Georgia governor proposes modest increase in Medicaid spending; critics say it’s not near enough
By Maggie Lee
Georgia Gov. Brian Kemp today announced a plan to extend public health care assistance to what the administration thinks would max out at about 50,000 poorer Georgians at a time.
For Kemp’s team, it’s ideally a short-term assist that would boost folks into the kind of jobs that come with health care benefits. For critics, it’s a plan that leaves too many people out.
“One of the problems that we have for hard-working Georgians as they’re trying to get ahead, is they’ll get moving, they’ll make more money, they get kicked off [of means-tested benefits] or they have an emergency and it sets them back and they’re like, ‘You know, this isn’t worth it,’” said Kemp on Monday.
“We’re creating a pathway where it is worth it, where they can make fundamental change in their lives and their careers and that’s going to be good for them and good for the state,” Kemp said.
By the Kemp team’s math, there are about 400,000 Georgians from the ages 19 to 64 who don’t have health insurance and are below the poverty line, which is about $17,000 per year for a two-person household.
His plan would extend federal Medicaid dollars plus state money to subsidize health insurance for folks in that group who are working or volunteering for 20 hours a week or are in school or professional training.
In its first year, the administration thinks about 25,000 people would enroll, and maximum enrollment would be about 50,000 in a few years.
The state price tag over five years would come to about $250 million, according to administration officials.
As soon as Kemp finished his announcement, critics were already gathered outside the Capitol. Tafia Smith Butler, executive director of the Georgia Budget and Policy Institute, called Kemp’s Medicaid idea plus a proposal on the private insurance market from last week together a dismal future for health care access.
She said the new Medicaid policy covers too few people, it won’t take full advantage of federal matching funds, and that things like work requirements are a barrier to access.
“Fully expanding Medicaid to the extent permitted under the current federal law remains the best moral and economic case and option for the state of Georgia,” Butler said. She was referring to the Affordable Care Act, under which the federal government pays 90% of Medicaid costs in states that expand that health insurance to people with incomes that are 38% above the poverty line.
GBPI estimates full Medicaid expansion would cover about 567,000 uninsured adults who are at 138% or below poverty-line income. It would cost the state $320 million annually.
Work requirements have also run into court challenges in other states, though the Kemp administration is confident this system will pass legal muster.
The debate around the state Capitol on Monday mirrors the one in February, when the Republican-controlled Legislature granted Kemp the power to go to the federal government an ask for some kind of change to Medicaid.
Basically points of view are unchanged: Republicans say full Medicaid expansion is way too expensive, though some modest tweaks are good ideas. And Democrats say full expansion is quite doable given the federal match and will be simpler and cover more people than small changes.
But before any changes are made to either Medicaid or the private insurance market in Georgia, the federal government needs to approve the ideas, which are technically called “waivers” from federal rules.
Kemp’s office is planning six public comment sessions around the state on the Medicaid plan and the associated plan on the private insurance market. None are in Fulton, DeKalb or Gwinnett.
Details on each waiver and a site to submit public comment, via the Georgia Department of Community Health.