U.S. Health and Human Services Secretary Kathleen Sebelius told state legislators from around the nation Monday that her agency is open and willing to...

U.S. Health and Human Services Secretary Kathleen Sebelius told state legislators from around the nation Monday that her agency is open and willing to discuss different proposals by states to expand their Medicaid programs.

“We are very eager to continue these conversations with states around the country,’’ Sebelius said in Atlanta during a meeting of the National Conference of State Legislatures.

“I don’t think there’s any question that if you want a healthier population, looking at the opportunity to expand Medicaid has got to be a piece of the puzzle.’’

Earlier, a federal official told legislators that if the administration approves a state’s expansion plan that’s different from the standard approach,  the federal government still will pick up all the costs for the first three years — even if it’s more expensive.

The 2010 health care law, known as the Affordable Care Act, or ACA, encourages states to expand their Medicaid programs. The federal government offers an incentive for them to do so. It will pay 100 percent of the costs of expansion for the first three years, a percentage that will eventually decrease to 90 percent.

But the U.S. Supreme Court, in its 2012 ruling on the ACA, said the states can refuse expansion without being penalized. To date, while about half the states have agreed to expansion, Georgia and most other Southeastern states have decided against it.

States can opt into or drop out of expansion at any time, Sebelius noted Monday. The federal government currently funds 57 percent of the Medicaid program nationally, though in Georgia the federal share is higher.

Sebelius, who was Kansas governor before being chosen for the HHS post, asserted that expansion would reduce the costs of uncompensated care at the state level and ignite economic development in individual states.

“No one’s health care should be determined by their ZIP Code,’’ she said. “This is no longer a political debate. This is the law of the land.’’


A sweeter deal?


Legislators at the conference also heard a presentation on the Arkansas proposal for expansion, now under consideration by federal officials. It would let newly eligible Medicaid beneficiaries shop for insurance policies along with other consumers in the online marketplaces, also known as exchanges, created by the ACA.

A Centers for Medicare and Medicaid Services official told the legislators that if the federal agency grants a waiver to an Arkansas-like plan, the federal government will pay 100 percent of the tab, even if it costs more than a conventional Medicaid expansion.

“We are open for business, eager to partner’’ with states, said Cindy Mann, a deputy administrator of CMS.  “We are very interested in entertaining a limited number of waivers. We are not at our limit.’’

Gov. Nathan Deal has rejected Medicaid expansion in Georgia, chiefly citing the cost to the state. A spokesman for the governor told GHN recently that “under any scenario, implementation of Obamacare would be a huge new cost to the state.”

The Arkansas plan, meanwhile, has grabbed the attention of some Republican-led states. Arkansas state Rep. Mark Biviano, a Republican, said that while the Affordable Care Act is not popular in his state, there is a push to reform Arkansas’ Medicaid program.

A compromise, Biviano said, would allow for a different type of expansion, what he called “the right thing to do,’’ providing health coverage for everyone.

“We have rural hospitals at risk of closing,’’ he said.  Expansion would help many low-income residents have access to health care and become more productive citizens, he added.

One health insurer has dominated the insurance market in Arkansas, but now the state’s insurance exchange will have four companies seeking business, Biviano said.

Georgia state Rep. Pat Gardner (D-Atlanta) said after Sebelius’ address that federal officials appear willing to entertain Arkansas-like proposals. “I think we need to find a way that’s workable in Georgia and is acceptable to CMS,’’ she told Georgia Health News.

Georgia state Sen. Judson Hill (R-Marietta), who was also asked about the Arkansas plan, said he is against expanding “a government-run system.’’

“I’m interested in a free-market, patient-centered system,’’ Hill said.

The current Medicaid program, he said, “is rampant with examples of delayed [care] and not the best care. I think we can do better.’’


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

  • lonleylibertarian

    August 13, 2013 #2 Author

    The Taxpayers pick up the cost – the Federal Government can only give money to states that it collects from Taxpayers – why is this so hard to be accurate about in this kind of article/post.


  • GraceD

    August 13, 2013 #3 Author

    state Sen. Judson Hill (R-Marietta) said he is against expanding “a government-run system.’’
    “I’m interested in a free-market, patient-centered system,’’ Hill said.
    The current Medicaid program, he said, “is rampant with examples of
    delayed [care] and not the best care. I think we can do better.’’ –
    If he really believed that Ga could do better, why hasn’t he/legislators passed something?
    The republicans are all talk & no action. Just stalling.
    Go to the polls & vote them out!!!


