Deal Says Georgia Won’t Be Bullied Into Medicaid Expansion

The law’s lead implementer – U.S. Health and Human Services Secretary Kathleen Sebelius – has been in Atlanta this week promoting Georgia’s coming health exchange and urging Deal to reconsider expanding the state’s Medicaid program.

She says Medicaid expansion would extend coverage to 700,000 low-income Georgians and bring billions in new economic activity.

“The law was passed and signed in 2010, it was upheld by the Supreme Court last year, the president was reelected, we are implementing it, the law is the law,” said Sebelius.

In 2012, the U.S. Supreme Court upheld the law but gave states to ability to opt-out of expanding Medicaid. Deal opted-out, saying Georgia couldn’t afford it. That’s despite the federal government covering 100 percent of its cost for the first three years and about 90 percent thereafter.

Deal said he won’t be bullied.

“Instead of adjusting and accepting the Supreme Court opinion, it appears the tactic is to try to intimidate states which is exactly what the Supreme Court said that the federal act would not allow them to do.”

He said Sebelius has denied “virtually every request” for greater flexibility in rolling out the law. 

“There has been, from my point of view, very little cooperation by the secretary and by the federal government to try to accommodate the desires and wishes of states.” 

Deal has previously argued Medicaid should be turned into a block grant program, or a system in which the federal government pays out an annual lump-sum to states. He says greater state control over things like coverage requirements would mean a more efficient program. Democrats, however, strongly oppose the idea, saying it would shrink the size of a vital social safety net. 

In any case, Deal has also opted out of managing the state health exchange. As a result, the federal government is stepping in to do it for Georgia. Deal said he believes the exchange – scheduled to launch in October – will ultimately raise premiums for consumers.