Georgia governor's Medicaid proposal would leave hundreds of thousands uninsured

On Monday, Republican Gov. Brian Kemp announced a plan to expand Medicaid coverage to Georgia’s poorest residents — but there’s a catch. 

Kemp’s plan includes work requirements, a signature Trump administration health care policy that has been shown to be ineffective at improving health outcomes and coverage. To qualify for Medicaid under Kemp’s plan, recipients would have to spend 80 hours a month working, studying, volunteering, or receiving training, and make no more than $12,500 — the federal poverty level.

Kemp insisted that his plan would “give 408,000 Georgians the opportunity to purchase affordable health insurance.”

However, Kemp’s own aides estimate that only 50,000 of the state’s 408,000 uninsured residents will be covered under the plan.

Kemp’s “Georgia Pathways” plan strongly resembles Indiana’s Medicaid expansion, which former Gov. Mike Pence signed into law. Indiana’s plan failed to provide coverage to the state’s most vulnerable residents, and, like Georgia Pathways, mandated monthly payments to private health companies.

Kemp insisted Monday that Medicaid — a program created in 1965 to provide health care for disabled and impoverished Americans — should not be a “free handout.” 

“Hardworking Georgians who qualify will have skin in the game,” Kemp said. “It is a path forward toward higher earnings, better opportunities and a healthier future.”

Proponents of Medicaid work requirements often claim they make people healthier and reduce poverty.

But a recent study of Medicaid work requirements in New Hampshire and Arkansas confirmed what other studies have found: Work requirements don’t have a measurable effect on poverty, don’t improve health outcomes, can lead to sick people getting sicker, and can force struggling households deeper into poverty. They’re especially harmful for Americans with mental illness, according to the Center for Budget and Policy Priorities.

And because recipients are required to provide monthly updates of their employment and disability status, eligible people can easily lose their coverage if they fail to report their job or disabilities.

Monthly reporting requirements are also incredibly expensive. The nonpartisan General Accounting Office found that Kentucky’s plan to track Medicaid recipients’ work hours would have cost $270 million if federal courts hadn’t struck the program down. 

However, studies do find one constant: Work requirements reduce the total number of people on Medicaid.

Even the person responsible for approving work requirements in nine states, Center for Medicare and Medicaid Services Administrator Seema Verma, had trouble providing evidence supporting the policy.

During an October House Energy and Commerce committee hearing, Rep. Joe Kennedy (D-MA) asked Verma if she could cite a single study supporting the Republican claim that they make people healthier. Verma instead claimed to have seen “many studies that talk about how employment has a positive impact on health outcomes.”

Asked to provide a single study that says work requirements are good policy, Verma dodged, saying she had “spoken to many people living on the Medicaid program living in poverty, and none of those individuals want to stay where they are.”

Kemp’s announcement comes after a spate of federal court rulings that struck down Medicaid work requirements in states like Kentucky, Arkansas, and New Hampshire. It has not yet received approval from the Trump administration.

Published with permission of The American Independent Foundation.