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An analysis of Georgia’s Section 1115 Medicaid Pathways to Coverage program
An analysis of Georgia’s Section 1115 Medicaid Pathways to Coverage program
- Collection:
- Health Policy and Services Research
- Author(s):
- Gardner, Allexa, author
Alker, Joan, author
Cuello, Leo, author - Contributor(s):
- Georgetown University. Center for Children and Families, issuing body.
- Publication:
- [Washington, DC] : Georgetown University Health Policy Institute, Center for Children and Families, June 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Government Programs
Medicaid -- legislation & jurisprudence
Medicaid -- organization & administration
Medically Uninsured
Program Evaluation
Georgia - Genre(s):
- Technical Report
- Abstract:
- Georgia’s Pathways program is a limited Medicaid expansion, offering the possibility of coverage to parents and childless adults with incomes below the poverty line who meet work reporting requirements and, in some cases, pay a premium. Georgia currently covers parents up to 31 percent of the federal poverty line (no more than $642 a month for a family of three); adults with income above that but below the poverty line do not qualify for federally subsidized coverage in the Marketplace and thus fall into a coverage gap - as do all adults without dependent children in Georgia with incomes below the poverty line. The partial expansion is authorized through a section 1115 demonstration; full expansion would cover adults below 138 percent of the federal poverty line and would not require a Section 1115 waiver. To become eligible and retain health coverage, individuals must successfully report at least 80 hours of work or other qualifying activities each month. Additionally, individuals with incomes at or above 50 percent FPL will have to pay an initial premium to be enrolled in coverage and then pay monthly premiums to retain coverage. Premium amounts range from about 1 to 1.5 percent of household income. The Pathways program also includes federal waivers allowing the state to eliminate the following for people enrolled through the Pathways partial expansion: (1) Non-emergency medical transportation for most enrollees; (2) 90-day retroactive coverage; (3)Wrap-around benefits for individuals receiving employer-sponsored insurance; and (4) Hospital presumptive eligibility coverage.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (9 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918697352906676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918697352906676