HealthFILE - Georgia Gov. Brian Kemp, left, and Centers for Medicare and Medicaid Services Administrator Seema Verma, right, sign healthcare waivers at the state Capitol in Atlanta, Oct. 15, 2020. Pathways to Coverage launched last July and is the only Medicaid plan in the country that requires beneficiaries to work or engage in other activities to get coverage. As of June, it had about 4,300 members.
Georgia Pathways requires all recipients to show that they performed at least 80 hours of work, volunteer activity, schooling or vocational rehabilitation each month. It also limits coverage to able-bodied adults earning no more than the federal poverty line, which is $15,060 for a single person and $31,200 for a family of four.
The Centers for Medicare & Medicaid Services twice rejected the request to extend Pathways, saying the state had failed to meet requirements for an extension request, including a public notice and comment period. Georgia argued that it was seeking to amend the program, so those requirements should not apply.