https://mailchi.mp/7f59f737680b/the-weekly-gist-june-30-2023?e=d1e747d2d8

On July 1st, Georgia will launch its Pathways to Coverage program, which partially expands its Medicaid program to enroll individuals with incomes up to 100 percent of the federal poverty line (FPL), but only if they demonstrate at least 80 hours a month of work, education, job training, or community service. 

This expansion is only projected to extend Medicaid coverage to an additional 50K state residents, far short of the 400K that full Medicaid expansion (without work requirements, to individuals earning up to138 percent of the FPL) would have covered. Georgia’s plan was approved by the Trump administration in 2020, but the Biden administration rescinded its waiver prior to implementation. Georgia then sued the Biden administration, and a Federal District Court sided with the state, allowing the partial expansion with work requirements to proceed. The Biden administration chose not to appeal. 

The Gist: Though Georgia’s implementation is more limited in scope compared with other states which are currently pursuing Medicaid work requirements, Georgia sets a precedent to motivate those states that are looking to pursue similar strategies. 

Research has shown that most adults on Medicaid who do not face barriers to work are already working, and that the cost of systems to monitor beneficiary work status likely offsets any savings in reduced Medicaid spending. 

The burden of having to report work status is onerous for potential Medicaid enrollees, discouraging some from seeking coverage altogether.