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Medicaid

Health Law and Policy

Emory University School of Law

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Clearing The Path: Improving Implementation Of Georgia’S Pathways To Coverage Program, Nicholas Smith Apr 2024

Clearing The Path: Improving Implementation Of Georgia’S Pathways To Coverage Program, Nicholas Smith

Emory Law Journal Online

Georgia’s Medicaid program is in flux. The State recently launched Pathways to Coverage, a partial Medicaid expansion program for non-disabled adults in households under 100% of the Federal Poverty Line, with eligibility contingent on reporting 80 hours of work per month. Pathways’ rollout coincides with Medicaid “unwinding,” an ongoing post-COVID redetermination process in which thousands of Georgians have already lost coverage. As such, Pathways could play an important role in offsetting the unwinding’s disenrollment effects. But Pathways may also serve as a test case for conservative lawmakers hoping to institute (or reinstitute) work requirements to restrict Medicaid coverage in their …


Section 1115 Waivers: Innovation Through Experimentation, Or Stagnation Through Routine?, Nicole Johnson Jan 2023

Section 1115 Waivers: Innovation Through Experimentation, Or Stagnation Through Routine?, Nicole Johnson

Emory Law Journal

The Medicaid program operates as a federal-state partnership, in which the states agree to meet certain federally mandated requirements in exchange for federal matching funds for program expenditures. These federal matching funds can be anywhere from 50–90% of health care expenses incurred through state Medicaid programs. As such, states have a substantial interest in continuing this partnership and ensuring that their state plans comply with federal requirements. There is a way, though, in which states can gain more freedom in building their individual state plans. Through section 1115 waivers, states can ask the Centers for Medicare and Medicaid Services (“CMS”) …