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CMS Takes Steps to Protect Georgians from Harmful Effects of
Work
Requirements and Premiums in the Medicaid Program
The Centers for Medicare &
Medicaid Services (CMS) announced that Georgia will no longer have
authority to require work activities as a condition of Medicaid
eligibility, or charge premiums beyond those allowed under the Medicaid
statute, in its Georgia Pathways to Coverage demonstration. The decision,
conveyed in a letter sent to the state today, supports the Biden-Harris
Administration’s efforts to reduce health disparities while ensuring access
to comprehensive, affordable, person-centered care.
In light of the ongoing disruptions caused by the COVID-19 pandemic,
Georgia’s work requirements significantly compromise the state
demonstration’s effectiveness in promoting coverage for intended
beneficiaries. The lingering health consequences of COVID-19 infections
further exacerbate the harms of these barriers to coverage for people with
low income. Additionally, premiums can present a particular barrier to
coverage. They can result in limited access to health care coverage for
underserved communities, especially Black and low-income individuals
compared to White and higher income peers.
Georgia had previously received section 1115 authority to charge premiums
beyond those allowed under the Medicaid statute as a condition of eligibility
for some individuals to receive demonstration coverage, but had not begun
to implement the demonstration, including charging beneficiaries premiums
under such authority. In the letter sent today, CMS notified the state that
this authority, in addition to work requirements authority, is rescinded.
For additional information, including details on approved portions of the
demonstration and other specific terms and conditions, consult Georgia’s
state waiver overview page on Medicaid.gov.
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