Georgia Dems Renew Push for Full Medicaid Expansion

Dave Williams

Friday, October 27th, 2023

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Democratic legislative leaders renewed their call for Gov. Brian Kemp to fully expand Medicaid coverage in Georgia Wednesday, citing a report last week that few Georgians have enrolled in the governor’s limited Medicaid expansion program.

The state Department of Community Health had predicted Kemp’s Pathways to Coverage program would eventually serve up to 345,000 uninsured Georgians, including an estimated 100,000 during its first year. But nearly four months after the program was launched, only about 1,300 have signed up for coverage.

“Governor Kemp’s Pathways is failing Georgia,” state Senate Minority Leader Gloria Butler, D-Stone Mountain, said during a news conference across from the state Capitol. “Pathways doesn’t cover enough Georgians, and for those it does cover, it takes too long.”

Democrats in the General Assembly have pushed for full Medicaid expansion for more than a decade, since a U.S. Supreme Court decision on the Affordable Care Act prohibited the federal government from requiring states to do so. Since then, 40 states have opted to fully expand Medicaid, including some led by Republican governors.

Georgia House Minority Whip Sam Park, D-Lawrenceville, said a key obstacle holding up the Pathways to Coverage program is a requirement that enrollees participate in at least 80 hours per month of “qualifying” activities, including work, education, job training, or community service. Georgia is the only state that enforces such a requirement for Medicaid eligibility, he said.

“It’s a bureaucracy you have to overcome that has the effect of limiting access,” Park said.

A full Medicaid expansion would cover enrollees with household incomes up to 138% of the federal poverty level – 30,000 a year for a family of four. Under Pathways to Coverage, only enrollees with incomes up to 100% of the poverty level are covered.

Butler said the 90-cents-on-the dollar match the federal government provides to states that fully expand Medicaid would cover up to 500,000 Georgians, create 50,000 jobs, provide $6 billion in annual economic impact, and allow financially struggling rural hospitals to stay open.

“We’ve already lost nine rural hospitals in the last several years,” she said. “Think of all the hospitals that could still be open, the jobs that could be created, and the lives that would have been saved,” she said.

Kemp opposes full Medicaid expansion, arguing such a program would not be sustainable in the long term because there’s no guarantee the feds would continue to keep the money flowing, which could leave states holding the bag.

Park doesn’t buy that argument.

“The speculation that the federal government would pull the rug out in 40 states is highly unlikely,” he said.

Park and Butler introduced Medicaid expansion bills into their respective legislative chambers this year. While neither measure gained any traction in the Republican-controlled legislature, the two Democrats expressed optimism that the dismal enrollment numbers for Georgia Pathways might convince Republicans they need to change course.

“I don’t think it’s fixable,” Park said of the Pathways program. “A little humility goes a long way.”