Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | HENRY HERALD

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | HENRY HERALD

The federal Centers for Medicare & Medicaid Services (CMS) could decide in a matter of weeks whether it will remove the work or activity requirement in Georgia’s partial Medicaid expansion plan.

The CMS said the plan, which was approved by former President Donald Trump’s administration in October, does not “promote the objectives of the Medicaid program” and would be impossible to accomplish because of the COVID-19 pandemic…

In a statement released Friday, the nonprofit Georgia Center for Opportunity (GCO) said CMS’ decision could lead to court battles, leaving the thousands of Georgians who stand to get coverage under the program in a lurch.

“Instead of using our resources and time to bicker before the courts, we should apply them to seek out the best ways to improve people’s lives,” said Erik Randolph, GCO’s director of research. “[Georgia Pathways] is based on the idea of helping adults escape poverty, plain and simple. It will propel them into situations where they have better opportunities and more resources for health coverage, such as through affordable individual markets or employed-based coverage.”

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

The federal Centers for Medicare & Medicaid Services (CMS) could decide in a matter of weeks whether it will remove the work or activity requirement in Georgia’s partial Medicaid expansion plan.

The CMS said the plan, which was approved by former President Donald Trump’s administration in October, does not “promote the objectives of the Medicaid program” and would be impossible to accomplish because of the COVID-19 pandemic…

In a statement released Friday, the nonprofit Georgia Center for Opportunity (GCO) said CMS’ decision could lead to court battles, leaving the thousands of Georgians who stand to get coverage under the program in a lurch.

“Instead of using our resources and time to bicker before the courts, we should apply them to seek out the best ways to improve people’s lives,” said Erik Randolph, GCO’s director of research. “[Georgia Pathways] is based on the idea of helping adults escape poverty, plain and simple. It will propel them into situations where they have better opportunities and more resources for health coverage, such as through affordable individual markets or employed-based coverage.”

Let’s Take Politics Out of Healthcare

Let’s Take Politics Out of Healthcare

Let’s Take Politics Out of Healthcare

healthcare politics

The federal government’s surprise move against Georgia

In a raw political move, the Centers for Medicaid & Medicare Services (CMS) removed the approval of Georgia’s Pathways to Coverage, labeling the program as “pending.” 

Despite the fact that the COVID-19 vaccine rollout is consuming the resources and attention of the Governor’s office and the Department of Community Health, CMS gave Georgia only 30 days to respond before the federal government might eviscerate the program. In its February 12 letter, CMS targeted the program’s work or other community engagement components and also threatened “review” of other provisions of the program. 

This move by the new administration in Washington, D.C., appears to be unprecedented. Finally secured last fall, the approval was part of an administrative process, which included time for public comments, that took years to develop. 

Pathways to Coverage serves non-disabled adults below the poverty line. It is a critical component of Georgia’s plan to reduce the number of uninsured and make healthcare coverage more affordable, without sacrificing quality of care or causing other serious drawbacks associated with a traditional Medicaid expansion. It is based on the idea of not keeping these adults below the poverty line but moving them above it. 

The Success Sequence provides an outline of how to reverse the cycle of poverty in our communities. GCO uses this as a framework for much of our work.

Let’s focus on helping people instead

Pathways to Coverage is really about helping people. Readers might want to check out my prior blog on this program as well as some of our published research on fixing the healthcare system.

The so-called Affordable Care Act (ACA) has caused havoc for Georgians when it comes to healthcare coverage and costs. The rate of healthcare price increases did not abate but accelerated. As we reported before, our own data analysis confirmed other research by showing that for individual markets, “Georgians suffered average price increases of 70.7% for Bronze plans, 77.3% for Silver plans, and 70.4% for Gold plans” over five years.

We also found that prior to the ACA, the median cost for a health insurance plan on the individual market for a family of four was $5,386 per year. But within six years, the cost varied from $17,550 to $26,081, depending on the level of the plan. 

The bulk of Georgia’s uninsured problem lies not below the poverty line, but above it. Therefore, Pathways to Coverage necessarily links to Georgia’s Reinsurance Program designed to drive down costs in the individual markets. The test of the demonstration project will be to see how well Georgia can move people out of poverty into situations where they have better opportunities and more resources for health coverage, such as coverage through affordable individual markets or, better yet, employer-based coverage. 

America has one of the world’s best and most innovative healthcare systems, if you have insurance to afford it. By far, employer-based and private insurance provides the best coverage. Medicaid has among the worst healthcare outcomes, can trap families in poverty (as we and others have demonstrated), and can be an obstacle in moving to the much-better private coverage. Incentivizing people to improve their circumstances is an important strategy that this demonstration project hopes to prove. 

The Spirit of the Law

The new administration in Washington might feel like they are doing the right thing by attempting to strongarm states like Georgia into Medicaid expansion. However, this action raises concerns. 

First, the question of whether the federal government can mandate states to expand Medicaid was already settled in the negative by a seven-to-two U.S. Supreme Court ruling. Second, removing a critical component of this demonstration project will not likely accomplish expansion but, if followed through, will compromise the effectiveness of the project. Third, it goes against the whole purpose of demonstration projects. 

Pathways to Coverage is an approved—and hopefully remains so—Section 1115 waiver to Medicaid rules, which is found in the Social Security Act. In enacting this section of the law, Congress acknowledged that a one-size-fits-all approach dictated by the federal government is not always the best way to solve our public policy challenges. 

