The federal government pays 90 percent of the costs for people with Medicaid expansion coverage. This means for every dollar a state spends on coverage for this population, it will bring in an additional nine dollars in federal matching funds. Georgia has already missed out on $21 billion federal health care dollars because of our refusal to expand Medicaid. Georgia cannot afford to keep waiting. This infusion of federal dollars will boost state economies if, as expected, the public health emergency leads to a severe recession. The additional funding is also one of the most rapid, proven ways to deliver fiscal relief to states during an economic downturn.
Georgia can explore several options to expand Medicaid in this moment. First, the governor should consider if his emergency powers would allow him to authorize a full Medicaid expansion by suspending the restrictions from Senate Bill 106 that only permitted the state to pursue a partial expansion. The governor’s public health emergency powers allow him to “suspend any regulatory statute prescribing the procedures for conduct of state business, or the orders, rules, or regulations of any state agency, if strict compliance […] would […] delay necessary action in coping with the emergency.” The Department of Community Health should consider ways to expand coverage through emergency 1115(a) Medicaid waivers and resubmitting the state’s partial Medicaid expansion waiver to remove work reporting requirements. And when state lawmakers reconvene for legislative session, they can amend the legislation that says Georgia can only expand up to 100 percent of the poverty line to allow expansion up to 138 percent of poverty and/or add language to the budget allowing the state health agency to pursue a full expansion.
Georgia has already waited too long to expand Medicaid, and our state’s people are now paying the cost. Georgia, particularly southwest Georgia, has seen the effects of a large number of uninsured Georgians in recent years, and is now particularly vulnerable to the effects of COVID-19. There is no time to waste; Georgia must take immediate action to expand Medicaid and support the health and well-being of our communities.
Laura Harker is senior health care analyst for the Georgia Budget and Policy Institute.