‘Nothing matters when you can't take care of yourself when sick’: Warnock introduces Medicaid bill

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Sen. Raphael Warnock introduced legislation on July 11 to provide a three-year relief plan to cover those in the Medicaid coverage gap under private insurance.

Credit: X/Senator Reverend Raphael Warnock

On Thursday, July 11, Georgia U.S. Sen. Raphael Warnock introduced legislation that would temporarily relieve the thousands of Georgians stuck in the Medicaid coverage gap.

The Bridge to Medicaid Act would provide a three-year temporary relief to those in the coverage gap who can't afford health insurance on the marketplace while states continue to decide to expand Medicaid.

Georgia is one of the nine states that has yet to expand Medicaid.

The Center on Budget and Policy Priorities reports that over 100,000 Georgia adults are in the coverage gap because their income is too high to qualify for the state's Medicaid program "but too low to qualify for financial assistance in the Affordable Care Act (ACA) marketplace."

"If you're an individual, a single adult, you can't get on traditional Medicaid," Warnock's office said. "A family of three can't make more than $7,750 a year to qualify for Medicaid. That's below 30% of the federal poverty line."

The Bridge to Medicaid Act gives states like Georgia the time to plan for Medicaid expansion while providing people in the coverage gap with three-year waivers so they can get private insurance, not government Medicaid.

"We'd give people tax credits to cover the cost of their premiums, and up to 99% of their deductibles would be covered," Warnock's office said.

Per a press release, the coverage details behind the Bridge to Medicaid Act are the following:

• Beginning in 2026, current Affordable Care Act (ACA) premium subsidies would be available to those below 138% of the federal poverty level;
• In the first year, those under 138% of the federal poverty level would be eligible for plans with reduced deductibles and cost-sharing (defined as a 94% percent actuarial value);
• In 2027 and 2028, these individuals would be eligible for further reductions in cost-sharing charges (plans would have a 99% actuarial value) to better afford to get care;
• Continuous enrollment applies — once an individual is deemed eligible based on income, they can enroll at any time during the year;
• The Federal Medical Assistance Percentage (FMAP) for existing expansion populations in expansion states would be enhanced by 3% (from 90% to 93%) for the duration of the coverage gap policy (from 2026 to 2028).

Warnock explained to GPB that he had made the legislation to help those like Heather Payne, a constituent and a North Georgia ER nurse currently in the coverage gap.

"Here's a woman who, ironically, spent her life caring for others as a nurse," he said. "She was a traveling nurse, so sometimes she had health care, sometimes she didn't. She had a series of strokes which completely changed her life, and this very morning, Heather, who needs access to care, literally has no options. None. And my program would provide for her tax credits that would allow her to purchase extremely affordable health care coverage in the marketplace."

Heather, who started having the strokes when she was 50 years old, is now 52 and shared to GPB her troubles in getting medical help while in the coverage gap.

"My doctors have been having trouble finding the cause of the strokes," she said. "If you can't find the cause, you can't prevent them from happening again. There are specialists that they would like me to see to address some of the things that happened because of the strokes and to try to figure out what is causing them, and I can't afford it.

"I've already spent my savings that I had, sold my house, there's no money to pay for this, I cannot work the shifts that I used to, and have been turned down twice for disability."

On the legislation, she explains that if it can provide assistance to those out there who need it, "it's a wonderful thing."

"Nothing else matters when you can't take care of yourself when you're sick," she said. "It's bad. The doctors will tell you, ‘you need to go see the stroke specialist in Chattanooga, or, ‘I want you to go to Vanderbilt to their rheumatology specialist,’" she said. "I've done some of that and the money is gone, so, I'm literally sitting around watching myself sink into decline and I can't do anything about it and can't magically go hold a job."

Warnock acknowledged that, during Georgia's decisions to expand Medicaid, his attention remains on those like Heather who remain in the coverage gap.

"I recognize that this is a short-term fix," he said. "Ideally, I'd love to see things like Georgia expand Medicaid, but they continue to dig in their heels, and in the meantime, people like Heather are stuck in the in the Medicaid coverage gap."

When Congress passed the American Rescue Plan in 2021, Warnock helped pass a provision that gave $14.5 billion in federal incentives for non-expansion states, including Georgia who received $1.2 billion in incentives.

For states like Georgia, that money is still waiting if they expand Medicaid.

"I fought to get them additional incentives to [expand Medicaid], which don't expire," Warnock said. "I was able to secure for Georgia, by negotiating with my colleagues, Democrats included, who come from states where they've already expanded, an additional $1.2 billion to incentivize Georgia further to expand Medicaid. And so I think it's important for people not to forget that. $1.2 billion is ready for Georgia when it finally expands."

Warnock clarified that when he talks about expanding Medicaid, he's talking about a way for Georgia to use the resources already available to provide health care to those in the gap.

"When I say Georgia needs to expand Medicaid, we're not talking about a new program," Warnock said. "This is the Affordable Care Act that's been around for more than a decade. Be clear that I'm not talking about additional taxes for Georgia citizens. We're not asking Georgia citizens to pay a single dime extra in taxes. We're begging our state leaders to let our citizens have access to the tax dollars they're already spending."

The Warnock team's goal for the legislation is to include it in the big tax package in 2025, including tax cuts and credits for those in the top 1% because those expire soon.

"If we could provide tax cuts to the richest of the rich — and believe me, come 2025, there will be a robust effort to extend those tax cuts to people who don't even need them — Top 1%," Warnock said. "I think that if we can be talking about that, we certainly can be talking about how to provide health care for ordinary people like a nurse in Dalton, Ga., who spent her career caring for others and now has no access to health care herself.

"That's fundamentally just wrong. It's not right. And we have an opportunity to fix it. I think that's a moral issue that transcends partisan politics, and I will keep fighting until we get it done."

On the push for Medicaid expansion's connection to partisan politics, Warnock says this is not a red-and-blue issue.

"Kentucky, where Mitch McConnell is a United States senator, and Rand Paul, has expanded. North Carolina has expanded. And, there was conversation about it this past session in the [Georgia] General Assembly," he said.

In the meantime, Warnock wants Georgians to know he will continue to do all that he can at the federal level as the state considers Medicaid expansion.

"I'm not about to give up on something as basic and necessary as health care," he said. "I'm going to do everything I can with the levers that I have to encourage the state leaders to finally expand Medicaid."

Co-sponsors for the Bridge to Medicaid Act are Sens. Jon Ossoff (D-Ga.), Tammy Baldwin (D-Wisc.), Bob Casey (D-Penn.),  and Elizabeth Warren (D-Mass.).