Reviving a health care sisterhood in Georgia

Credit: Alyssa Pointer

Credit: Alyssa Pointer

Historically, a political sisterhood has stood behind expanded health insurance coverage in Georgia.

The alliance has fallen into disrepair. Rebuilding it has become a crucial part of Stacey Abrams’ Democratic bid for governor, marked by a nonstop call for Medicaid expansion. “You’ll hear me talk about this ad nauseam, because it is the only answer to Georgia’s challenges,” she said Monday.

But green shoots of revival are sprouting on the Republican side as well.

As the gubernatorial contest has heated up, allies of Abrams and Brian Kemp, her Republican rival, have been poking through the two candidates’ legislative histories.

The Georgia GOP has accused Abrams of coddling sex offenders — with questionable results. Early this week, the state Democratic party pointed to 2005 legislation supported by Kemp that would have allowed small businesses to offer stripped-down health insurance policies, free of pesky, state-mandated coverage for such things as mastectomies, testing for chlamydia and contraceptives.

To Democrats, that’s proof that Kemp, who opposes Medicaid expansion in Georgia, would also want to end the Obamacare prohibition on denying insurance to those with pre-existing conditions. (A campaign spokesman said Kemp would “never” support that.)

But pursuit of the “gotcha” element has obscured the more important, 13-year-old story behind Senate Bill 174, which ended up gutted by a bipartisan coalition of female state lawmakers.

At the time, Georgia had 20 or so mandated coverage provisions that governed health insurance companies. They had been added one at a time, many during the 1990s. Many, though not all, dealt with neglected areas of women’s health.

One mandate overturned the insurance company practice of denying hospital stays following a mastectomy. Another ended “drive-by pregnancy” coverage that booted mom from the hospital almost as soon as the baby dropped. The required coverage of tests for chlamydia was aimed at a sexually transmitted disease that could have a devastating impact on a woman’s reproductive system.

Year after year, insurance companies sought to overturn the mandates, citing added costs. The fight in 2005 was no different. An informal caucus of Republican and Democratic women lined up against SB 174, and neutralized it. “Women and men look at legislation from a different perspective. That’s why it is good we have both in the General Assembly,” said state Rep. Sharon Cooper, R-Marietta, who chaired of the House Health and Human Services Committee.

The women’s alliance was broken up in 2010 by Gov. Sonny Perdue, as Republicans stoked their opposition to the Affordable Care Act, which President Barack Obama had just signed into law. In the midst of yet another state Capitol attempt to dump coverage mandated by the state, Republican women were ordered to stand down.

“That mantra of no mandates was taken up by the GOP,” said state Sen. Nan Orrock of Atlanta, who acted as a Democratic partner.

Women lawmakers in the state Capitol still tend to bipartisanship on health-related issues, ranging from legislation on suicide awareness to standardized forms governing end-of-life treatment. But the topic of health insurance coverage remains off-limits.

The alliance that has disappeared from the state Capitol is what Abrams is attempting to build on the ground now. In that recent poll commissioned by The Atlanta Journal-Constitution and Channel 2 Action News, more than 1,000 likely voters identified the economy, health care, and public education as their top concerns. Those three topics also happen to be the only issues in the poll that showed a measurable split along gender lines.

Men were more concerned about the economy and jobs. Women were more likely to worry about health care and education.

In this era of Donald Trump, female voters are also the key to Democratic chances in Georgia and elsewhere. So it was no surprise on Monday to hear Abrams, offering more details on her health care platform, emphasize expanded access to "essential health services for women."

More than half of Georgia’s 159 counties have no obstetrician/gynecologist, 64 have no pediatrician, and the state has one of the highest maternal mortality rates in the nation.

Credit: Pablo Martinez Monsivais/AP

Credit: Pablo Martinez Monsivais/AP

Kemp has been sparing in his comments on health care and insurance coverage. But other Republicans are making careful ventures into what has been forbidden territory. Tom Price, the former head of the U.S. Department of Health and Human Services, was once tasked by President Trump with dismantling Obamacare.

Last week, the former congressman was interviewed by Emma Hurt of WABE (90.1FM). "I try to challenge policy-makers to think creatively and innovatively about how we're going to solve the challenge of 1.4 million Georgians who don't have health coverage. That's the fundamental problem," Price said. "Whether it's through Medicaid expansion, in a creative way that's responsible, or whether it's through some other program – I don't know that that makes a whole lot of difference to me. So long as we do it in a way that solves the problem."

Whether or not Abrams is elected governor, the Legislature has the final say-so over an expansion of Medicaid. The two Republican lawmakers whose committees would oversee that debate are both women. Cooper still chairs the same House committee she did in 2005. Renee Unterman of Buford chairs the Senate committee that handles health care issues.

On Tuesday, Unterman posted a Twitter message indicating that, come January, she’s ready to make a push to seek additional Medicaid cash to address the state’s opioid epidemic. “Answer to Georgia substance abuse epidemic; what’s the alternative? Families suffering & young people dying. I won’t sit back & do nothing. Limited targeted population waiver,” she tapped out.

Cooper said she’s open to the idea, but wants more. Grady Memorial Hospital, she said, thinks it has developed a system for cutting the cost of treating the elderly poor. “I would love for us to have some trial situations like that,” Cooper said. “If we ever move to where we have an ability to do a whole state plan, I would like for us to have tried some smaller programs ahead of time.”

Which means that come January, we could see the return of the health care sisterhood.