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Georgia Republicans seriously consider Medicaid expansion [1]
['Daily Kos Staff']
Date: 2023-11-21
After a decade of stubborn, partisan resistance, Georgia Republicans are finally ready to consider providing health coverage for their 300,000 or so uninsured state residents with Medicaid expansion under the Affordable Care Act. State House members held a hearing last Thursday to hear testimony on the issue.
The legislators heard from officials in Arkansas, an early adopter of Medicaid expansion under then-Gov. Mike Beebe, a Democrat. The officials testified about the significant drop in uninsured rates after expansion and the fact that while 56 rural hospitals in the surrounding states have been forced to close in recent years, only one has closed in Arkansas. “This sounds incredibly good and sensible,” Rep. Lee Hawkins, chair of a House Health Committee, told the Arkansas officials. That’s what advocates for expansion have been arguing around the country and in Georgia for a decade now.
Georgia is among the last 10 Medicaid expansion holdout states, and ranks third from the bottom in percentage of its population that’s uninsured, with just Texas and Oklahoma doing worse. The only nondisabled adults who are eligible for Medicaid in the state are pregnant women and the relatively few people enrolled in the state’s new work-requirements program.
It’s also suffered nine rural hospital closures since 2010, as well as the closure of a major metropolitan hospital. The Atlanta Medical Center, which shut down a year ago, served a population that was roughly 70% Black and more than 15% uninsured. In states without Medicaid expansion, these hospitals provide a disproportionate level of uncompensated care and take the financial hit. Numerous studies have shown that Medicaid expansion has had a positive financial impact for hospitals, particularly smaller rural providers.
The hearing is a not so subtle recognition that Gov. Brian Kemp’s big alternative plan to Medicaid expansion—a work requirement—is failing. In the first three months, it enrolled just 1,343 people out of the 370,000 who are supposedly eligible. The program imposes requirements that force low-income Americans to work, volunteer, study, or train to become eligible for coverage, as well as paying premiums.
According to one analyst, Leah Chan at the Georgia Budget & Policy Institute, the program will cost the state five times more per person than simple Medicaid expansion because of the high administrative costs—and that’s if the estimated 100,000 people enroll in the first year of the program. "With this program, there's the added layer of not just enrollment, but monthly reporting where you have to provide some verification of your 80 hours of employment, higher education, volunteering, etc.," Chan said. "Even for people who are eligible, that act of doing that monthly reporting could keep them from being covered."
That requires a lot of staff time—and money—to verify every month. That’s how far a Republican governor will go to punish poor people. Maybe his legislature will finally decide to end the suffering.
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We talk about North Carolina non-stop on "The Downballot," so it's only natural that our guest on this week's episode is Anderson Clayton, the new chair of the state Democratic Party. Clayton made headlines when she became the youngest state party chair anywhere in the country at the age of 25, and the story of how she got there is an inspiring one. But what she's doing—and plans to do—is even more compelling. Her focus is on rebuilding the party infrastructure from the county level up, with the aim of reconnecting with rural Black voters who've too often been sidelined and making young voters feel like they have a political home. Plus: her long-term plan to win back the state Supreme Court.
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