Report sets stage for Georgia’s health care debate

ATLANTA — A state-funded report released Thursday underscores the challenges that Gov. Brian Kemp faces in crafting a plan to provide more health care coverage to uninsured Georgians without expanding Medicaid, which he has long opposed.

The report by consulting giant Deloitte found that an estimated 1.5 million residents lack health insurance and that Georgia trails other states, even those that also have not expanded Medicaid, in covering lowincome residents.

The consultants didn’t include any policy recommendations, but Kemp aides cast it as a road map leading to how Georgia could pursue “waivers” from President Donald Trump’s administration that could allow the state to seek more federal funding.

“This is the Bible moving forward that we’re going to reference,” said Ryan Loke, a health care adviser to Kemp.

It jump-started a political debate over how to better provide coverage for the estimated 15% of the state’s population who lack health insurance, including a disproportionately high number of minorities and young adults.

The findings also stoked new calls to expand Medicaid, which provides coverage for workingage adults who earn up to 138% of the federal poverty line. It found about 666,000 Georgians fit in that category — higher than some previous estimates.

State Rep. Scott Holcomb, D-Atlanta, called it “yet another wake-up call to policy makers” to expand the program.

“For those who advocate waivers, they have their work cut out for them,” he said. “They must demonstrate how waivers will improve outcomes at less cost than full expansion.”

And the report could prod politicians to explore new ways to provide new incentives to smaller businesses to provide coverage to their employees. It showed that 60% of uninsured Georgians over the age of 16 currently have jobs.

A group of lawmakers, health officials and Kemp aides met Thursday to discuss the report, which includes these findings:

› Georgia’s uninsured rate in 2017 was 14.8% compared with 10.5% nationally. The uninsured rate in some counties, particularly in rural areas, soared above 30%.

› An estimated 28.5% of the population below the poverty line is uninsured — 478,000 people. That rate is higher than the national average of 20% in states that have expanded Medicaid and 26% in states that have not. Another 190,000 uninsured adults make less than 138% of the poverty line.

› Roughly 27% of young adults, aged 19-34, are uninsured. That’s the second-highest uninsured rate for that age bracket in the nation. And 8% of children don’t have insurance coverage, above the national average of 5%.

› Minorities are more likely to be uninsured than white residents. About one-third of Hispanic residents and 15% of African Americans have no health coverage, compared to 12% of whites.

› Over one-third of the uninsured population in Georgia is concentrated in five metro Atlanta counties: Clayton, Cobb, DeKalb, Fulton and Gwinnett.

› Seven rural hospitals have closed in Georgia since 2010, the third-highest rate of closures in the nation behind Texas and Tennessee. Another 26 of the state’s remaining 63 rural hospitals are at risk of closure.