Medicaid expansion: House panel votes to shift power to Legislature

A proposed bill that would strip Gov. Nathan Deal of the power to expand Georgia’s Medicaid program cleared its first hurdle Wednesday afternoon.

Members of a House Judiciary subcommittee approved House Bill 990, which would give the General Assembly the power to decide on a Medicaid expansion. The bill would put expansion — already a long shot — even further out of reach.

Medicaid is already one of the state’s large expenditures and expansion would cost hundreds of millions of dollars more, said House Speaker Pro Tem Jan Jones, R-Milton, one of the bill’s sponsors.

“It’s a fundamental policy shift and certainly one I feel should be decided by the Legislature,” Jones said.

A pillar of the Affordable Care Act, expansion would add about 650,000 low-income Georgians to the Medicaid rolls. Deal, an ardent Obamacare opponent, has rejected the expansion, saying the state can’t afford to broaden the already overwhelmed program.

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The governor’s office estimates expansion would cost the state $4 billion over a decade. Obamacare supporters argue, however, the cost of expansion to the state is closer to half of what Deal has asserted.

The governor’s estimate includes new costs tied to the health law that the state must pay regardless of whether it opts to expand Medicaid, said Tim Sweeney, a health care policy expert at the left-leaning Georgia Budget & Policy Institute. The cost falls even lower to about $350 million over 10 years when new sales tax, income tax and other revenue is factored in, according to Sweeney’s estimates.

HB 990 would create more barriers to expansion, said Cathryn Marchman of Saint Joseph’s Mercy Care Services, who spoke out against the bill. The Atlanta nonprofit sees roughly 13,000 patients a year, the vast majority of whom don’t have insurance.

“This is not just a political issue,” Marchman said. “This is about not making a decision on the backs of the poor.”

HB 990, backed by top House leaders, is one of two pieces of legislation targeting Obamacare. House Bill 707, introduced by Rep. Jason Spencer, R-Woodbine, would bar the state from using of its resources to implement any portions of the health care law.

“We’re required to balance the budget,” said committee member Rep. Edward Lindsey, R-Atlanta. “If we’re the ones holding the purse strings then we should be the ones to say whether to expand or not.”

Spencer, who supports 990, said that Medicaid is already rife with abuse and expanding the program would only worsen the problem.

Rep. Roger Bruce, D-Atlanta, who voted against the bill, questioned Spencer about where that leaves people who are truly in need of Medicaid services.

“How do you balance taking it away from those who need it?” Bruce said. “We still have people we have a commitment to help.”

The bill now goes before the House Judiciary Civil Committee.

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