  • fedupwithtbagrs

    October 1, 2013 #6 Author

    My son is twenty-four with epilepsy and a related heart condition. He does not qualify for social security and thought he cannot work, he tries when he can but makes minimum wage part-time, he doesn’t qualify for medicaid because he does not have a minor child. Now if he goes out and gets a girl pregnant, he can be covered. I think that’s bs. Georgia’s medicaid is not fair, Christian, or right in any way. Georgia is sick in how it administers its current medicaid program, people who make alot of money can get medicaid if they have alot of bills. My son cannot get labs done or see the doctor or neurologist, or get tests like EEGs and scans done. They cannot investigate to see if he has a brain tumor or something repairable. He gets indigent care at the Emergency room in an emergency, indigent care is rationed care and they will not do anything expensive for him, like a cat scan. I say to those in government in Georgia opposing healthcare for the poor and disabled, especially poor single people, that you are sick in the head and the heart. You kill people and cause great suffering to God’s children every day. You are the epitomy of evil and self-absorption. You need serious mental health care and probably medication, and to the media that covers this type of insane showboating to rally the worst of us and the worst in us, that you have created this monster and are just as sick for giving these people any coverage. They are not credible. Any Congressional member representing the state of Georgia is not representing the people here in opposing medicaid expansion and deserve impeachment. Why don’t more democrats run? What happens to them? Death threats, that’s par for the course in Georgia.. This is a state that is the only state in the country that refuses to file water quality reports, it just pays the fines!!! Our water could be totally toxic. That’s how much they care about the people here… We didn’t even have any democratic options this election cycle. They just ally yourselves with the corrupt Baptist church and other fundamentalist groups that prey on their congregations, funded by crazy rich greedy self-absorbed rich people or corporate donors. You can’t even attend church around here, there is so much prostylatizing from the pulpit, what kind of people use the church for political gain, really, only the lowest life forms. So go for it, you will reap what you sow. Don’t dream of heaven, there’s no place in it for you. Jesus said that how you care for the least of us, that is how you care for Him. You spit in His face, you are soul-less. Enjoy your wealth and privilege at the expense of poor suffering children, of young people that die of preventable conditions because you are a selfish jerk just wanting attention and acceptance, who can’t stand on your own two feet and stand for something good in your life, yeah, you are real men. I think people like Paul Ryan should personally be made to unplug babies from life support that receive medicare or medicaid, with his whole family in attendance, so they can continue to be so proud of him, and those that agree with him should be made to do the same thing. I think he should be made to tell the elderly, the disabled, and the working poor, that that when they get sick, they should just die, that they do not deserve to live because they have not been greedy or crooked enough, that despite, that to seek out health care would make them “takers”, that they do not deserve to ever retire, but are born or have descended, either through age or infirmity, into a caste of parasitic worthlessness. I would like him to go take the few canned goods from my 75 year old mother’s cabinet, my mother who worked her entire life, despite illness because she had to, until she had a stroke at 70, to take what little food she gets as she lives on $600.00 a month and $100 in foodstamps, because now that she is not making someone else rich at her own expense by working for nothing, not complaining, not having any benefits or retirement, you need to get rid of her. You want all the “handouts” stopped? You go stop ’em. How many people would you be willing to do this to? What, all because stupid spoilt psycho Ayn Rand told you to? Take some logic classes and grow a heart, Ayn Rand supports communism in its worst form, she simply pushes forth a communism of the elite, the richest. She was a propagandist for communism, not any kind of hero or unique thinker. “The Virtue of Selfishness” should teach you that. Don’t say you’re a Christian if you believe in that and her, she was a devout atheist, and her work comes from an atheist perspective. Start caring about whether what you say, do and believe makes sense because I can guarantee you, God does. Quit the hypocrisy and hate. People aren’t dependent and you aren’t doing them any favors. people worked and paid taxes to have these benefits. and it’s not up to you to decide to change the deal once its been made. The government is not broke, its a lie I’m sick of hearing. Your state may be, but that is because you’ve destroyed the futures and quality of life of your states consumers/taxpayers. All to be accepted by a bunch of soul-less crazies.


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