Gover­nor sparks Med­i­caid de­bate

The Atlanta Journal-Constitution - - METRO | OBITUARIES - By Ariel Hart [email protected] and Mark Niesse [email protected]

What to do about Ge­or­gia’s thou­sands of poor adults with­out health cov­er­age sparked a wave of de­bate Fri­day, one day af­ter Gov. Brian Kemp was quoted in The At­lanta Jour­nal-Con­sti­tu­tion em­bark­ing on plans to ad­dress it.

Democrats de­cried Kemp’s plan to spend $1 mil­lion on re­search­ing and de­vel­op­ing a more con­ser­va­tive Ge­or­gia plan for Med­i­caid.

Repub­li­cans came back with a range of crit­i­cism. Some took aim at the ex­pan­sive plan that Democrats sup­port. Oth­ers seemed to ques­tion any plan at all.

“I do think there’s more we can do through in­no­va­tive so­lu­tions,” said House Speaker Pro Tem Jan Jones, a Repub­li­can from Mil­ton. How­ever, she cau­tioned, “Look very care­fully un­til we add an en­tirely new en­ti­tle­ment pro­gram that doesn’t re­ally look at the long-term fi­nan­cial im­pli­ca­tions.”

Kemp’s team met with the AJC on Thurs­day to out­line a path for deal­ing with Ge­or­gia’s poor and mid­dle-class res­i­dents who strug­gle with ac­cess to med­i­cal cov­er­age. The big­gest is­sue con­cerns some 300,000 to 600,000 child­less Ge­or­gia adults who fall in the “Med­i­caid gap,” too poor to re­ceive Oba­macare sub­si­dies and with­out health in­sur­ance. The Af­ford­able Care Act, also known as Oba­macare, as­sumed states would ex­pand Med­i­caid to cover them; Ge­or­gia did not. The state au­di­tor es­ti­mates that cov­er­ing them could cost Ge­or­gia be­tween $139 mil­lion and $213 mil­lion a year, with the fed­eral govern­ment match­ing the state spend­ing at a 9-to-1 ra­tio.

For con­ser­va­tive states, though, there’s an­other path, called a “waiver.” Those states can ask the fed­eral govern­ment to waive cer­tain rules of Med­i­caid to tai­lor a pro­gram in their own way. One waiver op­tion Ge­or­gia GOP lead­ers have floated is a work re­quire­ment. Kemp’s ad­vis­ers said their con­sul­tants will look at all op­tions, ex­cept for straight ex­pan­sion.

The idea of Med­i­caid ex­pan­sion is sup­ported by more than 70 per­cent of Ge­or­gians, ac­cord­ing to AJC polls over the years. And Democrats have used that “Med­i­caid gap” as a cud­gel in elec­tions. In her 2018 run for gover­nor, Stacey Abrams got trac­tion call­ing over and over for Med­i­caid ex­pan­sion.

In a tweet af­ter the floor ses­sion Fri­day, Abrams’ suc­ces­sor in House Dis­trict 89, state Rep. Bee Nguyen, echoed Abrams, tak­ing aim at the con­sul­tant ef­fort.

“I voted against the (state bud­get con­tin­u­a­tion bill, which con­tains the con­sul­tant fee) be­cause we don’t need to spend $1 mil­lion of Ge­or­gia tax­payer dol­lars + $1 mil­lion of fed­eral tax dol­lars on an ex­ter­nal Med­i­caid waiver con­sul­tant,” she wrote. “We can lis­ten to Ge­or­gians & ex­pand Med­i­caid now for 500,000 of our con­stituents.”

Her fel­low Demo­crat, Mi­nor­ity Leader Bob Tram­mell, waved a fi­nan­cial anal­y­sis of the Democrats’ bill propos­ing to sim­ply ex­pand Med­i­caid, House Bill 37. The eco­nomic ben­e­fits of sim­ple ex­pan­sion out­weighed any ben­e­fit of go­ing through tai­lor­ing a Ge­or­gia-spe­cific waiver, he said, a process that would burn time and money.

“We’re con­tem­plat­ing hir­ing some­one to fill out a waiver and go through a process to see who we could cover and how we could con­struct it, but Med­i­caid is an ex­ist­ing pro­gram,” he said. “Ex­pand­ing Med­i­caid is a sure, cer­tain way to cover over a half-mil­lion Ge­or­gians. It’s the fastest way to pro­vide re­lief for peo­ple who don’t have in­sur­ance who could be cov­ered un­der Med­i­caid ex­pan­sion.”

Repub­li­can state Rep. Ed Set­zler of Ac­worth ques­tioned Tram­mel on the floor and said he needed to clar­ify that Med­i­caid ex­pan­sion wouldn’t fund care for chil­dren, just work­ing-age adults.

In an in­ter­view after­ward, Set­zler said he doesn’t op­pose ex­pan­sion of the med­i­cal ben­e­fit but it should be strate­gic, as Kemp seems to be con­tem­plat­ing, not a hand­out.

“I think mak­ing it eas­ier for peo­ple and cre­at­ing per­verse in­cen­tives for peo­ple to take a free ben­e­fit, as op­posed to work­ing for bet­ter ben­e­fits and a higher pay­ing job, is mov­ing in the wrong di­rec­tion,” he said. “I think we want to cre­ate in­cen­tives for able-bod­ied adults to be as pro­duc­tive as they pos­si­bly can be and con­trib­ute as much as they pos­si­bly can. Cre­at­ing con­di­tions in which peo­ple who are em­ployed want to stay em­ployed is im­por­tant.”

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