Partisan sparring follows rejection of Georgia Medicaid plan

The Biden administration's decision to revoke approval of Georgia's plan to require Medicaid recipients to meet a work requirement was jeered by top Republicans in the state but welcomed by Democrats as an opportunity for a bigger expansion of the health care program.

U.S. Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said Thursday that implementing the work requirement during the ongoing coronavirus pandemic would "only work to hinder the overall well-being of low-income Georgians." The work provision was part of the state's plan — dubbed "Georgia Pathways" — to make more low-income Georgians eligible for Medicaid.

"Considering the physical, mental, social and economic toll the public health emergency has taken on individuals, CMS believes it is especially important that the low-income individuals who are the intended beneficiaries of the Georgia Pathways to Coverage demonstration be able to access coverage and care without the initial and continued eligibility obstacle of a work requirement that may be unreasonably difficult or impossible for individuals to meet under the circumstances of COVID-19 and its likely aftermath," she wrote in a letter to Georgia Department of Community Health Commissioner Caylee Noggle.

The work requirement had been approved by the Trump administration. CMS revoked it and Georgia's plan to charge some Medicaid recipients monthly premiums for their health coverage.

Gov. Brian Kemp's office in a statement Thursday accused the White House of attempting to "hide behind the holiday" by announcing the revocation two days before Christmas. It said it planned to challenge the decision in court.

Georgia House Speaker David Ralston, a fellow Republican, said it is "shameful that President Biden has denied thousands of Georgians health care coverage." 

"Like the Grinch, he has stolen hope away from so many families who need it — right at Christmas," Ralston said on Twitter.

Republicans had presented Georgia's plan as a financially 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.

Democrats in Georgia said the state should fully expand Medicaid.

"What's shameful is blaming Biden and others for @GaRepublicans ongoing failure and refusal to expand Medicaid," Democratic State Rep. Sam Park said on Twitter.

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.

The Democratic Party of Georgia called Kemp a "Grinch," saying a full Medicaid expansion would cover 500,000 people in the state.

"Brian Kemp and Georgia Republicans — who have the power to fully expand Medicaid right now — are entirely responsible for denying health care coverage to thousands of Georgians," Democratic Party of Georgia spokeswoman Rebecca Galanti said in a statement.

The Biden administration is separately reviewing Georgia's plan to overhaul how state residents buy health insurance under the Affordable Care Act. That plan — under which Georgia residents would bypass healthcare.gov and shop for federally subsidized health insurance through private agents — was also approved by the Trump administration.