Bourdeaux joins congressional Dems backing Medicaid look-alike option

Proposals aim to fill coverage gap in non-expansion states

By: - July 21, 2021 6:21 pm

Georgia Rep. Carolyn Bourdeaux, a Suwanee Democrat, filed legislation to create a federal Medicaid look-alike option for low-income adults in Georgia and other GOP-led states that haven’t expanded insurance coverage for the poor. Chip Somodevilla/Getty Images

More Democrats are lining up behind a plan to create a federal Medicaid look-alike option for low-income adults in Georgia and other GOP-led states that have not expanded the government-run insurance program.

Congresswoman Carolyn Bourdeaux has filed a House version of a proposal introduced in the Senate earlier this month by U.S. Sen. Raphael Warnock. Georgia U.S. Reps. Lucy McBath and Nikema Williams and Sen. Jon Ossoff have also backed the measure.

Georgia is among the dozen states have taken a pass on federal incentives to expand Medicaid to poor adults without children. State officials here were also not swayed by sweetened perks packed into the spring’s coronavirus relief package, which could deliver a net gain of about $710 million to the state, according to the Kaiser Family Foundation.

“We know this abdication of responsibility has cost our constituents dearly,” Bourdeaux said at a press conference Wednesday. “The human cost is very high, but also each and every one of us in Georgia pays higher premiums because of the uncompensated care that is treated in the emergency room in our state.”

The plan to create a program that mirrors Medicaid for some 4 million Americans in non-expansion states – including nearly a half million in Georgia – is an attempt to bypass GOP resistance. The proposal would offer even greater financial incentives to holdout states while directing the Centers for Medicare and Medicaid to provide health care coverage to the states’ eligible residents in the meantime.

Congress cannot, however, go as far as to mandate states expand coverage through the program. The U.S. Supreme Court ruled in 2012 that states can choose whether to expand Medicaid under the Affordable Care Act.

“This is a look-alike program administered not by the state, but by the federal government,” Warnock told reporters earlier this month. “And we’re not rewarding states for bad behavior. We are pulling Georgians out of the coverage gap. This is about benefiting people.

“It’s just not right that Georgians who pay federal taxes would not be able to access the benefits of their own federal taxes because the legislature is standing in the way, and that’s why we’re going to set up this program.”

Bourdeaux pointed to new research published in JAMA that found outstanding medical bills are now the top source of debt for Americans – and that those debts are greater in states that rejected Medicaid expansion.

The federal look-alike proposal, though, is not the only one floated targeting non-expansion states. Another would allow cities and counties to pursue Medicaid expansion on their own. Other options could also be in the works as Democrats map out a budget reconciliation package, which would only require a simple majority vote in the Senate.

Bourdeaux said Wednesday she would support an alternative plan achieving the same result.

“I would say my goal is certainly to make sure that everybody has quality, affordable health care, and that’s what we’re pushing for. This is a path to getting there,” she said.

State leaders in Georgia have long opposed Medicaid as too costly in the long run. Republican Gov. Brian Kemp is pushing his own health care plan that includes a slight expansion of the Medicaid rolls, extending coverage to up to 50,000 people.

But the Biden administration has balked at the plan’s proposed requirements that participants satisfy 80 hours of work, school or other qualifying activity every month to gain and then keep their coverage. Congressional Democrats have urged the administration to scrap the program entirely.

The state recently delayed the program’s planned July 1 rollout until “at least” Aug. 1.

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Jill Nolin
Jill Nolin

Jill Nolin has spent nearly 15 years reporting on state and local government in four states, focusing on policy and political stories and tracking public spending. She has spent the last five years chasing stories in the halls of Georgia’s Gold Dome, earning recognition for her work showing the impact of rising opioid addiction on the state’s rural communities. She is a graduate of Troy University.