A follow-up proposal to fully expand Medicaid received a surprise hearing Thursday in a Senate committee, but was narrowly defeated with the chair who authorized the hearing voting decisively to shelve it. .
Negotiations over a high-profile health care bill that had been seen as potentially including a full Medicaid expansion also concluded Thursday night.Instead, the bill ended there started Last month: With a committee looking at ways to expand health insurance coverage.
Thursday's dizzying turn of events appeared to have closed the door on extended Medicaid expansion negotiations this year. Parliament adjourns next Thursday.
“Some days it's heartbreaking to be in this building, and I think today was one of those days for many of us,” Rep. Michelle Orr, D-Johns Creek, said Thursday night.
This year's session started like this new bipartisan chatter Regarding full expansion of Medicaid. Much of that can be traced back to House Republican leaders who have shown openness to an Arkansas-style model that uses federal funds to buy private plans for eligible people. Lieutenant Governor Bert Jones did not dismiss it.
However, the barrier to these talks has always been the governor's partial expansion plans. The plan began last July after being delayed by the federal government.
Some 3,500 people have enrolled in the program, which has cost the state at least $26 million so far, according to one source. Story From this week's KFF Health News. More than 90% of his expenses go toward management and consulting fees.
Just last week, Kemp said he remains focused on his health care plan, which he described as “a limited expansion of Medicaid in a conservative way.”he sued the federal government Last month I spent some more time trying to get the program working. Currently, the federal waiver authorizing the program is scheduled to expire next fall.
Georgia is one of 10 states that have not fully expanded Medicaid under the Affordable Care Act.
'That doesn't work'
A bill to create a PeachCare Plus-style Medicaid program received a hearing in a Senate committee Thursday morning.
The proposal is modeled after the Arkansas-style expansion and would require federal approval. The bill would prevent the state from seeking new federal waivers until Georgia's existing programs expire.
Sen. Bill Cowsert, R-Athens, who chairs the Senate Regulated Industries and Utilities Committee, which considered the bill, said the proposal is similar to the state's existing partial Medicaid expansion, but with a “more aggressive approach.” ”.
Cowsert ultimately decided he wanted to give Georgia Pathways to Coverage more time. He later told reporters that the discussions were healthy but perhaps “a little premature” and that he wanted to give Pathways a chance to work on it.
The committee voted 7-6, with Cowsert breaking the tie and blocking the bill from proceeding. Sen. Ben Watson, R-Savannah and a former member of the committee, appeared at Thursday's meeting and voted against the proposal.
“If that fails, we'll be back here next year to discuss other options,” Cowsert said.
But Sen. David Lucas, a Macon Democrat who sponsored the Medicaid expansion proposal, didn't hold back when the certificate of need bill reached the Senate for final passage with no immediate plans for full expansion.
He argued that Pathways had enough time to operate and blamed the governor's influence for the bill's failure in committee.
“If you're the governor, you have influence, but his plan won't work. It won't work,” Lucas said. “And we invested $26 million in it. So if a rural hospital closes when we finish our practice, I'm going to blame it on you.”
But Thursday's committee hearing remained a rare public debate on Medicaid expansion in Republican-controlled legislative committees. Two Republicans, Sen. Matt Brass of Newnan and Sen. Kaden Summers of Cordell, voted with Democrats.
Blas, who chairs the Senate Rules Committee with oversight, proposed several changes, including adding a workforce development fund like the one adopted in North Carolina. But he also unsuccessfully proposed an amendment that would completely eliminate the state's medical business regulations.
Blas said he believes the governor's program has the potential to be successful, but that it will always be limited to people below 100% of the federal poverty line, or about $15,060 per adult. Ta. Participants must also complete 80 hours of work, school, or other qualifying activities each month to earn and maintain coverage.
Blass said he is concerned about rising premiums for people with health insurance and overburdening emergency rooms with uninsured patients. But he also said he changed his mind about Medicaid expansion after his own experiences as a small business owner who couldn't afford insurance for his employees and in the construction industry that didn't provide 80 hours of continuous work each month.
“I pay them well, but on an hourly basis, sometimes the roof leaks, sometimes it doesn't,” he said.
A bill with changes to required certificates will be sent to the governor.
Another proposal is now on the governor's desk that would loosen some health care business regulations in hopes of attracting more health care services, especially in rural Georgia.
The proposal originally came from House leaders, with Speaker John Burns as the second signer and Minority Leader James Beverley as a co-sponsor. The Senate later pushed for further changes, including making it easier to open free-standing birthing centers, and both chambers agreed to a compromise Thursday.
The final product was praised by conservatives who called for changes that would roll back the state's certificate of need rules.
“For decades, unfortunately, CON laws have been a barrier to expanding quality health care,” Lt. Gov. Bert Jones said in a statement. “Today, we are taking a step toward reforming Georgia’s CON and reducing the barriers Georgians face when trying to receive accessible, high-quality health care.”
Gov. Burns said in a statement Thursday that the bill is “an important action to reform certificates of need and expand access to quality, affordable health care in our state.”
The measure also increases the cap on the Local Hospital Tax Credit Program to $100 million and dedicates an additional $25 million to the program.
When it comes to Medicaid expansion, Rep. Butch Parrish, the Swainsboro Republican who proposed the bill, framed his proposal as something that could be accomplished this year. Parrish chairs the powerful House Rules Committee.
“There was an attempt today in the Senate to pass Medicaid expansion, but it didn't pass. So what we have to do is to serve as many people in the state as possible. , I think it's about doing the best we can to do what we have to work together,'' Parrish said during Thursday's debate.
But Democrats criticized their Republican colleagues for not including a full Medicaid expansion in the final version. The bill previously had bipartisan support, but Thursday's final vote was largely split along party lines in both chambers.
Rep. Sam Park, D-Lawrenceville, said House Democrats were hopeful until Thursday that Medicaid expansion would still happen before the end of the year.
“Despite having one of the highest uninsured rates in the country, this CON does not cover a single Georgian,” Park said. “Today is yet another reminder of Republican cowardice and the failure of Republican leadership in leaving hundreds of thousands of Georgians uninsured.”
