Key Point: “Georgia’s experiences portend what’s to come if work requirements are imposed nationally … The resident of Dalton, Georgia, went back to school for a master’s degree to become a nurse practitioner but cannot afford to earn enough credit hours to qualify for Pathways to Coverage, Georgia’s expanded Medicaid program. … Belinda Sherley, a 44-year-old resident of rural Quitman, Georgia, said she can’t work because she cares for her husband, who has severe agoraphobia and anxiety … But when she tried to get Medicaid, she was told there would be no exceptions.”

Washington Post: As Republicans weigh Medicaid work requirements, Georgia offers a warning

By Fenit Nirappil

• Georgia’s experiences portend what’s to come if work requirements are imposed nationally, Medicaid researchers said.

• “It’s going to be creating this administrative bureaucracy and devastating amount of poor people who, despite being eligible, are going to lose coverage so that Congress can fund tax cuts for the wealthiest,” said MaryBeth Musumeci, an associate professor of health policy and management at George Washington University’s Milken Institute School of Public Health.

• Medicaid advocates say work requirements are unnecessary because most recipients already work — often in low-wage or informal settings with no health insurance. Of the 26 million working-age adults who used Medicaid in 2023, 64 percent had jobs, according to KFF, a health policy organization.

• Of the remaining 36 percent, 8 percent don’t work because they are retired, cannot find jobs or have some other reason. Most others don’t work because they are caring for a relative, have a disability or are in school.

• “It’s not really this huge population of young, able-bodied adults who just aren’t working, are sitting at home and want Medicaid,” said Cynthia Gibson, a health law specialist at Georgia Legal Services Program, which assists residents seeking Medicaid.

• Heather Payne, a 52-year-old former travel nurse who stopped working after suffering strokes, said she’s been caught in a bind trying to get back into the workforce while addressing medical expenses from her recovery.

• The resident of Dalton, Georgia, went back to school for a master’s degree to become a nurse practitioner but cannot afford to earn enough credit hours to qualify for Pathways to Coverage, Georgia’s expanded Medicaid program. The degree offers only nine credit hours per semester; the state requires at least 11.5.

• Because students must be insured, Payne has been forced to use a school insurance plan with limited coverage and high co-pays.

• “It feels like I tripped and fell, and I picked myself back up and I started trying to walk and someone is sticking out their foot and trying to trip me again,” said Payne, who was a guest of Sen. Raphael G. Warnock (D-Georgia) at President Joe Biden’s State of the Union address last year.

• An independent evaluator hired to scrutinize Georgia’s program found that older adults (ages 50 to 64) were more likely to be ineligible for Medicaid under the work requirements and recommended exempting them. The report also recommended exempting family caregivers.

• Belinda Sherley, a 44-year-old resident of rural Quitman, Georgia, said she can’t work because she cares for her husband, who has severe agoraphobia and anxiety. She received federal food benefits after submitting a letter from her husband’s doctor confirming her account. But when she tried to get Medicaid, she was told there would be no exceptions.

• She wants to be on Medicaid so she can see a gynecologic specialist and receive Ozempic for her diabetes. Instead, she relies on a local clinic without a specialist that charges about $25 on a sliding scale for basic care. That’s still a lot of money when the couple’s sole source of income is less than $1,000 a month from her husband’s disability payments.

• “Work requirements are great if you’re able to work,” Sherley said. “I’m falling through the cracks.”