Capitol Recap: Georgia ready to begin smaller-scale expansion of Medicaid

Now, the state is opting for a more limited expansion called Pathways to Coverage that will require enrollees to work or do other specific activities.

The state predicts that fewer than 100,000 will receive coverage under Pathways because most won’t meet the work requirements.

Those enrolled in the state’s standard Medicaid program will continue to receive coverage without meeting work requirements or entering the Pathways program.

Under Pathways, recipients must work or perform other activities, such as attending college or receiving on-the-job training, for at least 80 hours a month.

Supporters say those requirements will help lift beneficiaries out of poverty. Opponents say most who don’t work can’t.

The reduced-coverage program isn’t likely to save Georgia any money.

Under Pathways, Georgia will not be eligible to receive the level of support the federal governor gives to states that fully expand Medicaid for all their poor. Those states pay only 10% of the cost of the new recipients’ medical bills, while the federal government pays 90%. In contrast, Georgia will pay 35% of the cost for coverage under Pathways, with the feds picking up the remaining 65%.

Georgia also will not receive a bonus paid to states that undertake a full expansion. For Georgia, that would have meant more than $1.3 billion over two years, according to estimates by KFF, a nationwide health research nonprofit.

Leah Chan of the Georgia Budget and Policy Institute, which supports full expansion, estimates that if Pathways covers 100,000 people, it will cost the state $10 million more than if it had fully expanded Medicaid to cover all 482,000 uninsured, low-income Georgians.

Aides to Gov. Brian Kemp say that number is closer to 345,000 poor and uninsured Georgians.

For what it’s worth, KFF puts Georgia’s Medicaid coverage gap — people who earn too much to receive standard Medicaid benefits but not enough to qualify for subsidies in the ACA marketplace — at 252,000..

Using any of those figures, Chan points out, doesn’t change the fact that “the program will cover fewer Georgians and cost substantially more for the state to implement than a fully expanded Medicaid program.”

AMC closing cited in warnings about Wellstar takeover of Augusta hospitals

The Wellstar Health System during a public meeting this past week offered some details about its plans to spend hundreds of millions of dollars if it takes over the Augusta University Health System.

While the meeting was in Augusta, in the background was Wellstar’s decision last year to shut down facilities that provided care in low-income areas of metro Atlanta.

Leaders with the Cobb County-based hospital system promised that if the takeover wins final approval, core services at the state-owned Augusta University Medical Center’s 24/7 emergency room and other services will remain.

Wellstar CEO Candice Saunders said the contract with AU includes guarantees that would last for the first 10 years of the deal.

AU Health CEO Brooks Keel, who characterized his system’s financial situation as “not good,” pointed to Wellstar’s commitment to spend $797 million over 10 years.

Almost half of that, about $395 million, would go toward building a new hospital and medical buildings in affluent Columbia County, according to testimony at the meeting.

However, some at the meeting, such as the Rev. Melvin Ivey, president of the Augusta chapter of the NAACP, tried to direct attention toward the needs of those of lesser means. He asked Wellstar officials to agree to retaining AU’s policy on charitable care “for our citizens who are not able to afford the cost.”

Wellstar last year shut down two facilities that served lower-income areas, the Atlanta Medical Center and an AMC facility in East Point, citing financial losses it said were too steep to continue running them.

That prompted a warning from a pair of Democratic legislators from Atlanta, in conjunction with the city’s NAACP chapter, about trusting Wellstar with the state-owned AU Health System.

“Wellstar’s actions raise questions of its trustworthiness to control a major state asset like AUHS,” state Sen. Nan Orrock and state Rep. Kim Schofield wrote. “We believe extreme caution is warranted concerning the disposition of this major state asset.”

But Wellstar also found a friendly Democratic lawmaker: state Sen. Harold Jones of Augusta.

Jones told reporters it was important that Wellstar agreed to invest in the AU Medical Center and not shutter its services. Wellstar has promised to spend $31 million on the medical center during each of the first two years of the deal. Depending on how much money the hospital makes, that figure would then grow over the rest of the first decade. Wellstar also would assume AU Health’s debts.

“I heard commitments,” Jones said. “I’m very confident they’ll be kept.”

Any deal will require approval from Georgia Attorney General Chris Carr, as well as the Federal Trade Commission.

The General Assembly, according to contracts negotiated between Wellstar and AU Health, could also upend any agreement by overturning the state’s regulation system for hospitals known as the certificate of need. Such an effort stalled this past year in the state Senate but could return during the legislative session that begins in January.

Credit: AJC file photos

Credit: AJC file photos

Kemp blasts Biden initiatives at ceremony for business that got them

Gov. Brian Kemp picked an odd time to level his harshest criticism yet of President Joe Biden’s green energy initiatives: the groundbreaking ceremony for an $800 million electric battery supplier that is bringing 400 jobs to Bainbridge with the help of federal dollars.

Kemp maintains that Georgia’s growing role in green energy should be credited to the state’s business-friendly, low-tax policies under successive GOP administrations. Georgia’s own aggressive approach to incentives has also helped, including billions of dollars it dangled before Hyundai and Rivian to land two major electric-vehicle plants.

The state has made great gains toward reaching Kemp’s goal of becoming the “e-mobility capital of the world.”

Since 2020, EV makers and their suppliers have announced more than 40 projects in the state accounting for nearly 30,000 jobs.

