Chances of Medicaid expansion dim again this year as key health care proposal passes without it: The Current

A belated proposal to fully expand Medicaid received a surprise hearing in a Senate committee Thursday but was narrowly defeated, with the president allowing the hearing to cast the deciding vote to stop it.

And negotiations also ended Thursday evening on a high-profile health care bill seen as a potential host for a full complement of Medicaid expansion. Instead, this bill ended where it started last month: with a committee that will look for ways to expand health care coverage.

Thursday’s whirlwind of developments appeared to close the door on Medicaid expansion talks for this year. The legislature ends next Thursday.

There are days in this building that break your heart, and I think today was one of those days for a lot of us, Rep. Michelle Au, D-Johns Creek, said Thursday evening.

This year’s session had begun with new bipartisan talk about full Medicaid expansion. Much of that can be traced back to House GOP leaders who signaled an openness to an Arkansas-style model that uses federal money to buy private plans for those who are eligible. Lieutenant Governor Burt Jones, for his part, did not rule it out.

But the barrier to those talks was always the governor’s partial expansion program, which was launched last July after being delayed by the federal government.

About 3,500 people have signed up for the program, which has cost the state at least $26 million so far, according to a story this week from KFF Health News. More than 90% of the expenses have been intended to cover administrative and consulting costs.

Last week, Kemp said he remained focused on his health care plan, which he described as a limited expansion of Medicaid in a conservative way. He sued the federal government last month to get more time for the program to work. As of now, the federal waiver authorizing the program will expire next fall.

Georgia is one of 10 states that have not fully expanded Medicaid under the Affordable Care Act.

‘Out of order’

A bill that would have created a Medicaid program called PeachCare Plus was heard in a Senate committee Thursday morning.

The proposal was modeled after Arkansas’ style of expansion, which would require federal approval. Under the bill, the state would not seek a new federal waiver until Georgia’s existing program expires.

Sen. Bill Cowsert, an Athens Republican who chairs the Senate Regulated Industries and Utilities Committee where the bill was considered, described the proposal as partial Medicaid expansion from the states, but more aggressive.

Ultimately, Cowsert stepped aside eager to give Georgia Pathways to Coverage more time. He told reporters afterward that the discussion was healthy, but probably a little premature, and said he wanted to give Pathways a chance to work.

The committee vote was 7 to 6, with Cowsert breaking the tie that prevented the bill from moving forward. Sen. Ben Watson, a Republican from Savannah who is a former member of the committee, appeared at Thursday’s meeting to vote against the proposal.

If it fails, we will discuss other alternatives again next year, Cowsert said.

But Sen. David Lucas, a Macon Democrat who sponsored the Medicaid expansion proposal, didn’t hold back later when the certificate of need bill came to the Senate floor for final approval without an immediate plan to to full expansion.

He argued that Pathways has had enough time to work and attributed the failure of his bills in committee to the influence of governors.

Sen. David Lucas, a Macon Democrat, sponsored a bipartisan proposal to fully expand Medicaid. Jill Nolin/Georgia Recorder

When you’re the governor, you have influence, but his program doesn’t work. It doesn’t work, Lucas said. And we’ve invested $26 million in it. So when those rural hospitals close when we get out of session, I’ll blame you.

But Thursday’s committee hearing still represented a rare public discussion of Medicaid expansion in a Republican-controlled legislative committee. Two Republicans, Sen. Matt Brass of Newnan and Sen. Carden Summers of Cordele, voted with the Democrats.

Brass, who chairs the Senate Rules Committee, offered some changes, including adding a workforce development fund like the one adopted in North Carolina. But he also unsuccessfully proposed an amendment to repeal the states’ health trade regulations entirely.

Brass said he believes the governors’ program can be successful, but it will always be limited to those who fall below 100 percent of the federal poverty line, or about $15,060 for a single adult. Participants must also complete 80 hours of work, school or other qualifying activity each month to obtain and maintain their coverage.

Brass said he was concerned about rising insurance costs for people with health coverage and the strain on emergency rooms for uninsured patients. But he also said he changed his mind about Medicaid expansion because of his experience as a small business owner who can’t afford insurance for his employees and the construction business consistently doesn’t provide 80 hours of work each month.

I pay them well, but hourly and sometimes sometimes the roofs leak, sometimes they don’t, he said.

The bill with the certificate of need changes goes to the governor

A separate proposal to ease some of the health business regulations in hopes of attracting more medical services, especially to rural Georgia, is now on the governor’s desk.

The proposal originally came from House leaders, with Speaker Jon Burns the second signatory and Minority Leader James Beverly as a co-sponsor. The Senate then pushed for more changes, such as an easier path for freestanding birth centers to open, and the two chambers agreed to a compromise measure Thursday.

That final product was celebrated by conservatives who pushed for changes to loosen state certificate of need rules.

For decades, CON laws have unfortunately represented a barrier to expanding quality health care, Lt. Gov. Burt Jones said in a statement. Today, we took a step toward reforming the CON in Georgia and easing the obstacles Georgians face in their efforts to receive accessible, quality health care.

Burns said in a statement Thursday that the bill represented an important action to reform the Certificate of Need and expand access to affordable, quality health care in our state.

The measure also increases the cap on the rural hospital tax credit program to $100 million, dedicating an additional $25 million to the program.

When it comes to Medicaid expansion, Rep. Butch Parrish, a Swainsboro Republican who sponsored the bill, pitched his proposal as what could be accomplished this year. Parrish chairs the powerful House Rules Committee.

Today in the Senate, there was an attempt to pass a Medicaid expansion, and it didn’t happen. So I think what we have to do is do what we can with what we have to work with to get the services to as many people as we can across the state, Parrish said during Thursday’s debate.

But Democrats criticized their GOP colleagues for not including full Medicaid expansion in the final version. The bill had previously found bipartisan support, but Thursday’s final votes fell largely along party lines in both chambers.

Rep. Sam Park, a Lawrenceville Democrat who serves as minority whip, said House Democrats had held out hope until Thursday that the Medicaid expansion would still happen this year.

This CON will not cover a single Georgian despite the fact that we have one of the highest uninsured rates in the country, Park said. Today was another reminder of Republican cowardice and Republican failure of leadership in leaving hundreds of thousands of Georgians uninsured.

The Georgia Recorder is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity.

News type: News

Based on facts, observed and verified first-hand by the reporter, or reported and verified from informed sources.

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