Legislators share thoughts on Medicaid expansion

While describing how Georgia’s economy has escaped its “deep freeze,’’ Gov. Nathan Deal again showed no signs of thawing on the idea of expanding Medicaid.

“The Affordable Care Act is anything but affordable and is costing our state $327 million this year,’’ Deal told lawmakers Wednesday in his State of the State speech, which touted an improved state economy.

Rep. Pat Gardner
Rep. Pat Gardner

Expansion of Medicaid as called for under the ACA would cost the state even more, Deal added. “We will not allow ourselves to be coerced into expansion.’’

A legislative panel Thursday offered different figures regarding the expansion issue.

State Rep. Pat Gardner (D-Atlanta) cited a Georgia State University study that estimated that $40 billion in federal dollars would come to Georgia over 10 years under a Medicaid expansion. The state’s spending over that time would be roughly $2 billion, she said.

“It’s simple mathematics,’’ Gardner told an audience at a breakfast sponsored by Georgians for a Healthy Future. She said the state has a moral obligation to extend coverage to the uninsured.

The panel, which included fellow Democrat Rep. Karen Bennett of Stone Mountain and Republican Sen. Chuck Hufstetler of Rome, also discussed pending legislation,  including a proposal to allow guns on college campuses and in churches. They talked about helping medical providers under the state Medicaid program, the issue of medical marijuana, and the widespread complaints about the state employees’ health plan.

An estimated 400,000 low-income Georgians fall into a coverage gap under Georgia’s decision to reject Medicaid expansion. These are uninsured individuals who earn below the federal poverty level and who are not eligible for subsidies in the insurance exchange. They would qualify for Medicaid under expansion.

Gardner also said the federal funds gained under expansion could supplant state funds currently spent in the state mental health budgets.

Bennett added that with the uninsured gaining new coverage, their improved health would save lives and improve the economy.

Sen. Chuck Hufstetler
Sen. Chuck Hufstetler

While Medicaid expansion has its vocal advocates, Deal’s fellow Republicans in the state leadership strongly support his opposition to expansion, making change unlikely soon. State Sen. Jason Carter of Atlanta, a Democrat who is running for governor, did not mention the issue when he gave his party’s response to Deal’s speech Wednesday.

Hufstetler, an anesthesia provider in Rome, said he has long been opposed to the ACA. He also applauded Gov. Deal for his efforts to improve the state’s economy.

But Hufstetler expressed interest in finding a way to leverage “the good parts’’ of the ACA without hurting the state budget.

“By doing nothing [on expansion], Georgia is getting less money from the federal government,’’ he said. And Hufstetler noted that the feds, by approving variations on Medicaid expansion in states such as Arkansas, are showing more flexibility.

But he also pointed out that in Oregon, where a Medicaid expansion program has been closely studied, it was followed by an increase in Medicaid enrollees’ visits to hospital emergency rooms, the most expensive way to get medical care.

Bennett said Georgia’s government is not promoting the ACA exchange at all in the state. “It has been a grass-roots effort.’’

A GOP-sponsored bill that would forbid state employees from implementing provisions of the ACA is not likely to pass, Hufstetler said. “I do have concerns there would be unintended consequences to this bill,’’ he added.

Hufstetler said some legislators are interested in studying the idea of allowing the medicinal use of marijuana in Georgia. “We need to be very careful’’ about the uses of it, he added. Several states have loosened or considered loosening their medical marijuana laws.

The proposal for guns on campuses has strong GOP support, and nearly passed last year, though it was opposed by the Board of Regents.

Bennett said she is opposed to a proposal to allow weapons on campuses and in churches. “I’m a pastor,’’ she said. “I would not like to be concerned about who’s packing and who’s not.’’

But Hufstetler noted that a compromise plan is being formulated that would give university presidents and pastors the ultimate say on whether guns are allowed where they hold authority.

Bennett, a physical therapist, cited a bill she’s sponsoring that would bring new oversight to how the Medicaid program deals with medical providers.

Since Jan. 1, complaints from teachers and other state employees have engulfed state government in response to the debut of the new medical plan under the State Health Benefit Plan, which covers more than 650,000 state employees, teachers, other school personnel, retirees and dependents.

“A lot of legislators are hearing complaints about the plan,’’ Gardner said.

Teachers have been among the most vocal critics, saying they have to spend more for services, have higher out-of-pocket costs and no longer have access to their doctors because they are outside the new system’s provider network.

Department of Community Health Commissioner Clyde Reese told legislators that more SHBP members chose the Bronze plan – which has the lowest premiums – than the state anticipated. As a result, they face higher out-of-pocket costs than those who picked Gold and Silver plans.

One of the biggest complaints from state employees is that the plan choices are offered by just one vendor, Blue Cross and Blue Shield of Georgia. Reese said Thursday that it’s possible to add another insurer for 2015, but that no decision has been made on that issue.