September 14, 2016 1:02 PM
Although the number of people in Georgia without health insurance fell between 2014 and 2015, the Peach State still has the country’s third highest uninsured rate at 13.9 percent. This is somewhat higher than the 9.1 percent national rate. The 13.9 percent uninsured rate comes outs to nearly 1.4 million Georgians, which accounts for about 4.8 percent of the 29 million Americans lacking insurance. By comparison, Georgia has about 3.1 percent of the country’s overall population.
One contributing factor to Georgia’s relatively high rate of uninsured people (and don’t be fooled, there are many factors) is the state’s failure to expand Medicaid. Expansion of government-provided health insurance for people with lower-incomes was a major plank of the Affordable Care Act, which had the primary policy goal of reducing the number of Americans without health insurance. As passed, the law required states to expand Medicaid (with the federal government covering the costs for the first several years) to persons whose incomes reached 138 percent of the federal poverty line. However, the Supreme Court later struck down that provision and made expansion voluntary.
Georgia’s leaders, along with many other Republican governors and legislatures, have refused to expand Medicaid thus far, citing the long-term costs to the state. Federal data show that the 31 states which have expanded Medicaid (including two southern states, Arkansas and Kentucky) generally have lower rates of uninsured people.
The Georgia Chamber of Commerce recently assembled a task force to look at more “conservative” ways to expand Medicaid á la Mike Pence’s $1 premiums in Indiana. They released a few policy options including expanding coverage for childless adults who are trapped in the coverage gap between traditional Medicaid and credits for the ACA exchanges, allowing Medicaid to pay for private insurance plans, and enrolling all beneficiaries earning up to 138 percent of the federal poverty line in Medicaid. Rep. Jason Spencer (R-Woodbine) quickly jumped on the task force plans as expensive and risky. Gov. Deal’s office noted that they appreciated the effort, but made clear that he wanted the General Assembly to be in charge of the policy formation.
If Medicaid expansion does happen in the upcoming session of the General Assembly, it will likely start in the Senate. Senate Health and Human Services Committee Chairwoman Renee Unterman (R-Buford) has previously stated that she wants to “re-examine” Medicaid expansion. Senator Fran Millar (R-Dunwoody), one of the GOP Senate Caucus’s more moderate members, said last session that he believes it is “inevitable” that Georgia will expand Medicaid.
Medicaid expansion will be a bitter pill for many Republicans to swallow as they have spent much of the past six years railing against the “big-government” takeover by the Obama administration. Embracing a major component of his signature legislative achievement will require a good bit of humility (and explanation to angry constituents).