The Georgia Chamber of Commerce unveiled what it bills as a conservative-friendly blueprint for Medicaid expansion on Wednesday, outlining a trio of proposals that could offer more coverage to Georgia's poorest residents under the Affordable Care Act.
A task force deputized by the influential business group cast its options as a starting point for Georgia lawmakers who are preparing for a bruising debate in 2017 over healthcare coverage that could cost less than a wholesale expansion of the program. It calls it the "Georgia Way" - though it spares many crucial details, such as the cost of each option, how it could be financed or how many people it could cover.
Gov. Nathan Deal has long opposed accepting more federal funds to expand Medicaid, saying it will be too costly in the long run. But a growing number of Republicans say it is past time for Georgia to begin accepting tens of billions in federal money to expand coverage to more than 600,000 low-income residents and shore up the struggling network of rural hospitals.
Just how to do that promises to be a main theme of next year's legislative session. A 2014 law gives the legislative branch authority to expand Medicaid, though Deal would still have to sign off on the changes. So far, state leaders have been holding their cards close to their vests.
"The governor is always open to financially sustainable solutions or ideas to provide healthcare coverage to Georgians, however any action in regards to this report will have to come from the General Assembly," said Deal spokeswoman Jen Talaber Ryan.
A spokesman for Lt. Gov. Casey Cagle said the Republican is interested in "conservative proposals that would increase our citizen’s access to care and protects the long term viability of Georgia’s rural hospitals." And House Speaker David Ralston hinted at the difficult conversations to come.
"While we are committed to maintaining access to quality, affordable healthcare in Georgia, we must recognize that there is no easy – or cheap – solution available,” Ralston said.
The first option would provide new coverage through the state's Medicaid program to childless adults who earn less than $11,700 annually - an at-risk population that now falls below the minimum income requirements to receive federal subsidies under the Affordable Care Act's insurance exchange.
The second option would increase eligibility to adults earning up to $16,242, or 138 percent of the federal poverty level, and enroll all beneficiaries up to that income level in the Medicaid program. The third would also increase eligibility to adults earning up to $16,242 but place those who earn above $11,770 in a private insurance plan.
“Any of these plans would serve as a game-ready playbook for lawmakers seeking a fiscally responsible and sustainable path to cover Georgia’s uninsured, revitalize a rural healthcare network in crisis and undergird our safety net hospitals," said Chris Clark, the chamber's chief executive , in a prepared statement.
The task force did not include cost estimates or other figures for the three plans, but said it would release more data and cost projections before lawmakers convene in January. It also said the three approaches would require special waivers from the federal government.
Clark said he hoped the proposals would kick start a "serious conversation" with Deal and other state officials.
"As our nation continues its debate about the proper role of the federal government in healthcare, we need to focus on the state level on what we can control, under current laws, to keep Georgia’s healthcare network alive and vibrant and our business climate the best in the nation," he said.
House Minority Leader Stacey Abrams, long an outspoken supporter of an expansion, said the report lays out in "stark detail" the need for more healthcare coverage for needy Georgians.
"While the details matter, Democrats are pleased by the thoughtful work evidenced by this report, and we look forward to a robust debate about how and when we move forward to accept the billions in investment available to our state," she said.