FIVE THINGS TO KNOW: A Georgia Medicaid waiver

For seven years, Georgia GOP leaders have rebuffed the notion of expanding Medicaid to cover the state's poorest, citing concerns about future costs. That may be about to change, as newly installed leaders consider doing an expansion but with a "waiver" to allow Georgia to shape the program more conservatively. Here's the lowdown:

  • What's Medicaid? Medicaid is the government health insurance program that pays for care for the poor, as well as some children, elderly people and disabled people.
  • Expand it to whom? Right now there's a coverage gap in Georgia for thousands of very poor adults. Programs help pay health coverage for other people: the elderly, children, mothers of minor children, people the government declared disabled, and people who make at least, say, $16,000 a year for a single person. But for people who make less money than that and don't fit into those categories, it's up to the state to decide whether Medicaid should cover them. Up to now Georgia has decided not to, citing the cost.
  • Why the controversy? It's financial and political. Medicaid costs money. Opponents point out that outright expansion could cost Georgia $200 million or more per year. Advocates counter that the federal government would likely match that at a 9-to-1 ratio, sending billions of dollars into the state's health system. Politically, Medicaid expansion is tied to President Barack Obama's Affordable Care Act, a deeply unpopular concept to the GOP base.