Today, the Centers for Medicare & Medicaid Services (CMS) approved a temporary extension and amendment of the “Georgia Pathways to Coverage” section 1115 demonstration. Approval of this temporary extension and amendment will extend Georgia’s authority to expand Medicaid coverage to demonstration beneficiaries. The state retains existing authorities to extend full state plan Medicaid coverage to low-income adults ages 19 through 64 who meet the qualifying activities requirement as a condition of initial and continued eligibility, as well as to maintain the state’s Employer Sponsored Insurance (ESI) assistance program. CMS is also approving the state’s request to broaden the allowable qualifying activities under the demonstration, as well as to decrease the frequency of required beneficiary reporting to expand compliance opportunities and decrease the administrative burden for beneficiaries. Per the state’s request, this amendment does not continue the state’s prior authorities to require premium payments, tobacco surcharges, or modified copayments for demonstration beneficiaries, none of which the state has implemented to date.
This demonstration is effective through December 31, 2026. Today’s approval and other administrative documents can be found on the Medicaid.gov demonstration page.
