Timeline
This timeline chronicles major developments in Georgia's health care "waiver" plans. One plan would make changes to Georgia's Medicaid program and the other would change private health insurance for Georgians.
December 7, 2023
Medicaid
The Georgia Department of Community Health (DCH) hosted a forum to allow for public comment on the implementation progress of Georgia Pathways. The forum focused on how Georgia residents feel about the increased access of coverage that is available through the new Medicaid eligibility category.
July 1, 2023
Medicaid
Georgia Pathways is officially launched. The program is intended to close the health coverage cap through providing a new Medicaid eligibility category. State officials stated that the program should increase coverage eligibility to between 31,000-100,000 Georgia residents. While the program provides coverage to some low-income adults, the rules and requirements leave many Georgia residents left out. Read GHF's latest blog post on what you should know about Pathways to Coverage.
November 29, 2022
Medicaid
CMS did not appeal the district court’s decision. Therefore, Governor Brian Kemp announces the state will begin implementing its work-for-Medicaid program, Georgia Pathways, in July 2023. The partial Medicaid expansion will require low-income individuals to work, study or volunteer for at least 80 hours per month to qualify for Medicaid coverage, and verify the hours each month.
August 19, 2022
Medicaid
A district court in Brunswick, Georgia ruled that the federal government’s ruling for rolling back work and premium payment requirements was unlawful. The district court judge stated that blocking its implementation prevents increased coverage from happening. Georgia now has the option to immediately implement the waiver with the original work requirements and premium payments CMS also has the ability to appeal the district court’s decision to the 11th circuit appeals court.
August 9, 2022
Private insurance
The Centers for Medicaid and Medicare Services officially suspended the 1332 waiver, which the state planned to implement by November 2022. The suspension applies only to the second part of Georgia’s approved waiver, known as the Georgia Access Model. (The first part of Georgia’s waiver, for a state-based reinsurance program that began in the 2022 plan year, is unaffected.)
June 1, 2022
Private insurance
Georgia held a public hearing to accept public comments on the implementation and progress of the 1332 waiver. The only part of the waiver that is currently active is the reinsurance program.
April 29, 2022
Private insurance
The Department of Health and Human Services (HHS) and the Department of the Treasury informed Georgia that the 1332 waiver was at risk of being suspended. The April 29 letter comes after HHS and Treasury repeatedly asked Georgia to provide updated data to demonstrate the impact of the waiver in light of coverage gains and financial incentives included in the American Rescue Plan Act. Georgia has until July 28, 2022 to submit a corrective action plan that explains how state officials will bring the waiver into compliance with federal statutory requirements. If Georgia fails to provide this information, HHS and Treasury will suspend this portion of the waiver and Georgians would continue to enroll in marketplace coverage through HealthCare.gov. Alternatively, Georgia can formally challenge this determination.
January 22, 2022
Medicaid
Governor Kemp filed a lawsuit against The Centers for Medicare and Medicaid Services for rolling back previous approval of the work requirements and mandatory premium contributions included in the original waiver submission.
December 23, 2021
Medicaid
The Centers for Medicare and Medicaid Services (CMS) approve Georgia's 1115 waiver. However, CMS does NOT approve the work requirements and premiums included in the initial waiver submission. This approval means that Georgia can expand Medicaid to all adults making up to 100% of the Federal Poverty Level, but may not implement work requirements or collect premiums as a part of the expansion.
November 9, 2021
Private insurance
Citing recent changes to federal law and policies, The Centers for Medicare and Medicaid Services (CMS) opens another public comment period for the 1332 waiver. The comment period will last 60 days and end on January 9th, 2022.
July 30, 2021
Private insurance
The Centers for Medicare and Medicaid Services (CMS) responds to Georgia's letter refusing to submit the requested data. CMS tells the state that they have until August 29th to submit the requested data or they will review the waiver without the new data. CMS tells the state that if the waiver is found not to meet the 1332 waiver requirements, they will take "appropriate actions."
July 2, 2021
Private insurance
Georgia sends a response letter to the Centers for Medicare and Medicaid Services (CMS) but does not include the requested data. Georgia officials ask for a meeting to discuss CMS's request for Georgia to submit additional data on how the 1332 waiver will impact enrollment, given the recent coverage gains. In the letter, they argue the request does not meet the Specific Terms and Conditions (STCs) agreed upon in the initial waiver approval by the Trump Administration.
