Fighting COVID-19 in Georgia With Medicaid and New Funding

The first cases of novel coronavirus (COVID-19) in Georgia were reported on March 3, 2020, and the number of people with the virus continues to rise statewide and across the nation. Efforts are underway to help slow the spread of the virus and increase health system capacity for testing and treatment.

President Trump declared a national emergency on March 13, and Governor Kemp declared the state’s first public health emergency on March 14. The General Assembly indefinitely suspended the regular legislative session on March 13 and convened for a special session on March 16 to approve the governor’s public health emergency declaration.

Furthermore, Governor Kemp instructed the General Assembly to increase the Governor’s Emergency Fund by $100 million in the amended fiscal year 2020 budget—using funds from the state’s reserve fund.

The state has taken several other actions thus far in response to the COVID-19 outbreak in Georgia:

  • March 9: The commissioner of insurance urged health insurers to waive cost-sharing for COVID-19 testing and allow for in-network rates in cases where an out-of-network provider is the only option.
  • March 13: The state announced that 20 temporary housing units are being built in Monroe County as quarantine space for people who test positive for COVID-19 and are unable to self-isolate.
  • March 16: Governor Kemp and the Georgia Health Care Association issued a joint statement urging long-term care facilities to limit visitation.

With these declarations, new state funding and creative efforts, Georgia has additional resources and powers to fight the COVID-19 epidemic, all of which can work in tandem with existing programs like Medicaid to help mitigate economic disruption and save lives.

Medicaid Options

Medicaid and PeachCare currently cover two million people—or about one out of every five Georgians. Medicaid is a state and federal partnership, meaning in emergencies where the state needs to spend more on health care, the federal government contributes more money to help. The federal government pays for 67 percent of the state’s Medicaid costs. The U.S. House of Representatives passed the Families First Coronavirus Response Act of 2020 that would increase this federal match by 6.2 percentage points, resulting in about $700 million in new federal funds for Georgia.[1]

Medicaid and PeachCare already provide benefits to help with the emergency response, such as telehealth coverage and laboratory testing. Medicaid can be leveraged to extend testing and treatment for COVID-19. Moreover, premium payments for PeachCare enrollees can be waived to reduce costs for patients in this emergency period.

In response to COVID-19, the state can also take advantage of Medicaid’s flexibility by:

  • Streamlining enrollment
  • Extending coverage
  • Implementing new state plan amendments and/or seeking new federal waivers

Streamlining enrollment can be accomplished by expanding presumptive and retroactive eligibility for faster Medicaid enrollment at hospitals, allowing enrollees to self-attest their eligibility and delaying the annual renewal process to ensure continuous coverage.[2] This will become even more critical as people face losing income or employment due to the closures and other disruptions as a growing number of people may become eligible for Medicaid and will need to be quickly enrolled in coverage.

Extending coverage will help the state have a broader reach with its virus-fighting efforts and enhanced federal support to do so, helping it save the lives of some of Georgia’s most vulnerable:

  • Adults with chronic illnesses and Georgians over 60: These are individuals who are not old enough to qualify for Medicare and are generally not able to enroll in Medicaid in Georgia because the state did not adopt the expansion for low-income adults. These groups have a higher risk of complications if they are infected with COVID-19 and need coverage options to pay for any needed treatment. The fastest way to cover these Georgians is to expand Medicaid eligibility to 138 percent of the poverty line, or $17,000 a year for an individual and $29,000 a year for a family of three, through a state plan amendment and accepting the 90 percent federal match.
  • Lawfully residing pregnant women and children: The state can remove the five-year waiting period to help get them covered sooner.

Implementing new state plan amendments and/or seeking new federal waivers will also help state officials fight COVID-19. The national emergency declaration allows the state to apply for a Section 1135 waiver. This waiver would allow the authority to make changes such as waiving requirements for providers to participate in Medicaid, waiving prior authorization requirements to deliver services more quickly or allowing services to be provided in alternative settings.[3]

In addition to the above, the state should also consider 1915 (c) waivers for home- and community-based services and 1115 waivers. Home- and community-based services waivers can be used to allow payments for services provided by family caregivers, add COVID-19 related services to the list of services covered, pay for home delivery meals and increase the number of people served by these waivers.

The state is currently awaiting approval for an 1115 waiver that would partially expand Medicaid coverage starting July 2021 and would require enrollees to report work hours monthly. The state should revise this waiver or submit a new waiver to begin coverage sooner and remove the work requirements that are especially harmful as people face job losses during this emergency response.

New funding options

The $100 million appropriated from the state reserves in the amended 2020 budget is set aside to be matched with federal funds and for other state spending. Most of this funding can be used for implementing the new Medicaid options outlined above and matched with federal Medicaid dollars. The rest of these funds should be directed to the Department of Public Health (DPH) in its testing and monitoring efforts and to hospitals to increase capacity and purchase items like respirators, ventilators and personal protective equipment.

The amended 2020 budget also included a $5 million increase in rural hospitalization grants that can help hospitals with equipment and other needs as they implement their emergency preparedness plans. The governor’s public health emergency grants him new powers such as providing temporary licenses to providers, compelling health care facilities to provide services for emergency response and directing DPH to coordinate the state’s response.

The Department of Public Health is also expected to receive $14.8 million from the Centers for Disease Control and Prevention as part of the funding the federal agency received through the $8.3 billion emergency supplemental funding signed by President Trump on March 6.


[1] Sullivan, J. (2020 March, 12). Medicaid funding boost for states can’t wait. Center on Budget and Policy Priorities.]

[2] Medicaid and CHIP (MAC) Learning Collaboratives. (2018 August, 20). Disaster Preparedness Toolkit for State Medicaid Agencies. (pp. 7-10)

[3] Medicaid and CHIP (MAC) Learning Collaboratives. (2018 August, 20). Disaster Preparedness Toolkit for State Medicaid Agencies. (pp. 7-10)

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