When Should An 1115 Medicaid Expansion Experiment be Approved? Considering The Case Of Georgia Pathways

Document Type

Article

Publication Date

4-11-2022

ISSN

1544-5208

Publisher

Project HOPE

Language

en-US

Abstract

Historically, demonstration waivers have been used to expand eligibility, improve delivery, increase benefits, and otherwise improve the Medicaid program. The waivers granted during the Trump administration were a departure from both Republican and Democratic administrations’ determinations as to the merits of state waiver proposals. Georgia’s proposed demonstration, known as Georgia Pathways, merited especially close scrutiny: a Medicaid “expansion” for low-income adults in name only, with exclusionary conditions on enrollment and coverage already proven to cause major harm when attempted in other states. In addition to the legal issues raised, the Georgia case raises deeper policy questions about when the Department of Health and Human Services (HHS) should use its considerable section 1115 powers.

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