The $1.7 trillion social policy and climate change bill pending in Congress underwent a lot of change before it passed the U.S. House recently.
But one provision that made the cut would be significant for many Georgians. As it stands now, the legislative package would offer health coverage for hundreds of thousands of low-income Georgia residents through the Affordable Care Act’s health insurance exchange.
These uninsured residents are currently caught in the “coverage gap” in Georgia and 11 other states that have not expanded Medicaid through the ACA. They’re too poor to qualify for subsidies offered in the exchange, but also don’t qualify for regular Medicaid in those states.
These people include Cynthia English, 46, of Albany. She is uninsured and has diabetes, hypertension and sciatica. She gets care at a local charity clinic but needs a sleep study in order to keep a job as a van driver.
“I have to pay for it out of pocket’' and can’t afford the cost, English said Monday. “I ended up having to leave my job.”
The new federal legislation would provide a Medicaid expansion “workaround” that would offer insurance to poor people through the exchange instead of through Medicaid. States could not block the coverage expansion because it falls outside of Medicaid, which is jointly funded by the federal and state governments.
An estimated 60% of those caught in that Medicaid coverage gap are Black or Hispanic, according to the Center on Budget and Policy Priorities.
Gov. Brian Kemp and fellow Republican leaders have pushed for federal approval of a Medicaid waiver in Georgia that would extend coverage for poor residents, but only if they work 40 hours a month or fulfill one of various alternative requirements. The Biden administration has so far been cool to those proposed requirements.
A press conference promoting the health care provisions in the Democrats’ Build Back Better bill Monday was hosted by U.S. Rep. Carolyn Bourdeaux (D-Ga.), who lives in Gwinnett County and represents a district that includes several northern Atlanta suburbs.
Bourdeaux is among the members of Congress from Georgia who have pushed to close the coverage gap, and she called it “an opportunity and a moral mandate.” She said at the Lawrenceville press conference that the health insurance provisions would be a “game changer’' for Georgia and would represent the “most significant expansion of health care’' since the ACA’s passage in 2010.
The Kaiser Family Foundation estimates that 269,000 uninsured Georgians are stuck in the coverage gap. But Bourdeaux and others have said it could be 500,000 or more.
Prospects for the Build Back Better bill in the U.S. Senate are difficult to assess. With a 50-50 split in the chamber, the Democrats can’t afford to lose a single vote.
U.S. Sen. Joe Manchin (D-W.Va.) has demanded some changes, including eliminating a new four-week paid family and medical leave program, according to the New York Times.
But Bourdeaux said Monday that she is “very optimistic” that the health care provisions will remain in the bill.
Besides the new insurance coverage, other health care provisions would:
** Extend the more generous subsidies for people who buy insurance through the exchange.
** Guarantee a year of Medicaid coverage for eligible women after they give birth
** Allow Medicare coverage for hearing aids.
** Enhance Medicare’s drug benefit
** Provide new funding for long-term care patients to remain in their homes, rather than in nursing homes.
Republicans have been united in opposition to the bill.
House Minority Leader Kevin McCarthy (R-Calif.) has said that Democrats understand how their “big government” policies are hurting America but they’re following through with the Build Back Better initiative because they know Republicans will take back the House in the 2022 midterms.
Andy Miller is editor of Georgia Health News.
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