Healthcare remains one of the top – and most divisive – issues in Georgia and in Washington. Georgia is one of several Republican-led states that did not expand Medicaid in the wake of the Affordable Care Act – often known as Obamacare – and this has not changed under Governor Brian Kemp. But between rural hospital closures and increasing insurance rates, there was momentum to take action.
The answer in Georgia was the Patients First Act. The Act was passed in the 2019 legislative session and signed into law by Kemp in March. The Act authorized the Georgia Department of Community Health (DCH) to submit Medicaid waivers to the Centers for Medicare and Medicaid Services. It also authorized the governor to submit a waiver aimed at identifying innovative health insurance coverage solutions. Those waivers were submitted on Monday.
“Since the passage of the Patients First Act, we have worked with subject matter experts, healthcare professionals, and stakeholders to craft Georgia-centric solutions to our state’s most pressing healthcare challenges,” said Governor Kemp. “After announcing Georgia Pathways and Georgia Access, our team traveled the state and solicited public input on our proposals to reduce the uninsured rate, enhance access to care, reduce insurance premiums, and improve health outcomes.”
The waivers would take a number of actions to increase coverage across the state. It would create a new Medicaid eligibility pathway for working Georgians, institute premiums and copayments for Georgia Pathways members with incomes between 50% and 100% of the Federal Poverty Level, incentivize healthy behaviors, create a Member Rewards Account, implement a mandatory premium assistance program for employer-sponsored insurance and eliminate retroactive Medicaid coverage and hospital presumptive eligibility for Pathways participants.
“The proposals we are submitting to our federal partners today increase the number of insured Georgians, lower the cost of health insurance for millions, and give families greater choice in which healthcare solutions best fit their needs. Moving forward, we will continue to work closely with the Trump Administration to ensure timely approval and implementation,” said Kemp. “Georgia Pathways and Georgia Access reflect our values as a state and advance our vision for a healthier Georgia. These two innovative waivers shake up the status quo and put patients first.”
It could be some time before the Trump administration responds with its approval decision on the waivers. Georgia Democrats, led by Rep. Bob Trammel (D-132 Luthersville) in the House and retiring Senate Minority Leader Steve Henson (D-41 Stone Mountain), will push once again during the legislative session for Medicaid expansion. Traction on the measure would be unlikely but Georgia could see some impact from the waivers next year, headed into election year. The results of that will either lock in or possibly upend the current healthcare strategy in Georgia.
