U.S. Health Secretary questions Georgia’s Trump-approved Medicaid plan

Health and Human Services Secretary Xavier Becerra says he hopes to soon wrap up the federal review of the governor’s health care plans even as state officials again push back the launch of Georgia’s slight expansion of Medicaid.

Becerra participated in a series of panel discussions Monday during a visit to the Atlanta area, including one on access to health care that was dominated by a discussion on Medicaid expansion. Georgia is one of a dozen GOP-led states that have not fully expanded Medicaid under the Affordable Care Act.

The Biden administration has objected to parts of Gov. Brian Kemp’s health care plans, including a proposed requirement that participants complete enough work or activity hours to keep Medicaid coverage through a strategy that would expand access to about 50,000 people.

Approved under the Trump administration, Kemp’s plan to slightly expand Medicaid has been under review since February. The Centers for Medicare and Medicaid is housed within Becerra’s agency.

“We’d like to work as quickly as possible because we know there are people in Georgia who are going without care, and we would like to make sure that we give the state as quick as a response as we can,” he told reporters Monday gathered at Southside Medical Center near downtown Atlanta.

Kemp’s Medicaid plan was originally set for implementation on July 1 but was delayed until “at least” Aug. 1. Caylee Noggle, the state’s new governor-appointed commissioner of the Department of Community Health, recently informed federal officials that the program would be pushed back further.

“At this time, we anticipate that delay extending to the end of the calendar year as we assess options and opportunities to resolve concerns … and to find a mutually agreeable path forward to increase access to health care for Georgia’s most vulnerable populations,” Noggle wrote in a July 27 letter.

Becerra said his job is to ensure the federal money that would go back to the state is “well spent.”

“Are you offering more care at a better price to more people? That’s what we want to get out of any kind of waiver that we give to a state,” he said.

He also continued to voice concerns about work requirements like the one Georgia officials are proposing, which ties coverage to whether a participant satisfies 80 hours of work, school or other qualifying activity every month. The Biden administration has already revoked previously approved work rules in two states, New Hampshire and Arkansas.

“We don’t want work to become an impediment to getting your care,” Becerra said.

The secretary’s ongoing negotiations with state officials happen as members of Georgia’s congressional delegation – including some who sat alongside Becerra Monday – press for a federal Medicaid look-alike program meant to step around Republican state officials who oppose expansion.

This is after Congress included new financial incentives in the spring’s coronavirus relief package for holdout states like Georgia. Those sweeteners have found no takers among GOP state officials. In Georgia, the state could potentially reap a $710 million profit and cover about a half million people if it expanded Medicaid fully.

Congresswoman Carolyn Bourdeaux, who is sponsoring a version of the proposal, said Monday she was drafting a letter to House leadership urging the inclusion of a work-around plan – hers or another version – in the upcoming reconciliation package. Sen. Raphael Warnock is pushing the same measure in the Senate.

 “We’re not wedded to any particular path,” the Suwanee Democrat said Monday. “We just want people covered.”

The Biden administration also stalled parts of a second Kemp plan that would bypass healthcare.gov and send consumers directly to insurance companies or brokers. The governor has defended the plan.

“There what we simply want to do is make sure that we offer the same standards, that there’s no race to the bottom in what providers offer to patients in Georgia. We don’t want Georgians to get a worse plan with less protections,” Becerra said. “We simply want to make sure that what people are getting is good coverage and they’re not getting some junk plan at the end of the day that doesn’t give them any real protection and service.”