Speak up to keep Georgia from getting short end of Medicaid stick

Georgia did not accept billions of dollars from the federal government to expand Medicaid and the governor's proposed skinny replacement figures to cover one-tenth as many poor Georgians. the_burtons/Getty Images

It’s time to tell state officials it’s not right to require poor people to punch a clock for their health care.

Gov. Brian Kemp’s six-city road show to sell his skinny version of Medicaid expansion wraps up this week. Nearly 500,000 uninsured Georgians could get health coverage if the governor expanded Medicaid income eligibility. Just one-tenth that many people stand to gain coverage under Kemp’s plan.

You can attend the last public hearing today if you don’t have a day job and are in the Kennesaw area. Got a day job? Let your elected officials know where you stand by commenting online through Dec. 3.

Few Georgians have been showing up in person, which is a shame because it’s the only way to ask Department of Community Health staffers questions directly.

It’s also the only way for the people to hear stories that bring home how the proposal could cause harm. At the hearing in Macon last week, a local mom explained how her son with a heart condition risks falling through the state’s health care safety net.

The governor’s program, dubbed Georgia Pathways, is projected to qualify just 50,000 low-income people for Medicaid coverage — but only if they report that they’re working hard enough to deserve it.

The proposed skinny Medicaid expansion is the first part of the governor’s one-two punch at the Affordable Care Act (ACA), i.e., Obamacare. The second blow would be a state-run “reinsurance” program and a plan that would allow Georgia to seize control of $264 million in federal subsidies to replace the federal Healthcare.gov insurance marketplace.

The governor frames Georgia Pathways as a way to get health coverage to “hardworking” Georgians. Clearly, it is not intended for people too busy getting dialysis treatments to put in 80 hours a month working, getting training or volunteering.

Medicaid coverage for the poor isn’t a welfare-to-work program. It’s a baseline level of preventative care for people without employer-sponsored health insurance, a workforce that includes landscapers, restaurant workers, home caregivers and other low-income workers whose services we all depend upon.

Georgia is not the first state to float a plan to impose work requirements on Medicaid recipients. Arkansas and Kentucky were among the 36 states that adopted full Medicaid expansion after the ACA passed in 2010. But then both states signed onto the Trump administration’s attempt to roll back Obamacare by imposing work requirements that shrink the number of people insured.

A judge blocked the imposition of work requirements in those states earlier this year, finding the federal agency that issues waivers failed to fully consider the effects on thousands of people who would lose coverage.

Those cases demonstrate why it’s important for Georgians to speak up. The judge ruled Arkansas and Kentucky were wrong to ignore citizens who made public comments in those states warning that thousands of people would lose health coverage.

Georgia, of course, did not accept billions of dollars from the federal government to expand Medicaid, as Kentucky and Arkansas did. So, Georgia’s proposal won’t reduce coverage that was never created. Still, the judge’s ruling shows public comments at this stage can provide a legal basis for later debate.

It’s worth having your say because the stakes are high for all Georgians. The state’s rural hospitals are in financial crisis, in part because they are required to care for uninsured people who show up in their emergency rooms.

About 1.4 million people in our state don’t have health coverage. What would it take to cover more than a third of them? A stroke of the governor’s pen to accept Medicaid expansion.

Instead, the governor is using his pen to sign what amounts to a death warrant for improved health care access in Georgia.

Use this public comment period to tell the governor to put Georgians’ health first and stop wasting time on anything less than full Medicaid expansion.

John McCosh
John McCosh, Editor-in-Chief, is a seasoned writer and editor with decades of experience in journalism and government public affairs. His skills were forged in Georgia newsrooms, where he was a business and investigative reporter, editor and bureau chief, and expanded his experience during years in nonprofit and corporate communications roles. For more than a decade at the Atlanta Journal-Constitution, McCosh investigated state and local government officials and operations. He also tracked regional growth and development with a focus on metro Atlanta’s population-related problems, including traffic congestion, air pollution and water quality. He first learned the power of public records to unlock information when he was a commercial real estate reporter at the Atlanta Business Chronicle. McCosh is a board member of the Georgia First Amendment Foundation and active in the Georgia State Signal Alumni Group, which advises student journalists.