The Jolt: Health care waiver sought by Brian Kemp doesn’t ‘add up,’ study says

11/04/2019 -- Atlanta, Georgia -- Gov. Brian Kemp answers questions from the media following a press conference to announce a proposed limited expansion of Medicaid in Georgia while at the State Capitol building in Atlanta, Monday, November 4, 2019.  (Alyssa Pointer/Atlanta Journal Constitution)
11/04/2019 -- Atlanta, Georgia -- Gov. Brian Kemp answers questions from the media following a press conference to announce a proposed limited expansion of Medicaid in Georgia while at the State Capitol building in Atlanta, Monday, November 4, 2019. (Alyssa Pointer/Atlanta Journal Constitution)

Credit: Alyssa Pointer

Credit: Alyssa Pointer

News and analysis from the AJC politics team

Georgia Democrats pushing for Medicaid expansion have just been handed some ammunition – in the form of an analysis of Gov. Brian Kemp's request for a federal waiver that would put a Georgia brand on health care for the poor. From the introduction of a study by the USC-Brookings Schaeffer Initiative for Health Policy:

A waiver structured in this way does not meet the requirements laid out in Section 1332 that waivers must provide coverage that is just as affordable and comprehensive to just as many people as would have it absent the waiver, all without increasing the federal deficit. And the analysis accompanying Georgia's waiver includes errors both obvious and subtle that mean that the waiver's actual effects are different than the state claims.

This makes it impossible for the numbers to add up or for the analysis to satisfy the requirements of Section 1332. The waiver also fails other procedural tests. HHS and Treasury (the Departments) cannot legally approve this waiver, and if they attempted to do so, a plaintiff suing to overturn it would be expected to prevail. Other states considering following Georgia's lead should be aware of these flaws before starting down this legally fraught path.

Kemp's effort to thread the needle when it comes to Medicaid expansion may be passé in any case. From the Washington Post:

Top Trump administration health officials are inviting states to convert part of Medicaid into a block grant — a longtime conservative goal Congress rejected more than two years ago.

A letter to every state Medicaid director, to be dispatched Thursday, will offer the possibility of trading away an entitlement program that expands and contracts depending on how many poor people need the government health coverage. In exchange, for able-bodied adults in the program, states could apply to receive a fixed federal payment and freedom from many of the program's rules, according to several individuals familiar with the plans.

***

Just in case you've been under a rock this morning: U.S. Rep. Doug Collins launched a bid for U.S. Senate on Wednesday with an appearance on Fox News, saying he'd center his campaign on support for President Donald Trump as he dismissed concerns about opening a bitter Republican rift.

***

A first thought on a Loeffler/Collins contest: In a very critical sense, Doug Collins' entry into the U.S. Senate contest may undermine Gov. Brian Kemp's core reason for selecting Kelly Loeffler as Johnny Isakson's replacement.

She was intended to appeal to suburban, white female voters who find President Donald Trump more than a little off-putting. But with Collins in the race, she now doesn’t dare let a sliver of light get between her and the man in the White House. Her gender advantage is diminished.

***

Several readers have pointed out a tweet that U.S. Sen. Loeffler "liked" that compared wearing a pro-Donald Trump hat to donning a yellow Star of David.

User @bvburgess tweeted, in part: "Today's MAGA hats were my family's Star of David. Forced to hide too avoid the tyranny. We're living in very scary times when tyranny seems acceptable by extreme leftist."

***

In Wednesday's print column, we noted that the U.S. Senate contest as one of two breaches between Gov. Brian Kemp and House Speaker David Ralston.

The conflict is of the seething variety, given that neither politician has openly declared hostilities.

The headline is Ralston’s push for legislation that would force U.S. Sen. Kelly Loeffler, who Kemp hand-picked for the job, into a May primary against U.S. Rep. Doug Collins.

There’s also a tug-of-war over Kemp’s demand for teacher pay raise and Ralston’s insistence on income tax cuts amid the governor’s broader call for budget reductions.

Ralston has even raised objections over Kemp’s primary feel-good proposal: An overhaul of foster care laws that would make it easier for some parents to adopt children.

Kemp’s top deputies have retweeted news stories critical of Ralston, while the speaker’s allies have eagerly courted Collins.

Ask the two men about their relationship, though, and it’s all smiles. Kemp has said nothing critical of Ralston -- and has declined comment on Collins’ plan to run.

As for Ralston, he pointed to a breakfast with Kemp on Tuesday as evidence of their warm ties.

“I think y’all have sort of inflated that,” he said, adding: “There’s no tension. We do look at the budget differently on some items. I think that’s healthy. I’m not one to think that it’s unhealthy to have disagreements over things.”

Privately, of course, senior GOP officials paint a different picture. One texted that the “Kemp-Ralston Cold War is going to go on until one of them topples the other.”

