Expanding coverage not part of GOP leaders’ legislative agenda

From a legislative standpoint, the chances of a broad increase of health insurance coverage look pretty dim this year in Georgia.

Lt. Gov. Casey Cagle on Monday told reporters that he is opposed to expanding Medicaid in Georgia.


“Big government won’t improve our health care system,’’ Cagle said at a press conference Monday at the Capitol. He added, “I have a philosophical difference’’ with supporters of expansion, which has been done in 32 states under the Affordable Care Act.

“It does no good to continue to grow government and create additional [budgetary] strain,’’ Cagle said.

A gubernatorial candidate, Cagle made the comments while highlighting bills that would create a health care advisory council and a commission on substance abuse.

Last week, House Speaker David Ralston said his chamber’s Republicans have no appetite to pursue a federal waiver to increase health coverage. And Gov. Nathan Deal has given no sign that his longtime opposition to expansion has changed.

Georgia has among the highest rates of uninsured, especially in rural areas, which also suffer from shortages of medical providers. In addition, the state continually ranks in the bottom tier of states on health measures.

Consumer advocacy groups have called for the state to address these problems, and have said the state’s inaction has been frustrating.

Other Republican-led states, though, are moving forward with expanding coverage. The Washington Post reported Sunday that Republican lawmakers in a half-dozen states are launching fresh efforts to expand Medicaid. Party holdouts who had blocked the expansion say they’re now open to it because of Trump administration guidelines allowing states to impose new requirements that program recipients work to get benefits.

Cagle acknowledged the problems in access to care in rural Georgia in discussing Senate Bill 357, whose goal, he said, is to improve the quality and affordability of medical care in the state.

“Our health system must become more efficient and effective,’’ he said.

Senate Bill 357 would create a Health Coordination and Innovation Council and a position of director of health care policy and strategic planning, who would report directly to the governor.

The council would bring together experts from academia and industry, as well as elected and appointed leaders to provide a forum to share information. And a Health System Innovation Center would be established as a research organization to develop new approaches for financing and delivering health care.

The council would be authorized to accept and use gifts, grants, and donations to carry out its functions.


When asked about whether the donations would tilt the council’s findings toward donors’ interests, Cagle said that industry stakeholders would serve on the council. But he said the primary focus would be “the best interests of all Georgians.’’

State Sen. Dean Burke, who is sponsoring the legislation, said the bill is patterned after Gov. Deal’s criminal justice reform. The bill would “develop a central point where great ideas can be vetted,’’ said Burke, a Bainbridge Republican who is a physician.

Under Senate Bill 352, the governor would appoint a director of substance abuse, addiction and related disorders and create a commission to address the addiction and substance abuse crisis. The bill also has language about a possible Medicaid waiver related to opioid abuse.

Cagle said opioid-related deaths have increased by 55 percent since 2012. And Sen. Renee Unterman, a Buford Republican, added that “there is not an agency in the state that is not touched’’ by the opioid epidemic.

Gwinnett County Superior Court Judge Kathryn Schrader told reporters that Georgia doesn’t have sufficient treatment options. “Recovery is real when it’s done right,’’ she said.


Laura Harker of the Georgia Budget and Policy Institute said Monday that the focus on better coordination of the state’s health care work and tackling the opioid epidemic are important priorities.

“But the work of these centers will take time, and there is an option Georgia can take now to address the rural health crisis and the opioid epidemic,’’ Harker said. “Expanding coverage through Medicaid expansion would bring in about $3 billion in federal dollars each year to connect more people with necessary health services and pay for those services.’’