Opinion: Medicaid waiver plan inadequate to Ga.’s needs

Georgia’s State Capitol.
Georgia’s State Capitol.

Gov. Brian Kemp’s slickly worded presentation announcing the approval of his Medicaid waiver plan almost had me believing that he had cured Georgia of its 1.4 million uninsured. And he spun a pretty good tale of how “millions and millions” of additional Georgians would also benefit. But the small print revealed he was selling us snake oil instead.

Gov. Kemp’s waiver only addresses a small fraction of Georgia’s uninsured - at a platinum price.

The governor’s healthcare waiver bans Georgians from using the HealthCare.gov website to shop for ACA health coverage plans. Georgians will instead be required to visit numerous private broker websites to compare their offerings, some of which could include junk plans that offer substantially less coverage to unsuspecting shoppers than ACA plans. Kemp called HealthCare.gov “simply awful,” yet according to Laura Colbert, Executive Director of Georgians for a Healthy Future, people shopping for ACA plans can already buy directly from insurance companies, yet 80% choose to use the government portal instead. Gov. Kemp also failed to mention that the Trump Administration has continuously cut marketing and education budgets for HealthCare.gov, intentionally making it harder for Georgians to sign up for ACA plans.

State Sen. Sally Harrell, D-Dunwoody
State Sen. Sally Harrell, D-Dunwoody

Credit: contributed

Credit: contributed

The governor’s waiver also includes “reinsurance” for private plans. This means the government will pay the big, expensive claims so private companies don’t have to. This corporate subsidy is meant to lower ACA plan premiums. This could work, but what’s more likely to happen is that brokers will steer healthier people into cheaper plans with less coverage, negating any price savings reinsurance has to offer. And as we have seen time and time again, government-paid corporate subsidies are rarely passed along to consumers, but instead make businesses wealthier.

The Affordable Care Act allows states to expand Medicaid, and the second of Kemp’s waivers expands Medicaid to 100% of the Federal Poverty Level (less than $12,760 per year for an individual or $21,720 for a family of 3), rather than those making a bit more ($17,600 and $29.970 respectively) as is called for under the ACA. Although it is commonly believed that anyone can get Medicaid if they are poor enough, this has never been the case in Georgia.

According to the governor, his waiver makes Medicaid accessible to about 50,000 additional low-income people, but with substantial strings attached -- these Georgians can only get and keep their Medicaid if they document 80 hours of qualified work activity per month. Kemp not only leaves out 350,000 uninsured people who could qualify under full Medicaid expansion, but ensures that people who are too sick to work, are at home caring for sick family members, or who lose their jobs, also lose their healthcare.

An overwhelming number of Georgians support Medicaid expansion, yet the governor belittled it, calling it a “bumper sticker plan for healthcare reform.” He said it sounds good, but costs too much. He says his plan costs $218 million. Yet the legislature had a fiscal note prepared last year that said full Medicaid expansion would cost only about $200 million - $18 million less than Kemp’s plan.

Our government should work to ensure that basic human needs are met with the same energy that it uses to foster a profit-driven economy. I’m sick and tired of this imbalance, and too many Georgians are literally sick because of it.

If Gov. Kemp actually listened to all of his constituents, he’d find that not everyone is happy with their private plan. That’s why Georgia needs a public option, which could be modeled after the popular PeachCare for Kids program. Through a public option, anyone, no matter their level of income or access to an employer-sponsored plan, could choose to purchase the PeachCare Public Option. The cost would be not a penny higher than what it costs the government to provide the service. Which incidentally, would be up to 10% lower than the cost of equivalent private plans.

Gov. Kemp has been spinning his wheels about his healthcare plan since he came into office - and meanwhile, Georgians have gone without treatment for health issues that put them at higher risk for being hospitalized or dying from COVID-19, especially Black people. And by the time Gov. Kemp’s plan finally goes into effect next summer, hundreds of thousands of Georgians will have suffered without needed care through what is expected to be the worst surge yet of the COVID pandemic.

This is no time for Gov. Kemp’s approach to “caring;” it costs us too much.

State Sen. Sally Harrell is a Democrat representing District 40.

In Other News