On November 4, 2019, Georgia officials announced a proposed Section 1115 demonstration waiver, referred to as the “Georgia Pathways Health Waiver,” to expand Georgia’s Medicaid program eligibility for non-disabled adults. If approved by HHS, Georgia’s Medicaid coverage under the Georgia Pathways Health Waiver would be expanded from its current threshold of 35 percent of the federal poverty line to 100 percent of the federal poverty line. The waiver would fall short of the full expansion to 138 percent of the federal poverty line established by the Affordable Care Act. The Georgia Pathways Health Waiver would require non-disabled, non-pregnant adult beneficiaries to work, volunteer in the community, or pursue education or training for at least 80 hours per month to qualify for coverage. Beneficiaries must also pay premiums ranging from $7 to $11 per month, with an additional surcharge of $3 to $5 per month for tobacco users.

Although HHS has approved Section 1115 waiver applications with work requirements similar to those included in Georgia Pathways Health Waiver, the U.S. District Court for the District of Columbia has blocked enforcement of the work requirements in Arkansas, Kentucky, and New Hampshire, and those decisions, available here, here, and here, are pending appeal at the U.S. Court of Appeals for the District of Columbia Circuit. Other states have suspended their work requirements because of the pending litigation. A decision from the D.C. Circuit is expected soon for the pending Kentucky and Arkansas appeals.