Advocacy in Action: Moves Toward Medicaid Changes Made in Georgia

On Feb. 13, 2019, the Patients First Act (SB 106) was introduced in the Georgia Senate, with the support of Gov. Brian Kemp, Lt. Gov. Geoff Duncan, Speaker David Ralston, and a number of others. This legislation would allow Gov. Kemp to seek two kinds of health waivers for Georgia.

The first, a 1115 Waiver, would close the coverage gap for those with incomes up to the federal poverty level, which is about $12,000 in 2019. The other, a 1332 Waiver, could impact those who access the Affordable Care Act’s (ACA) marketplace for insurance. This waiver would allow the state of Georgia to set up a fund to keep those ACA plans from drastically raising premiums.

The 1115 Waiver was established under the Social Security Act in the 1960s and allows the Secretary of Health and Human Services (HHS) to approve experimental pilot or demonstration projects that would improve care, increase efficiency and reduce costs associated with Medicaid and the Children’s Health Insurance Program (CHIP). 1332 Waivers allow states to apply for a State Innovation Waiver (now also referred to as a State Relief and Empowerment Waiver) to pursue innovative strategies for providing their residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA.

Currently, 38 states have approved 1115 Waivers and seven states have approved 1332 Waivers.