Too much expense. Too few doctors. Too little trust in the feds. State Rep. Sharon Cooper (R-Marietta), who chairs the House Health and Human...

Too much expense. Too few doctors. Too little trust in the feds.

State Rep. Sharon Cooper (R-Marietta), who chairs the House Health and Human Services Committee, laid out her party’s arguments Thursday against Georgia expanding its Medicaid program, as outlined by the health reform law.

“Georgia is not going to expand Medicaid,’’ said Cooper at a breakfast gathering in Atlanta. “We do have to balance the budget.’’

Gov. Nathan Deal, also a Republican, has indicated he’s against expansion, though advocates of it are making an effort to change minds on the issue.

On Thursday, more than 40 health-related groups, including the Georgia Rural Health Association, the Georgia Academy of Family Physicians, AARP Georgia, and the American Cancer Society, announced they have formed a coalition to support Medicaid expansion. It will be led by Georgians for a Healthy Future, an advocacy group that sponsored the breakfast forum Thursday.

Cost is a big part of the debate on both sides. The state is in a budget crunch, as it has been for several years, and Deal has ordered state agencies to come up with more than $500 million in cuts this year and next.

Cooper said legislative Republicans are not opposing expansion because they lack compassion. “It’s not because we don’t care . . . Somebody has to pay for it.”

Cooper, a nurse, noted that Georgia has a physician shortage, especially in rural areas. She said that scarcity would be worsened by expansion, which according to estimates would add more than 600,000 low-income Georgians to the Medicaid rolls. Cooper also questioned whether the federal government’s promises of funding for the expansion would actually occur.

Another state legislator, on the same panel, took a view exactly opposite to Cooper’s. Medicaid expansion would be a great bargain, said state Rep. Pat Gardner (D-Atlanta). “We’re one of the states that will benefit the most’’ from it, she said.

Almost 2 million Georgians are uninsured, one of the highest rates in the country. Expanding Medicaid represents a unique opportunity to extend insurance to many of those people, Gardner said.

Last June, the U.S. Supreme Court upheld the controversial Affordable Care Act. But in a blow to one key ACA provision, the court also ruled that the states had the option not to go along with Medicaid expansion. That laid the groundwork for possible battles in a number of states.

Like other Republican governors, Deal has said he opposes expansion as it’s currently outlined, citing the cost to the state. State officials project that price tag to be $4.5 billion over 10 years, though other estimates cite a lower figure.

Cooper said Thursday that the Medicaid program, which covers about 1.5 million poor and disabled residents, is inefficient and does not produce good health outcomes.

Georgia’s safety net currently has an array of charitable clinics for the uninsured, and the state is expanding its telemedicine network, she noted.

Gardner said the state hasn’t been able to fix a “broken’’ health care system with various tactics, such as malpractice reform, bare-bones insurance, and managed care.

“The health of all working families is way too important to get hung up on partisan barriers,’’ Gardner said.

Cooper responded: “It’s not a partisan issue. It’s about being able to pay for something.’’

The two legislators did agree on one issue, with both declaring that there’s a need to raise the state’s cigarette tax, now one of the lowest in the country. But legislative action on the tobacco tax has been stalled in past General Assembly sessions.

Another member of the panel, Insurance Commissioner Ralph Hudgens, predicted that the General Assembly would consider legislation to cut back some of the types of health insurance coverage required under state law.

Here’s a Walter Jones article on Hudgens’ statements about the “mandates’’ issue.

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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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