Everyday People Matter


| Jul 13, 2018 | Medicaid/SSI

Matt Bevin, Governor of Kentucky, announced his plans to require all Kentucky residents who receive Medicaid to meet work requirements.  Following that decision, the ACLU filed a constitutional law suit.  However, shortly after the Governor’s announcements, a federal judge struck the regulations down, stating that they were “arbitrary and capricious”.

This issue is very important to many Americans.  In April 2018, 67.3 million people  were covered by Medicaid—making it the single largest source of health coverage in the United States. Mandatory eligibility groups for Medicaid  include low-income families, qualified pregnant woman and children, and individuals receiving Supplemental Security Income (SSI).

In Georgia, the basic eligibility criteria for Medicaid requires you to be living in a low-income household. This varies based on the number of people in a household and whether the household includes medically needy parents and children under age 19. The 2018 chart breaking down the maximum income level to be eligible for Medicaid can be found here.     In addition to meeting the financial limits, applicants in Georgia must also meet one of the following descriptions in order to be eligible for Medicaid:

  • You think you are pregnant.
  • You are a child or teenager under age 19.
  • You are legally blind.
  • You have a disability.
  • You need nursing home care.

There are additional situations that may make you eligible for Medicaid including if you:

  • are leaving Temporary Assistance for Needy Families (TANF) and need health coverage.
  • have a family with children under 19 with very low or no income.
  • are earning an income higher than the limits and you have medical bills you owe (and you are pregnant, under 18 or over 65, blind, or disabled.)
  • are a child in foster care or adopted

The Medicaid work requirement is unlikely to affect in significant numbers the portion of people who receive Medicaid and are eligible to work.  Ninety-four percent of the Medicaid recipients are either already working or are exempt due to disability, school or care-giving responsibilities.  Out of the 6% of the national population who are not working and covered by Medicaid, 2% are retired, 2% are unable to find work, while only 1% are not working for some other reason.   Work requirement laws attached to Medicaid may cause some beneficiaries to lose coverage due to stringent reporting requirements.  Most people losing Medicaid coverage would likely become uninsured due to limited affordable coverage for low-income individuals. This would be especially problematic for the many adults on Medicaid who will be unable to treat for severe and chronic medical problems and who require life-saving prescriptions.  States are also likely to need to spend more money with this law due to having to hire additional staff to implement the new requirement–making it highly questionable whether this law is an effective use of tax dollars. This policy is likely to disproportionately hurt older adults, people with disabilities, and caregivers who are likely to face challenges meeting exemptions or navigating exemption policies. As of January 2018, nine other states—not including Georgia–have submitted Medicaid waiver proposals to the Center for Medicare and Medicaid Services (CMS), showing how important of an issue these work requirements have become.

These are issues to discuss with your elected state representatives and to analyze with candidates in the upcoming elections.  If you have any questions about Medicaid coverage, please contact this law firm.