Congress acknowledged this principle again when it enacted Section 1332 of the Affordable Care Act that allows states to come up with alternative plans in coordination with Section 1115 waivers. Georgia took advantage of both these provisions of law in developing its healthcare strategy. 

Finally, demonstration projects allow states to experiment with what works best. Without experimentation, we hinder our ability to discover better ways to run public programs for the benefit of people. 

What’s next

The best overall resolution would be for CMS to reinstate the approval and allow the demonstration to move forward. CMS will monitor the project, of course, but it must let it play out to see if the project will demonstrate a better way. Georgia has a vested interest in making it work. If not, Georgia could choose to modify or abandon the project. Besides, the federal government will have the opportunity to review the results when the waiver comes up for renewal.

Failure to reinstate the approval will likely result in a legal struggle before the courts. Who knows how long such a legal process will take? Instead of using our resources and time to bicker before the courts, we should apply them to seek out the best ways to improve people’s lives. 

*Erik Randolph is Director of Research at the Georgia Center for Opportunity. This blog reflects his opinion and not necessarily that of the Georgia Center for Opportunity.

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

City Of Lawrenceville, Gwinnett County And Impact46 Partner To Fund Lawrenceville Response Center | PATCH LAWRENCEVILLE

City Of Lawrenceville, Gwinnett County And Impact46 Partner To Fund Lawrenceville Response Center | PATCH LAWRENCEVILLE

The City of Lawrenceville and Gwinnett County partner with Impact46 to provide $525,000 in funding for the Lawrenceville Response Center (LRC). The Lawrenceville City Council unanimously finalized support at a special called meeting on Wednesday, February 10. Gwinnett County will secure their support for the project through the C.A.R.E.S. Act…

Clock ticks as feds threaten to remove work requirement from Georgia’s partial Medicaid expansion | CENTER SQUARE

Lawrenceville organization gets money for coronavirus help | AJC

Lawrenceville organization gets money for coronavirus help | AJC

A Gwinnett County resource to help residents struggling through the coronavirus pandemic just got a boost in funding.

The Lawrenceville Response Center, which opened last April, this month received more than half a million dollars in additional funding, including money from the city and the county…

Is it time for voting rights reform for felons?

Is it time for voting rights reform for felons?

Is it time for voting rights reform for felons?

prisoners listening

Coming off the contentious 2020 election, the issue of voting rights has been in the news lately. That is likely why, this year, there is a renewed push among some lawmakers in the Georgia legislature to reform voting-rights laws for those convicted of a felony.

This issue is central to our mission here at the Georgia Center for Opportunity (GCO). For well over a decade now, GCO has advocated for criminal justice reforms that help returning citizens create a new life—through joining the workforce, caring for their loved ones, and becoming productive members of society once again. Voting rights are part of that.

Here’s where Georgia law currently stands: Those with a felony on their record automatically have their voting rights restored once they complete their sentence, which includes serving all parole and probationary periods and paying all outstanding fines, fees, and restitution. They are also eligible to vote if they have First Offender status and that status has not been revoked.

“Just coming out of incarceration period, you feel like you have no opportunity. You feel like there are no options. I don’t have any options.”  

 

Understanding the challenge of voting rights for felons

The goal of voting rights laws for those with a criminal record should be moving them in the quickest way possible to becoming positive, contributing members of society again. Once the individual has fully paid his or her debt to society, it makes perfect sense—and is in the best sense “just”—to reinstate their voting rights.

At the same time, there are good reasons for restricting felons from voting until the end of their sentences. Society has an obligation to prevent people who have demonstrated impaired ability to make good decisions from voting. That’s why we don’t let children or the mentally ill vote. 

Felons have an added strike against them in that, in addition to poor judgment, they’ve also—in many cases—expressed contempt and disregard for the laws that govern us and shouldn’t be allowed to impose laws on the rest of us until they have shown their respect for and willingness to abide by the law.

 

A good place to begin

So, where should we begin with reforms to voting rights for felons? A great place is also the simplest and most non-controversial: There is strong evidence that even some felons who have fully paid their debt to society face challenges in having their voting rights restored.

For example, in 2019 a representative from the Georgia Justice Project testified before a state Senate committee that there is frequently misinformation within voter registration offices, and sometimes among volunteers, about whether someone ever convicted of a felony can vote. There are also challenges with felons proving they are officially “off paper” (i.e., they have completed their probation or parole) and are now legally eligible to vote.

Let’s begin here with clearing up misunderstandings around the law on voting rights for returning citizens and ensuring that all election-related officials are applying it correctly. A big step would be for election officials to be required to accept Certificates of Sentence Completion from the Department of Community Supervision as sufficient proof that a returning citizen should be added back to the voter rolls.

 

Work is important, too

A central goal of the Georgia Center for Opportunity is to help returning citizens reintegrate into society. Voting rights is one aspect of reintegration, but there are others—like finding stable employment—that are far more important to improving outcomes for returning citizens. 

We know that work is a key way to reduce recidivism: Research has shown that if an ex-offender can keep a job for six months or more, their likelihood of ending up back in prison drops dramatically. It also improves the odds that a returning citizen will reconnect with loved ones, especially their children, another key to preventing recidivism.

GCO’s efforts through initiatives like Hiring Well, Doing Good are making progress here, and stories like Kevin’s are inspiring.