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Another sign Georgia could be inching toward Medicaid expansion

We have another sign of Georgia GOP dalliance with Medicaid expansion under the Affordable Care Act.

From Michell Eloy and WABE (90.1FM):

State Sen. Renee Unterman, R-Buford. AJC file/Bob Andres, bandres@ajc.com

State Sen. Renee Unterman (R-Buford) didn’t endorse the idea of Medicaid expansion under the Affordable Care Act, also known as Obamacare. Rather, she thinks the state should look at negotiating a federal waiver, as other Republican-majority states have done, to tailor how any potential Medicaid expansion would work.

“We have to open that box and look just a little bit and see what’s available,” Unterman said. “Hopefully, if you draw down federal dollars, you can free up some of those state dollars. Right now, we’re just pumping out state dollars to stay in the midst of the crisis.”

The “crisis” Unterman is referring to is the struggle many Georgia hospitals are facing to keep their doors open. At least four rural hospitals have closed in Georgia since 2013.

She's not the first Republican lawmaker to reframe the debate over Medicaid expansion, which Gov. Nathan Deal and other GOP politicians have said is too costly in the long run, as a way to bolster the growing number of rural hospitals struggling to stay open.

State Sen. Chuck Hufstetler of Rome has long argued that an expansion is overdue, as have several other of his GOP colleagues. And Deal flirted with a Medicaid 'experiment' to request more federal funding for struggling rural hospitals.

But Unterman's comments could herald a new willingness by state lawmakers to explore the "private option" adopted by Republicans in Arkansas and other conservative states. The hybrid program uses federal funds to buy private insurance for low-income Arkansans, providing coverage for more than 220,000 people.

Modern Healthcare, a healthcare policy website, quotes Unterman in a May piece saying she thinks there's enough support in her chamber for an Arkansas-style program. Here's more from the piece:

State Rep. Sharon Cooper, the Republican chairwoman of the House's Health and Human Services Committee, said she and her colleagues will entertain the proposals, but added that she doesn't believe it will solve the access problem.

“The problem with expansion is, who is going to treat these people,” Cooper said. “We don't have the physicians, nurse practitioners or physician assistants to care for them in rural areas of the state.”

Any expansion push would have to start in the Legislature. Deal signed a law in 2014 that takes the power to expand the program away from the executive branch and gives it to the General Assembly.

Insider's note: A version of this post ran in the Morning Jolt.

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About the Author

Greg Bluestein is a political reporter who covers the governor's office and state politics for The Atlanta Journal-Constitution.