Georgia is not the first state to request funding for a partial expansion, but the administration last year told states it would not approve any such requests.

Medicaid expansion has become increasingly popular, despite the strong opposition of Republican governors and legislators. To date, 39 states have accepted federal money to expand health coverage.

Other states have imposed work requirements, but none are actively in effect because of court challenges.

In February, a federal appeals court struck down work requirements in Arkansas, ruling the approval was “arbitrary and capricious” after more than 18,000 people lost coverage.

Verma on Thursday acknowledged the inevitable legal challenges.

“As surely as night follows day, there will be those that will be bent on weaponizing the legal system to thwart state innovation,” Verma said.