Kemp’s health care policy opposes Medicaid expansion, supports waivers

Republican Brian Kemp unveiled his first detailed health care policy on Wednesday, proposing to boost the rural hospital tax credit program and seek federal waivers to help stabilize insurance premiums.

He also opposes expanding Medicaid, a key tenet of Democrat Stacey Abrams’ own campaign for governor. In unsparing terms, he said such a move would reduce access to quality care and lead to “sky-high premiums.”

“The solution is not more government,” he said, adding that his plan would deliver a “patient-centered system that’s right for Georgia not California.”

Kemp chose a symbolic setting for his announcement: the Cook Medical Center in Adel, which was on the cusp of shutting down last year before it partnered with a larger hospital. At least eight rural Georgia hospitals have closed and an additional 21 have faced severe budget shortfalls since 2001, and Kemp said his plan would help shore up the flagging system.

Abrams has higlighted the plight of rural hospitals, long saying that Medicaid expansion is the key to economic growth in struggling Georgia communities. In a statement Wednesday, her campaign called it the only way to cover roughly 500,000 uninsured residents and preserve the rural health care system.

Kemp and other Republicans have long opposed the move, saying the estimated cost — which ranges from $246 million to $468 million a year — would be too pricey in the long run.

He added a wrinkle to his policy, though, when he said he would support a broader Affordable Care Act waiver modeled after a Wisconsin program approved earlier this year. That five-year waiver is designed to create a $200 million reinsurance program to stabilize premiums and protect residents with pre-existing conditions.

“We believe that’s going to lower costs, increase markets and make health care more accessible,” Kemp said, adding: “You can call it a waiver, you can call it innovation, there’s all kinds of different names. I call it more innovation, more private-sector solutions.”

Abrams said last month she would explore similar waivers, saying that the federal dollars could be used to stabilize insurance premiums by partially reimbursing insurers for some claims.

‘Marching orders’

Any major health care overhaul would need the approval of state lawmakers, and several influential Republicans are openly supporting a Medicaid expansion. They point to polls that show broad support for the expansion and a range of GOP-led states that have made the move.

State Sen. Renee Unterman, the chairwoman of the Senate Health and Human Services Committee, said she recently patched up strained ties with Kemp — and lobbied him to support waivers for more federal funding for opioid treatment and mental health services.

“You’ve got to bring a lot of views to the table, and his team realizes that. These are huge issues,” she said. “And it takes the executive branch, the General Assembly, the industry — everybody getting together on them.”

Kemp’s plan also calls for an expanded medical school loan forgiveness program to increase the number of ob-gyn and primary care doctors in rural parts of the state, as well as the creation of a state Commission on Mental Health to address teen suicide rates and prescription drug abuse.

And he’d support association health plans, which let small businesses band together to create health insurance plans at lower costs but fewer benefits. That strategy is criticized by some health care advocates who say it could drive up costs by sapping healthy people out of the broader market.

Another part of his platform would increase the rural hospital tax credit program from $60 million to $100 million, an increase that's also embraced by Geoff Duncan, the GOP nominee for lieutenant governor. Those measures could be endangered, however, by a proposed federal rule that could limit or eliminate the federal tax break donors get for giving to such state programs.

Kemp's plan was released after weeks of needling from Democrats, who have launched a TV attack ad blasting him for an issues page that included only seven words on health care.

A white van driven by state Democratic staffers has followed Kemp’s bus tour, mocking his health care policy, and an Abrams spokeswoman jokingly applauded him for “finally” deciding to talk about his initiative.

“You’ll be glad to know that I’m not taking my marching orders from the Democrats,” Kemp said. “We’ve had more policy proposals out longer than anyone else in this campaign. We’ve been talking very strategically about the things I want to talk about in this campaign.”


It’s a busy election year, and The Atlanta Journal-Constitution is keeping the spotlight on the leading candidates for governor, Republican Brian Kemp and Democrat Stacey Abrams. Recent AJC stories have examined Kemp’s finances and Abrams’ position while in the state Legislature as a leading collector of per diem. Look for more at as the state heads for the general election on Nov. 6.