Georgia governor unveils Medicaid plan with work requirement

ATLANTA (AP) — Georgia Gov. Brian Kemp released a plan Monday to expand Medicaid to the state’s poorest, able-bodied adults, on the condition that they work, volunteer, receive job training or attend school.

Under Kemp’s proposal, which is more limited than other states, adults in Georgia who make up to 100 percent of the federal poverty level would qualify for Medicaid assistance if they spent at least 80 hours a month working, volunteering, training or studying. They would also have to pay monthly premiums.

The governor’s office called the reform, which requires Trump administration approval, a “conservative” approach that reflects the state’s values as a place that “honors work” and “champions individual responsibility.”

The Republican governor is pressing ahead despite legal challenges in other states. In March, a U.S. judge blocked work requirements in Arkansas and Kentucky, ruling the measures undermined the Medicaid program’s mission of providing health care for the needy. A federal appeals court sharply questioned the work requirements during a hearing on the case last month.

The Trump administration has allowed states to impose work or other requirements, but critics say many adults eligible for Medicaid face barriers to entering the workforce, including medical conditions and care-taking responsibilities. Requiring them to report their employment is not an effective way to connect them to work or volunteer opportunities and imposes additional burdens on them and state administrators, according to the Georgia Budget & Policy Institute.

Supporters argue that work can make people healthier. Nearly 20 states are in various stages of trying to implement work requirements.

Medicaid is a federal-state program that covers about 70 million people, from many newborns to severely disabled people and elderly nursing home residents. Under the Affordable Care Act, states gained the option of expanding the program to low-income adults who made up to 138 percent of the federal poverty level. The federal government would pick up 90 percent of the cost. More than 10 million people have gained coverage that way.

Georgia is one of 14 states that have not fully expanded Medicaid under the ACA. Kemp’s office said full expansion would cost Georgia taxpayers more than $1.5 billion in the first five years.

Kemp’s office plans to seek a 90 percent match from the federal government for its more limited expansion, which would cost the state $10 million in the first year. Otherwise, it would be $36 million.

Supporters of a full Medicaid expansion under the ACA estimated it would cover roughly 500,000 Georgia residents. The governor’s office envisions this expansion will cover more than 52,000 people in its fifth year.

The proposal came days after Kemp unveiled a separate proposal to reduce premiums for Georgia residents who buy health insurance under the Affordable Care Act, while giving the state control of billions of dollars in ACA subsidies. That, too, requires Trump administration approval.

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