June 3, 2021
Private insurance
The US Departments of Health & Human Services and Treasury send a joint letter to Governor Kemp asking for a new analysis of the 1332 private insurance waiver and how separating from healthcare.gov will impact Georgia consumers. Georgia must respond by July 3, 2021.
March 11, 2021
Medicaid
President Biden signs into law the American Rescue Plan (ARP) Act of 2021 (H.R. 1319). The ARP includes a number of key provisions that strengthen both public and private health insurance coverage.
One of the ARP's provisions provides a significant, additional financial incentive for states like Georgia that have not expanded Medicaid to low-income adults. States that newly expand Medicaid receive an additional five percentage point increase in their regular federal Medicaid matching rate (FMAP) for two years, no matter when they newly expand. The new incentive would be a financial windfall for Georgia.
February 12, 2021
Medicaid
The federal Centers for Medicare & Medicaid Services (CMS) sends a letter to the Georgia Department of Community Health stating that it has “serious concerns’’ about the state’s 1115 Medicaid plan. CMS changes the status of the Medicaid waiver plan from "approved" to "pending".
2021
November 1, 2020
Private insurance
CMS announces approval of Georgia’s Section 1332 private insurance waiver. The approved waiver includes both a reinsurance program and the Georgia Access model which would separate Georgia consumers from healthcare.gov.
October 15, 2020
Medicaid
Cover Georgia partners hold a press briefing in response to the announcement.
October 9, 2020
Private Insurance
Georgia made modest changes to the proposal following the federal public comment period. Georgia submits the revised 1332 private insurance waiver proposal to federal officials on October 9, 2020.
September 1, 2020
Private Insurance
The Brookings Institute and the Center on Budget & Policy Priorities release respective reports about the expected impacts of the revised 1332 waiver proposals on Georgia consumers.
August 17 to September 23, 2020
Private Insurance
Federal officials provide a 30-day public comment period for the revised 1332 private insurance waiver. The public comment period is extended for an additional week, to September 23rd, because of a technical problem that some commenters encountered when they submitted their comments.
Almost 1800 comments were submitted to federal officials during this time.
August 17, 2020
Private Insurance
Federal officials determine that Georgia’s revised 1332 private insurance proposal is complete.
July 9 to July 23, 2020
Private Insurance
Georgia provides only 15 days of public comment on the revised waiver application.
July 9 to July 23, 2020
Private Insurance
Georgia provides only 15 days of public comment on the revised waiver application.
July 9, 2020
Private Insurance
Governor Kemp announces revisions to the second part of his 1332 private insurance waiver plan. The updated proposal does not include some of the most harmful provisions included in the original draft but still proposes to eliminate healthcare.gov for Georgia consumers and move to a privatized, decentralized health insurance enrollment system.
May 12, 2020
Medicaid
Georgians for a Healthy Future publishes an analysis of all comments submitted about the 1115 Medicaid waiver during the two comment periods. Nine out of 10 commenters opposed the Governor's proposal and many expressed their support for Medicaid expansion.
February 7, 2020
Medicaid
The federal public comment period for the Medicaid 1115 waiver, Georgia Pathways, ends with 1720 comments submitted.
February 6, 2020
Private Insurance
Federal officials respond to Gov. Kemp’s letter with a decision that the reinsurance part of Georgia’s proposal is complete. The officials also request more information about the second part of the 1332 private insurance waiver plan (which would make changes to private health insurance plans and enrollment).
February 5, 2020
Private Insurance
Gov. Kemp sends a letter to CMS asking to pause the preliminary review of the "Georgia Access" part of the waiver. The letter requests that CMS continue their review of the reinsurance program only.
January 8, 2020
Medicaid
Federal officials at CMS determine Georgia’s Medicaid waiver application is complete. The federal public comment period begins during which any interested person or group can provide comments about the plan.
2020
December 23, 2019
Private Insurance
Georgia submits the Georgia Access 1332 State Relief and Empowerment Waiver to the Departments of Health & Human Services and Treasury.
