Medicaid cuts could be disastrous for state, health care advocates say

Georgia would face health care calamity and the state’s budget could be in jeopardy if congressional Republicans press forward on their budget proposal, which calls for cuts to Medicaid programs, health care advocates said Monday.

“These reforms would put significant stress on Georgia’s state budget, threaten access to care and mental health services for Georgians, and likely increase our already high rate of uninsured [people]” said Natalie Crawford, the executive director of Georgia First, a nonprofit in support of Medicaid.

Standing outside the Georgia Capitol, Crawford and members of the American Cancer Society’s Cancer Action Network said the proposed cuts would leave more people in Georgia without access to health care. More uninsured Georgians means businesses would pay more to insure their employees, property taxes could go up and the state would have a less-productive workforce, she said.

The proposed budget advanced out of the U.S. House Budget Committee Sunday evening. Georgia Rep. Andrew Clyde of Athens and three other hard-right members voted “present,” 17 other Republicans voted in favor, and 16 Democrats on the panel voted “no.”

Among the provisions in the legislation, Republican lawmakers want to allow a federal tax credit to sunset that subsidizes the cost of insurance for Georgians who are purchasing coverage on the open state marketplace.

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Nearly 800,000 low-income Georgians receive private insurance through the health care exchange created through the Affordable Care Act, also known as Obamacare.

“If Congress chooses to let those tax credits expire, enormous pressure would be put on our state budget, and many of those 800,000 Georgians will become uninsured,” she said.

Georgia lawmakers, she said, should also maximize “every existing opportunity” to provide residents with health care. That includes expanding Medicaid to allow those earning up to 138% of the federal poverty level — which is about $21,000 for an individual in 2025 — to qualify for the program.

Credit: Arvin Temkar/AJC

Credit: Arvin Temkar/AJC

Republican leaders have refused to do so, citing concern about the stability of federal funding. That has meant people like Alton Fry, a 54-year-old who has prostate cancer, does not have health insurance.

After struggling with drug use and spending time in jail, Fry started to rebuild his life. He works in masonry and has been trying to improve his credit score, but a cancer diagnosis last year brought him to his knees.

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He earns too much to qualify for Medicaid but not enough to pay for private insurance on the health care exchange. Although he has cancer, Fry also doesn’t qualify for disability coverage and can’t get Medicare without a disability status.

“I want to work. I don’t want to live off of the government. All I’m asking for is temporary help to get me over this hump,” Fry said. “But it’s not there.”

Because he doesn’t have health insurance, he has chosen the “least effective” option for treatment — radiation — instead of surgery, which he can’t afford.

The “big, beautiful bill” President Donald Trump has promised would eliminate an added 5% incentive given to the states by the federal government during the pandemic but preserves a 90% federal match for states that expanded Medicaid.

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It would also institutes work requirements for Medicaid recipients. However, in the bill’s current form, those requirements don’t go into effect until 2029.

Republicans have said their aim with the budget is to eliminate waste, fraud and abuse. Work requirements, said Rep. Buddy Carter, R-Ga., of St. Simons Island, would ensure Medicaid is going where it’s intended.

“You shouldn’t have an able-bodied person who could be doing some type of work — it even includes volunteer work — that is on that program,” he told the AJC’s Politically Georgia. “There are all kind of things we can do to find savings without kicking anyone off.”

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Georgia pioneered work requirements two years ago, but the program has seen low enrollment and high administrative costs. If work requirements are instituted nationwide, federal budget estimators say at least 7.7 million Americans would lose health insurance.

Republicans want the cuts to help offset tax breaks Trump would like to add, although the budget cut would not pay for the entirety of the tax breaks.

“This opposition to expanding and protecting health care access in Georgia and across the United States is not conservative, it’s fiscally irresponsible,” Crawford said.

Fry said the issue is urgent and shouldn’t be political.

“This is not a Democratic issue. This is not a Republican issue. This is an issue that affects Georgians and Americans alike. It affects me, and it may affect you in one way or another,” he said. “Let’s focus those efforts on helping people who truly, truly need help and can’t get it anywhere else.”

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Editor’s note: This story has been updated to clarify the number of low-income Georgians who receive health insurance through the Affordable Care Act.

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