Gov. Brian Kemp on Thursday introduced a health-care reform plan after the White House approved waivers to expand Medicaid coverage for Georgians.

The plan will expand coverage to adults with incomes up to 100% of the federal poverty level, which is set to $12,760 for individuals, so long as they meet requirements of working 80 hours per month in a qualifying activity, which include employment, training, education, and volunteering.

Kemp had sought waivers from the federal government to expand Medicaid coverage for uninsured Georgians under The Patients First Act, which the Legislature adopted in 2019. On Thursday, Kemp called a news conference to announce that the White House had approved two of the waivers he had sought.

The first waiver expanded the coverage to those at the poverty level. The second, aimed at serving uninsured Georgians who make too much to qualify for Medicaid but too little to receive insurance premium subsidies through the Affordable Care Act, is to be signed in the coming days.

“Georgia Pathways and Access will provide access to healthcare insurance for thousands of hardworking Georgians and lower premiums for millions more,” said Kemp. “This bold, innovative approach will lower the uninsured rate, spur competition in the marketplace, enhance the shopping experience for consumers, and improve health outcomes.”

In Douglas County, the U.S. Census’s website reports that approximately 14.9% of residents under the age of 65 are without health insurance.

Using data from 2017, Douglas County had a rate of 14% of uninsured individuals under 65-years-old, or 17,901, according to countyhealthrankings.org, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

Healthcare.gov, the Affordable Care Act’s enrollment website, will be blocked under the second waiver, and multiple enrollment portals from the state will be offered instead. Kemp said that since 2016, enrollment through the ACA portal declined by 22%, citing its difficulties.

Kemp also announced that Georgia would be launching a statewide reinsurance program that he said would empower the private sector and subsequently lower costs.

Georgia Senate Majority Leader Mike Dugan, R-Carrollton, praised the governor’s plan, saying that it would help “hundreds of thousands, if not millions,” of Georgia residents.

“You’ve heard me say this before, but with your health care and health care coverage, you had the choice between accessibility, affordability, or quality,” said Dugan, whose Senate district covers the western half of Douglas County. “You shouldn’t pick one, you should have all three. Because of the cost-effectiveness of what we’re doing, now you don’t have to choose. You can have all three. That’s what we’ve been looking for is to provide healthcare coverage to all Georgians, not just those that can most afford it.”

Kemp’s plan drew criticism from health policy experts and Democrats who say the governor is exaggerating the cost and leaving uninsured Georgians worse off by failing to fully expand Medicaid as 39 other states have done. Georgia has one of the highest uninsured rates in the country. Democrats have also argued Medicaid expansion is even more needed during the COVID-19 pandemic.

The American Heart Association and 17 other prominent nonprofits criticized the limited Medicaid expansion’s requirements, saying they effectively reduce access to health care and that the announcement’s timing isn’t good.

“This action would be problematic at any time,” the group said. “But it’s truly beyond comprehension that — in the midst of pandemic and recession — the federal government and Georgia are teaming up to reduce low-income residents’ access to health care.”

The state’s own fiscal analysts determined that when savings from reduced state expenses after Medicaid expansion are factored in, the annual cost to the state budget is closer to $200 million, said Laura Harker, senior policy analyst with the Georgia Budget and Policy Institute.

“It’s not as expensive as the governor has stated, to move forward with the full Medicaid expansion, and then compare it to the plans that are proposed,” Harker said. “Those plans, he said, would cost about $200 million. So you’re looking at a comparable level there as far as cost, but not covering nearly as many people.”

Kemp said he anticipated criticism of his plan from fans of healthcare.gov and proponents of a full Medicaid expansion, but he said securing the waiver represents a first step in solving the state’s health care crisis. Many of Georgia’s rural hospitals are struggling to stay open and several have closed across Georgia in recent years.

“I know that some will complain that this reform package doesn’t fix every health care problem or concern that we have in our state, and that is absolutely true, but this plan is no doubt a big first step on a long journey to ensure a safe and healthy future for all Georgians,” he said. “Doing nothing, quite honestly, was not an option.”

Sentinel Managing Editor Ron Daniel, Times-Georgian Staff Writer Michael O’Hearn and Capitol Beat News Service and Georgia Recorder contributed reporting for this article.