December 23, 2019
Medicaid
Georgia submits the Georgia Pathways 1115 Demonstration Waiver to the Centers for Medicare & Medicaid Services.
December 7, 2019
Medicaid
State officials make very few changes to the Medicaid 1115 waiver after the submission of nearly 1,000 comments. Changes included modifications to work requirements to include part-time students.
November 4 to December 3, 2019
Medicaid • Private Insurance
Georgia begins accepting public comments about both proposed waiver plans. The state's public comment period lasted for 30 days, ending on December 3, 2019.
November 4, 2019
Medicaid
Governor Kemp announces details of his proposed 1115 Medicaid waiver, called the Georgia Pathways plan. This plan would allow Georgians with incomes below the poverty line to enroll in coverage. Georgians would only be able to enroll if they can prove they are working, going to school, in a job training program, or volunteering at least 80 hours per month. The plan would also require poor adults to pay premiums, among other harmful provisions.
October 31, 2019
Private Insurance
Governor Kemp announces the specifics of his proposed 1332 private insurance waiver, called the Georgia Access plan. The plan consists of two parts:
- A reinsurance program to lower premiums; and
- A dramatic erosion of the ACA’s rules and structures, including provisions that cut ties with healthcare.gov; privatize insurance enrollment; cap the financial assistance available to low- and middle-income consumers; and erode fundamental consumer protections in private insurance.
June 3, 2019
Medicaid • Private Insurance
The state picks Deloitte Consulting as the winner of an almost $2 million consulting contract to develop health care "waivers" for Georgia’s Medicaid program and the private insurance market.
March 27, 2019
Medicaid • Private Insurance
Georgia’s Governor signs SB 106 into law. This legislation allows the state to pursue an 1115 waiver to make changes to Georgia’s Medicaid program that could include expanding Medicaid coverage to more poor adults and a 1332 state innovation waiver to make changes to private insurance in the state.
March 25, 2019
Medicaid • Private Insurance
After a long debate on the House floor, the Georgia House passes SB 106 with no changes largely along party lines.
March 21, 2019
Medicaid • Private Insurance
The House Special Committee on Access to Quality Health Care holds a hearing on SB 106. Several Cover Georgia coalition members testify about the need for changes in the bill. The bill passes out of committee with no changes.
March 21, 2019
Medicaid • Private Insurance
The House Special Committee on Access to Quality Health Care holds a hearing on SB 106, the Patients First Act. Several Cover Georgia coalition members testify and emphasize the need for changes in the bill. The bill passes out of committee with no changes and awaits a vote to move to the House floor.
February 26, 2019
Medicaid • Private Insurance
After a long debate on the Senate floor, the Georgia Senate passes SB 106 with no changes by a party-line vote.
February 20, 2019
Medicaid • Private Insurance
The Senate Health and Human Services (HHS) committee meets to hear testimony on and consider SB 106. Senate Minority Leader Steve Henson offers an amendment to the bill that would allow the governor to extend Medicaid coverage to people just above the poverty line, as intended by the ACA, but the amendment was not considered. The bill passes out of committee with no changes.
February 13, 2019
Medicaid • Private Insurance
Senator Blake Tillery introduces SB 106, the Patients First Act. The legislation allows Georgia’s Governor to:
- Pursue an 1115 Medicaid waiverthat may extend Medicaid coverage to adults with incomes up to the poverty line. (This falls short of the ACA’s Medicaid expansion.)
- Pursue at least one 1332 Innovation waiver to make changes to private insurance in Georgia. The legislation does not limit what changes may be made within the waiver plan
February 7, 2019
Medicaid • Private Insurance
Governor Kemp announces his intent to seek two health care “waivers.” The 1115 Medicaid waiver allows states to make changes to their Medicaid programs, including expansions of coverage for state residents. The 1332 Innovation waiver allows states to make changes to private insurance by altering the Affordable Care Act’s rules.
January 2019
Medicaid • Private Insurance
Governor Kemp submits his first budget recommendations which includes $1 million for the Department of Community Health “to review and analyze Medicaid waiver options” for consideration by the Governor’s office. This waiver could include a pathway to health coverage for low-income Georgians.
2019