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Expansion of Medicaid for Georgia’s poor on the table, with a twist

A leading Georgia state senator voiced full-throated support for expanding government health coverage for the poor under a federal “waiver,” similar to what Vice President Mike Pence did when he was governor of Indiana.

The comments came Friday during a testy study committee hearing about hospital financing. The committee’s chairman, state Sen. Ben Watson, R-Savannah, had proposed draft legislation that would roll back regulations that protect hospitals. Watson said he supported rolling back the regulations, but he also backed the idea of the waiver.

Under such waivers, states tailor Medicaid expansion to cover those who make less than the poverty level in the state’s own way.

“I think it is the responsibility of our Legislature, of our society, that people have coverage so that they can be seen,” said Watson, a doctor.

Watson said that for people who lack coverage, he and others had discussed Medicaid waivers “like what Mike Pence did in Indiana,” which included small payments into health savings accounts, and then later, an attempt to add in a work requirement.

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He encouraged a hospital representative to “lead the charge” on Medicaid waivers and block grants (an idea that would likely decrease federal Medicaid funding to states): “We need somebody to grab that mantle and do that.”

Watson’s committee is dedicated to examining the state’s Certificate of Need process, or CON. CON is a state regulation that is meant to prevent private companies from poaching the few profitable medical services that hospitals do, and thus leaving the hospitals with the money losers such as emergency room and neonatal care.

Profit-making medical providers — and Watson is part of one such partnership — say CON stifles entrepreneurship and patient options.

Watson’s proposal would eliminate CON for mental health services and roll it back in several other ways, including easing approval for some cardiac procedures and facility expansions.

Ethan James, a lobbyist for the Georgia Hospital Association, attempted to make the case that such a proposal could not be discussed without talking about how hospitals already lose money by providing uncompensated care. Watson disagreed.

He noted the Senate could have gone further on CON.

The House has its own proposal, which would simply lift CON in the metro Atlanta region.

“I never really thought that the Senate would be the moderate one in the room,” Watson half-joked to James. “Maybe that’s something we’ll have to embrace in the future.”

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