Senator Unterman Contemplates Medicaid Expansion in Georgia

Senator Renee Unterman of Buford has touched on a sensitive subject for Georgia Republicans. The chairman of the Senate’s Health and Human Services committee told WABE News that she thinks it’s time to look into expanding Medicaid in Georgia, albeit with a few caveats.

Under the ACA, the federal government expanded Medicaid coverage to all Americans under 65 years old whose income falls between 100 percent and 138 percent of the federal poverty level. That means the threshold for eligibility is about $16,400 for an individual in 2016, according to the National Conference of State Legislatures.

But some Republican-majority states, like Arkansas, Montana and Indiana, have accomplished the same expansion through a different program, called a 1115 Waiver. The program essentially allows the states to extend coverage on its own terms.

It’s the latter that Unterman says the state needs to consider. She pointed to Arkansas, which uses Medicaid dollars to buy private insurance for the poor on the federal insurance exchange.

Unterman’s concern appears to be financial. Georgia is spending almost 22% of its state budget dollars on healthcare. With federal contributions, that amount rises to almost 38%, although that spending funds much more than Medicaid. Unterman refers to a health care crisis that is highlighted by the number of rural hospitals that have closed or are facing closure, however the additional Medicaid dollars received through expansion will primarily benefit urban hospitals like Grady in Atlanta. Rural hospital funding is a separate issue.

Will Unterman’s proposal find support in the General Assembly dominated by Republicans?

Delegates at the Republican convention in Augusta this past weekend hope not. They approved a resolution opposing any form of Medicaid expansion, including the type of alternative “Arkansas model” Part 1115 waiver solutions that Unterman wants to look into. The resolution declares “That the Georgia Republican Party asks that all Republican Legislators in the Georgia General Assembly to cease pursuing all efforts to expand Medicaid under Obamacare through any federal waivers;” and that legislators should “aggressively oppose any expansionary form of Medicaid pursuant to the Affordable Care Act (Obamacare) in the State of Georgia.”