The governor accused Biden and others of trying to take false credit for Georgia’s success.

But some of the state’s new business partners say the Biden initiatives helped make a difference.

The solar manufacturer Qcells linked a $2.5 billion expansion announced earlier this year to Biden incentives, leading the president to declare it was a “direct result” of the Inflation Reduction Act, a tax and health care law that Congress passed without any GOP support.

And Anovion Technologies, Kemp’s host at this past week’s groundbreaking ceremony, has pointed to the federal assistance it is receiving as a motivator for building the plant in Bainbridge, which will become the largest synthetic graphite production facility in North America.

The company was awarded a $117 million grant to spur domestic battery manufacturing under the federal infrastructure law, a $1 trillion package that passed with bipartisan support — although it drew no votes from Republicans in Georgia’s congressional delegation.

Kemp has come down against such incentives, accusing the federal government of putting its “thumb on the scale, favoring a few companies over the industry as a whole.”

“We either need to do one of two things,” Kemp has said. “You need to give them to everybody or take them away, just make the playing field completely level.”

Kemp’s stance could involve his political plans after he leaves the governor’s office. He’s considered a potential contender in 2026 against Democratic U.S. Sen. Jon Ossoff, whose votes have helped win passage of the Biden administration’s green energy proposals.

Ossoff, who attended the Bainbridge groundbreaking, said Kemp’s denouncement was “just politics.”

He sees room for credit going to both the state and the federal government.

“It’s a collaboration, and I don’t see why there’s political drama about this,” Ossoff said. “The federal infrastructure and manufacturing policies that (Democrats) passed are benefiting Georgia, more than just about any state in the country. We should celebrate that together.”

Credit: University of Georgia

Credit: University of Georgia

Supreme Court rulings in Alabama, Louisiana could have impact in Georgia

U.S. District Judge Steve Jones has set a Sept. 5 trial date for challenges to Georgia’s congressional map, which added a Republican seat in the U.S. House following redistricting in 2021.

The trial comes after two U.S. Supreme Court rulings calling for congressional maps to be redrawn.

In the first ruling, the high court found that Alabama’s GOP-controlled Legislature likely violated the Voting Rights Act when it drew a map with one majority-Black seat out of seven congressional districts.

Then came another decision this past week, when the justices lifted a hold on a lower court’s order setting new boundaries on Louisiana’s congressional map to add another Black-majority district.

In March 2022, Jones found that Georgia’s congressional map — which gives Republicans control of nine of the state’s 14 U.S. House districts — may have violated several aspects of the Voting Rights Act but that a trial was needed to decide. He allowed the new maps to remain in place for that year’s May primaries, ruling that it was too close to the election to make court-ordered changes.

Plaintiffs in the case, including civil rights and religious groups, alleged that redistricting following the 2020 U.S. census reduced the voting strength of Black residents even as their population grew by nearly 500,000 over the past decade. The ideal size of a Georgia congressional district in 2020 was set at 765,136.

If Jones throws out Georgia’s congressional map, he has two options: He could elect to redraw it, or he could force Gov. Brian Kemp to call a fall special session of the General Assembly to try drawing a more acceptable map.

Ethics panel OKs campaign money for caregiving expenses

Child care is often an issue voters weigh during a political campaign.

Now, it could be less of an issue for parents seeking election to the General Assembly.

The state Ethics Commission this past week gave those candidates the ability to use campaign donations to cover the costs for child care or taking care of other family members.

If they win election, they also will be able to use the money for such purposes while the Legislature is in session.

Rep. Stacey Evans, D-Atlanta, and Rep. Beth Camp, R-Concord — who sought the commission’s opinion on the issue — said allowing candidates to use campaign contributions to pay caregiving costs could help persuade more mothers and fathers to run for office. It may also make it more affordable to serve in the Legislature, a job that just saw a raise to $24,000 a year.

State law allows candidates to use the money they raise from donors to cover expenses related to their contests. If they win election, they can also use the money for maintaining their stay in office. So they can use the money to pay for advertising, consultants, food and transportation while campaigning or on official business, fundraising mailers and even club memberships in some situations.

But until now, they haven’t been able to use donations to pay for their children’s day care or hire somebody to watch a sick or elderly parent while they are campaigning or serving in the General Assembly.

Evans said 22 states now permit donations to be used for caregiving, and 11 more are considering it.

Credit: Ben Gray

Credit: Ben Gray

Federal assistance available to peach farmers hit hard by March freeze

The federal government is offering emergency loans to Georgia peach farmers who were hit hard by a freeze over several days in March that destroyed an estimated 90% of the state’s crop.

Federal officials delared a natural disaster, allowing the U.S. Department of Agriculture’s Farm Service Agency to make the loans available to farmers who need it.

The freeze came after an unusually warm winter — January through March was the hottest such period on record in Georgia history — had caused the peaches to develop weeks earlier than normal. When the cold rushed in, many trees were in bloom or had already set fruit.

The primary counties covered under the disaster declaration are Banks, Crawford, Fannin, Gilmer, Habersham, Hall, Jackson, Johnson, Macon, Madison, Meriwether, Monroe, Peach, Pike, Taylor, Towns, Union and Upson. More than three dozen other counties scattered across the state are also covered.

Georgia is still the Peach State, although it’s no longer the country’s top producer of the sweet fruit. California now ranks No. 1.

The deadline to apply for assistance is Feb. 26.

Political expedience