Medicaid expansion could get more bipartisan debate at the Gold Dome this year

Gathering facts about Medicaid expansion –– that’s what House Speaker Jon Burns said he’s working with other top Republican lawmakers to do this year.   

“When it comes to health care, there has certainly been a lot of discussion of late about Medicaid expansion,” he said.

And Burns talked about it at the Georgia Chamber’s annual Eggs and Issues event this week.  

“Expanding access to care for lower-income working families through a private option in a fiscally responsible way that lowers premiums is something we will continue to gather facts on in the House,” said Burns.

He was also careful to say that he supports Gov. Brian Kemp’s limited expansion of Medicaid called Pathways to Coverage.

Pathways launched last summer, making Georgia the only state in the country offering Medicaid to more low-income adults who meet 80 hours per month of work or education requirements. The program has had a minuscule rollout so far.  Kemp says it’s working. 

Burns this week called Pathways “a viable option.”

“And it will continue to work, but we want to make sure that we are looking at every option and certainly working with the governor and the senate, with the lieutenant governor to ensure that we have the facts on the table about good fiscal opportunities that may be important,” he said, “maybe something we could look at in the future to help provide that affordable, accessible health care to Georgians, no matter where you live in this state.”

Burns said he’s also interested in ways to expand access to telemedicine. And he is making mental health legislation a priority for the House. 

The 2022 House Bill 1013 Mental Health Parity Act, championed by the late Georgia House Speaker David Ralston, mandated that Georgia health insurers provide mental health coverage at the same level as coverage for physical health conditions.

The law, for the first time, brought state regulations into compliance with more than a decade of federal parity laws. The landmark legislation highlighted chronic gaps in Georgia’s mental health care system, laying out a multiyear roadmap of reforms for lawmakers to tackle.

Last year, lawmakers failed to pass the follow-up bill H.B. 520. The package would have included boosts in funding for mental health and addiction treatment programs, for recruiting more mental health system workers, and to target resources for Georgians with mental illness who continually cycle between hospitals, jails and homelessness.

Toward the end of the last legislative session, talks on the bill broke down amid a Senate Republican debate over so-called Certificate of Need rules. The regulations determine where in the state new hospitals and medical centers are permitted to open and operate.

This year, top GOP lawmakers say they are open to discussing potential changes to Certificate of Need, or CON.

“We believe that CON regulations have not been revised for a long time, since the ’70s, a lot of them. So we know that things have changed, the economy has changed. So a lot of things are different. But we wanted to make sure that we looked at all of those with clear vision from different perspectives –– big hospitals, small hospitals, senior services for folks who are in the senior living area of healthcare. We’ve tried to look at a broad spectrum and they’ve done a good job. We have some recommendations on the table that we’re looking at,” said House Speaker Jon Burns this week.

Meanwhile, House Democrats continue their push for full Medicaid expansion. Johns Creek Democratic state Rep. Michelle Au hosted a public hearing on the issue this week that drew more than 100 people. 

Good Samaritan Health Center of Gwinnett Executive Director Gregory Lang was among the dozens of people who signed up to speak. Lang said he votes Republican. And he supports Medicaid expansion to increase access to health care.

“Some of our patients have died unnecessarily or succumbed to a health care condition that has disabled them,” he said. “But it could have been treated and prevented had they had health insurance.”  

His nonprofit safety net clinic offers primary care and dental services to low-income and uninsured patients.

Lang said Medicaid expansion would give more Georgians access to medical care when they need it. And prevent their conditions from getting worse –– and more expensive down the road if they end up seeking help at the ER.

“If Medicaid expansion is going to insure people who currently do not have insurance, then it would be the right thing for us to do,” he said.  

Georgia is one of 10 states that haven’t expanded Medicaid under the Affordable Care Act. North Carolina is the latest to do so, with an expansion of Medicaid to uninsured adults beginning Dec. 1.

In Georgia, expansion would cover more than 400,000 uninsured adults with incomes up to 138% of the federal poverty line, according to health policy group KFF. The income levels translate to just over $20,000 a year for a single person or $41,400 a year for a family of four. 

Full expansion would also allow Georgia to tap into millions more dollars of federal funding. Kemp has long opposed full expansion. 

For now, it remains to be seen whether top state Republicans will continue to explore the idea during this year’s General Assembly legislative session.