***

State Sen. John Wilkinson, R-Toccoa, announced this morning that he'll run for the Ninth District congressional seat being given up by Doug Collins. Meanwhile, radio host Martha Zoller is letting it be known that she, like Senate President pro tem Butch Miller, R-Gainesville, has no interest in going to Washington.

***

More evidence of tectonic shifts in metro Atlanta: Our AJC colleague Tyler Estep reports that, after 24 years in office, Gwinnett County Sheriff Butch Conway has decided against running for re-election this year. In the same statement, Conway said that one of his chief deputies would be running to succeed him.

***

Over on the Georgia coast, former state Rep. Buddy DeLoach, a Republican and former mayor of Hinesville, announced this morning that he will attempt a return to the state Legislature. DeLoach intends to mount a primary challenge to state Rep. Jeff Jones of Brunswick.

Late last year, Jones was removed from his position as vice chairman of the House Regulated Industries Committee. Jones was one of the 10 GOP legislators who signed on to a resolution to oust House Speaker David Ralston.

***

 Joe Campbell, chairman of the Mitchell County Republican Party, won the House District 171 special election on Tuesday night.

Campbell received 58.3% of the nearly 5,000 ballots cast among three candidates, the AJC's Maya T. Prabhu reports. The southwest Georgia seat was made vacant by the death of state Rep. Jay Powell, R-Camilla, in November.

***

The Democratic race for U.S. Sen. David Perdue's seat may still be a jumble, but national Republicans have clearly identified a frontrunner.

In recent weeks, the Senate GOP's political arm has falsely claimed Jon Ossoff is in a "sham" marriage and claimed he was a "liar" without pointing to any outright falsehood from the candidate.

And on Monday, the group pushed a video of Ossoff from a recent forum claiming he asserted that he wants to make it so Republicans and supporters of President Donald Trump "never show their faces again."

Actually, his comments were part of a broader swipe at U.S. Sen. David Perdue. Here’s the full quote from a transcript of his remarks:

"The political leadership we have in this country is robbing us of our decency, our dignity, our kindness, our basic values, our commitment to human rights, our respect in the world. It is not enough just to beat Donald Trump and those like David Perdue who serve him. …

"We need to send a message this year. We need to send a message that if you indulge in this kind of politics, you're not just gonna get beaten, you're gonna get beaten so bad you can never run or show your face again in public." 

One of your Insiders was at the forum, and included a shorter version of the comment as the final quote in a story on the event:

"We need to send a message that if you indulge in this type of politics, you're not just going to get beaten. You're going to get beaten so bad, you can't run again or show your face in public." 

***

Attorney General Chris Carr is asking for additional money in the upcoming state budget to help his office defend multiple elections-related lawsuits. The AJC's Maya Prabhu has more here about Carr's $200,000 request:

The money would pay for attorneys and legal costs associated with the rising expense of court cases, including one alleging that the state's election laws create obstacles to voting and that voting machines aren't secure.

"Recently our state's election laws have become a central focus of litigation," Carr told a House Appropriations subcommittee. "The fiscal impact that this litigation will have on the state in the coming months and years is significant."

Among the lawsuits pending:

-- Stacey Abrams’ Fair Fight Action has accused the state of purging voters and throwing out absentee ballots unfairly and failing to protect the integrity of the voting system;

-- Groups are asking a judge to force the state to adopt a voting system that includes paper ballots filled out by hand instead of the touchscreen-and-printer system lawmakers are in the process of implementing.

***

And from the AJC's David Wickert: The Senate Transportation Committee on Tuesday approved a revised Senate Bill 159 that would define scooters for the purposes of regulations but impose no statewide rules of the road

***

Georgia environmentalists are worried that a new water rule rolling back regulations from the President Barack Obama era could jeopardize nearly 40,000 miles of streams.

The new “Waters of the United States” rule, announced by the Trump administration last week and scheduled to go into effect in the spring, distinguishes which property would require a federal permit for certain business activities or projects.

Advocates of the new rule say it will cut down on red-tape and reduce the burden on landowners, the AJC's Tamar Hallerman reports:

The updated rulemaking, which was finalized last week and will go into effect this spring, now distinguishes between navigable waterways — which fall under the jurisdiction of the Clean Water Act and are illegal to pollute without a permit — and certain wetlands, intermittent and "ephemeral" streams created by rainfalls.

That means major bodies of water like the Chattahoochee River and Carters Lake near Ellijay will still be regulated, said Mary Walker, administrator for the U.S. Environmental Protection Agency's Southeast region, and smaller or underground sources like groundwater, farm water ponds and wastewater treatment systems will not.

… Environmentalists warned that President Donald Trump's rulemaking would give heavy industry and developers more leeway to dump pollutants, harming drinking water, wetlands and the state's most iconic bodies of water.

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