ATLANTA — An influential business group is presenting three ways Georgia could expand health care coverage under Medicaid to poor adults, hoping to win over Republican lawmakers long resistant to the idea.
Georgia Chamber of Commerce President Chris Clark called the options released Wednesday a “kick start” for conversations with Gov. Nathan Deal and legislators.
“Any of these plans would serve as a game-ready playbook for lawmakers seeking a fiscally responsible and sustainable path to cover Georgia’s uninsured, revitalize a rural health care network in crisis and undergird our safety net hospitals,” Clark said.
The options all require approval from the federal Centers for Medicare & Medicaid Services. The strategy, called a Section 1115 waiver, has been used in other conservative states where officials refused the full Medicaid expansion offered under the Affordable Care Act but crafted alternatives that still covered more people.
The General Assembly returns to the Capitol in January, and health care is expected to dominate the 2017 session. The Chamber’s involvement and some key Republicans’ willingness to reconsider expansion have some advocates hopeful about overcoming years of resistance from GOP leadership.
One of the chamber’s options extends Medicaid to adults without children and who are making less than the federal poverty level, $11,700. That proposal wouldn’t cover people making up to 138 percent of the poverty level, a key benchmark for federal officials when evaluating other waivers.
The other options include coverage for adults making 138 percent of the poverty level, totaling $16,242 annually. In one plan, everyone is covered by Medicaid. The other option requires those making more than the poverty level to find private insurance coverage through marketplaces created by the health care law rather than being covered by Medicaid.
All three options suggest Georgia require recipients to pay something for insurance premiums and expand work requirements statewide for people receiving food assistance, sweeteners for conservative lawmakers who hold legislative majorities.
Adam Sweat, a spokesman for Lt. Gov. Casey Cagle, said Cagle is interested in “conservative proposals” that increase access to care. House Speaker David Ralston, a Republican from Blue Ridge, said the options “will add to ongoing conversations on how to mitigate the continuing fallout from Obamacare in our health care system.”
“While we are committed to maintaining access to quality, affordable health care in Georgia, we must recognize that there is no easy – or cheap – solution available,” Ralston said.
Deal, a Republican, has long argued that expanded Medicaid coverage is too costly. Lawmakers added another hurdle with a 2014 state law requiring their approval for any significant Medicaid changes. Deal told The Associated Press in June that he’s “always willing to discuss” options.
Wednesday’s report doesn’t the cost or number of people covered by each model. Chamber officials said more details will be released before the end of the year.
Georgia Democrats have pushed unsuccessfully to expand Medicaid. Rep. Stacey Abrams, House minority leader, said the chamber’s report demonstrates the harm of continued delays.
“While the details matter, Democrats are pleased by the thoughtful work evidenced by this report, and we look forward to a robust debate about how and when we move forward to accept the billions in investment available to our state,” Abrams said.