Democratic state lawmakers renew call for full Medicaid expansion after slow start to Kemp’s narrow version

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by Jill Nolin, Georgia Recorder [This article first appeared in the Georgia Recorder, republished with permission]

October 25, 2023

Democratic leaders in Georgia are calling on Gov. Brian Kemp to abandon a three-month-old Medicaid program that has been off to a slow start.

Senate Minority Leader Gloria Butler, House Minority Whip Sam Park and Senate Minority Caucus Chair Elena Parent held a press conference Wednesday to press Kemp and other GOP leaders to shift gears after new data showed Georgia Pathways to Coverage had so far enrolled about 1,300 low-income adults.

As many as 370,000 may be eligible, according to the state’s projections. The state planned for nearly 100,000 people to enroll in the first year for the partial Medicaid expansion program, which launched in July.

“At the current pace, it would take about 16 years to cover 90,000 people. A baby born this morning would be driving Georgia’s roads when Gov. Kemp meets his target,” said Butler, a Stone Mountain Democrat. “This is a failure of leadership. It is a failure of governance.”

Butler also criticized Georgia Pathways for being built to only cover at most a quarter of the eligible population, saying the program doesn’t cover enough people and takes too long to cover the Georgians it does reach. 

Georgia Democrats have long championed full Medicaid expansion, which could cover as many as a half million people and leave the federal government with 90% of the tab. Congressional Democrats have since offered up additional incentives designed to win over holdout states like Georgia.

Georgia is one of 10 states that have not fully expanded Medicaid under the Affordable Care Act, with North Carolina in the process of rolling out expansion next door. Georgia also has one of the highest uninsured rates in the country. 

In 2019, Kemp unveiled an alternative that would partially expand coverage to low-income adults who complete 80 hours of work or other activities every month to qualify and keep their health care coverage. The state successfully sued the federal government when the Biden administration objected to the work requirement.

Park, a state representative from Lawrenceville, said the activity reporting requirement creates a “bureaucracy that you have to overcome” when trying to sign up for coverage through Georgia Pathways.

“That clearly is having the effect of limiting access, especially for those who may be too sick to work,” Park said. “To say that you have to be able to work first in order to receive health care I think puts the cart before the horse, and clearly the numbers speak for themselves and it’s a program that’s failing to deliver for Georgians.”

The program’s supporters have touted the program as a tool to steer people toward private insurance options like employer-sponsored health care. State officials have also always said it would take time for enrollment to ramp up.

There are signs of interest in the program. As of mid-October, nearly 17,000 people had completed an application for Georgia Pathways that are under review. 

The governor’s press secretary, Garrison Douglas, also highlighted the governor’s other health care policies that have helped Georgians gain coverage. A reinsurance program that launched in early 2022 and the expansion of postpartum Medicaid coverage for new moms have found broad support.

He said Georgia Pathways has “brought innovation” to the Medicaid program. Georgia’s program is being closely watched nationally since Georgia is now the only state to partially expand Medicaid coverage while requiring the newly eligible people to satisfy a work requirement.

“Meanwhile, the Democrats’ proposal would kick over 200,000 Georgians off private health insurance. The only failure here is their inability to come up with solutions that actually work for hardworking Georgia families,” Douglas said Wednesday. 

But if the low enrollment numbers continue, Democrats say they hope their Republican colleagues will reconsider their support for the program and give full expansion another look.

Butler and Park plugged a pair of bills that would expand Medicaid – Senate Bill 24 and House Bill 62 – that were filed last year and remain alive for next year. Lawmakers will return to the Gold Dome in January.

“It seems like it’s going to take years to build up this roll but after so many failed years (one would think) that something would click and say we need to expand Medicaid,” Butler said.

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