Kemp's Medicaid Expansion Fails Low-Income Georgians

Georgia Gov. Brian Kemp proposed legislation to bolster Georgians’ access to health care through a bill that would give him the executive ability to partially expand Medicaid. Georgia Republicans have spearheaded the campaign to enact the Patients First Act, which gives low-income Georgians access to more affordable health care. The partial expansion is a step in the right direction to ensure the most vulnerable people in the state receive health care coverage.

But the bill is a half-hearted attempt to solve the health care crisis and fails to take advantage of federal funds already set aside for state Medicaid programs.

The proposal falls short in guaranteeing health care for Georgians who need it most. Georgia House Democrats unanimously oppose the bill for a reason: full Medicaid expansion is the smarter choice. Stacey Abrams, the 2018 Democratic Georgia gubernatorial candidate, has called the Republican proposal a “pale facsimile” of a plan which gives Kemp significant power in deciding how Medicaid will operate and who will ultimately benefit from the bill — a dangerous model considering Kemp strove to disenfranchise poor and minority voters to win the 2018 election. Without full Medicaid expansion, Georgia is also losing out on billions of dollars in potential federal funding and has to pay more money to cover fewer people; since Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010, the federal government will match state spending nine-to-one for states which have fully expanded Medicaid. Georgia is one of only 14 states in the country not taking advantage of that money, a result of fierce opposition by Georgia Republican lawmakers.

The scope of the expansion is also limited by Kemp’s proposed waiver structure, which would prevent people who are slightly above the poverty line from receiving Medicaid. It would also allow people who use the Affordable Care Act exchange market to buy private health insurance, competition which can drive up prices for Medicaid. Kemp’s law departs from convention as it would only allow people who fall below the poverty line to receive benefits, while states that have fully expanded Medicaid allow anyone who falls within a margin of the poverty line to also receive benefits. Few would argue a person with an annual income of $13,000 — only slightly above the poverty line for adults under 65 — doesn’t deserve to be covered by Medicaid. This method also incentivizes people to fall below the line to receive benefits.

Medicaid expansion is politically popular in Georgia, as 71 percent of registered Georgia voters polled by the University of Georgia said they supported expansion. But it’s questionable whether Kemp’s law would satisfy voters. The bill’s failure to expand Medicaid beyond the poverty line limits its ability to resolve Georgia’s rural health care crisis. In addition, the law is being proposed amid a national conversation that strongly favors more drastic overhauls to the American health care system. A staggering 70 percent of Americans, including a majority of Republicans, Democrats and Independents support a single-payer “Medicare for all” system. Such a system would abolish private health insurance, which would be replaced by a single provider managed by the federal government and paid for by taxes.

Kemp’s proposed Medicaid expansion would benefit some Georgians but would do little to alleviate wider frustrations for those who would still be required to purchase private insurance. America spends twice as much on health care than almost all other developed countries while achieving similar or worse health outcomes, according to a 2018 study from Harvard University (Mass.). Though we cannot expect that Kemp will jump on an Obamacare-esque bandwagon anytime soon, Americans are longing for more than Kemp’s partial Medicaid expansion.

Although Kemp and Georgia House Republicans have offered a serviceable proposal to partially expand Medicaid in the state, they should follow the lead of the 36 states which have already fully expanded Medicaid.