Georgia Senate Committee Approves Medicaid Waiver Proposal

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Sample Medicaid card.

A proposal to allow Gov. Brian Kemp to pursue Medicaid waivers from the federal government was approved by a Georgia Senate committee Tuesday.

The Senate Health & Human Services Committee voted 9-4 to approve a bill authorizing Kemp's office to pursue the waivers after lawmakers sped through testimony and questions in a one-hour meeting.

A federal waiver, as opposed to a full Medicaid expansion backed by Democrats, would give Georgia the flexibility to adopt a more conservative plan.

Kemp praised the committee's vote in a statement, saying it would help improve health care access, decrease insurance premiums and enhance the quality of care for Georgia's families.

"This legislation will allow state officials to craft a Georgia-centric health care plan that ensures a bright and healthy future for our state," Kemp said.

Republican Sen. Blake Tillery of Vidalia, Kemp's floor leader in the Senate, said the bill allows the governor to reject what he called a "one-size-fits-all" model of federal government control.

"It allows him to define and develop a Georgia-tailored solution to a Georgia problem," Tillery said. "What we've seen is hardworking Georgians in my district and yours are spending two and sometimes three times the amount of money they would spend on a whole mortgage on health insurance premiums."

Tillery said the measure allows for varying ideas but ultimately aims to decrease health care costs. But there's one thing the waiver is not flexible on.

Under the original call to expand Medicaid under the 2010 Affordable Care Act, anyone who fell slightly above the poverty line qualified for benefits. The bill would cap that eligibility at the poverty line, limiting the number of people who would receive benefits.

Georgia is one of 14 states that have not yet fully expanded Medicaid as prescribed under the ACA, also known as Obamacare.

The expansion was initially intended to be nationwide, but a 2012 ruling by the Supreme Court effectively made it optional for states. Most of the states that have not taken up expansion are Republican controlled.

Laura Harker, a health policy analyst with the Georgia Budget & Policy Institute, said she was concerned that the proposal would end up costing the state more to cover fewer people if it limited those receiving the benefits at 100 percent of the poverty level instead of 138 percent.

If capped at the poverty level, the proposed waiver plan would cost about $135 million dollars more to cover about 240,000 fewer people, according to the institute's estimates, Harker said.

Under the federal health law, every dollar Georgia spent on Medicaid coverage expansion would be matched by $9. But that's only if the expansion includes individuals who fall under 138 percent of the poverty line, said Laura Colbert, executive director of Georgians for a Healthy Future, a nonprofit consumer health advocacy group.

Colbert also said the measure grants broad authority to the governor and department of insurance.

"This lack of boundaries included in the bill allows for waiver proposals that could create seismic and detrimental change that harm consumers and destabilize the market," Colbert said.

Tillery disagreed that there would be no accountability.

"That waiver doesn't just come as a blank check," Tillery said, adding that the waiver would be subject to annual appropriations and other guidelines.

Tensions between the Republican chairman of the committee and the Senate Democratic leader flared as the session wrapped up.

Democrats said they felt the committee sped through an important topic.

"I was disappointed that we rushed that bill in a manner that is unusual without giving a chance to debate and discuss it," Senate Democratic Leader Steve Henson of Stone Mountain said. "My hope is in the rest of the process, the House committee is given time to ask questions and offer alternatives."

Henson tried unsuccessfully to convince lawmakers to raise the limit for receiving benefits under Medicaid to 138 percent of the poverty level.

Henson has authored a bill pushing for full Medicaid expansion in the Senate and expressed concern that his legislation did not get a hearing in committee.