In October, Georgia Governor Brian Kemp signed an agreement with the Trump administration to create a $ 218 million per year plan that limits the new Medicaid coverage pool to approximately 50,000 uninsured adults in Georgia. The Biden government wants to sweeten Georgia’s reason to expand Medicaid to more than 350,000 other low-income Georgians. Ross Williams / Georgia recorder

WASHINGTON – The US House Democrats are trying again to trick Georgia and other holdouts into expanding Medicaid coverage with the prospect of billions of dollars in federal funds.

The new offer, contained in a massive $ 1.9 trillion COVID-19 aid package that House Democrats are pushing through committees this week, could help more than 2 million Americans – more than 400,000 in Georgia – Providing Health Insurance. You are in the midst of the pandemic and economic downturn between the rifts in government programs.

Most are childless adults who make some cash but are still below federal poverty income, or around $ 12,880 per year.

In the vast majority of states, people in this situation could qualify for Medicaid, a public program that provides health insurance to people on low incomes and people with disabilities.

But in Georgia and 13 other states that have not yet expanded Medicaid, they are still not eligible for this program. In the meantime, they are still too poor to get subsidized private coverage through insurance exchanges.

Edwin Park, a research professor at the Center for Children and Families at Georgetown University, said the house proposal could “move the dial” in some states.

“Unfortunately for others, I think they can get away from this very good deal,” he said.

Holdout states include Georgia, Florida, North Carolina, Kansas, Tennessee and Wisconsin.

The GOP leaders in Georgia have refused to fully extend Medicaid’s income eligibility to people who represent 138% of the poverty rate since the state was eligible eight years ago under the Affordable Care Act.

In October, Georgia Governor Brian Kemp signed an agreement with the Trump administration to create a $ 218 million annual plan that aims to expand Medicaid coverage to approximately 50,000 uninsured adults in Georgia who are insured – if they meet a work or activity requirement of 80 hours a month. It should start in July and the last part will come into force in January 2023.

The US Supreme Court announced in December that it would hear a case to see if Georgia and other states can impose work requirements on Medicaid recipients.

Upon signing in October, Kemp said that a full expansion of Medicaid would be too expensive and cost the state $ 550 million a year.

If Georgia fully expanded Medicaid and the federal government took over 95% of the tab, the state could insure an additional 350,000 uninsured people, said Laura Colbert, Georgians executive director for a healthy future. She said an estimate by the governor’s office for planning and budget a few years ago calculated that the cost of full expansion, after taking into account the savings from programs or services that would instead be covered by Medicaid, is effectively a wash first program in Kemp’s patients program.

“In all honesty, it’s heartbreaking to see our state continue to forego what we believe to be the most affordable, moral, and sensible investment in our people and in our health care system,” said Colbert. “And that heartbreak grows when it’s in the middle of a pandemic.”

Supreme Court judgment

The loophole many low-income people find themselves in was created when the US Supreme Court struck down part of the Health Act, also known as Obamacare. The court said Congress could not get states to expand their Medicaid programs.

But states have gradually signed up over the past decade because Congress has given them such huge financial incentives to do so. Initially, the federal government paid the entire cost of adding childless adults and others to the Medicaid list. Nowadays it still covers 90 percent of the cost. The federal government last covered 95% in 2017.

However, in much of the south, as well as places like Kansas, South Dakota, Wyoming, and Wisconsin, state officials have resisted calls to expand their Medicaid programs. Republicans in particular have opposed what they see as the overreach of the federal government.

However, the latest move would add a new twist. It would give holdouts more money for the patients they already insure if they agree to expand Medicaid.

“Even if states still pay 10 percent [for the new patients]You would still be ahead of the game, ”said Robin Rudowitz, co-director of the Kaiser Family Foundation program on Medicaid and the uninsured. “I think that will change the math.”

An analysis by the left-wing Center for Budget and Political Priorities shows that states would gain significantly under the democratic proposal:

  • Florida could get $ 3.5 billion.
  • North Carolina would be $ 2.4 billion.
  • Georgia could bring in $ 1.9 billion.
  • Tennessee could raise $ 1.7 billion.
  • Wisconsin could make $ 1.3 billion.
  • Missouri could get $ 1.7 billion.
  • Kansas could raise $ 330 million.

Texas will win the most, with a potential of nearly $ 6 billion. The extra money would expire after two years.

How Medicaid works

Medicaid is jointly operated by the state and the federal government. The federal government reimburses states a set amount of the money they spend on the program, and this rate varies by state.

States whose residents have a lower median income receive higher reimbursement rates. In March, Congress increased the reimbursement rate for all states as long as the COVID-19 emergency persists. The Biden government has announced that it will extend this emergency to at least the end of 2021.

The House’s proposal would raise the reimbursement rates for new expansion states by a further 5 percentage points.

The new incentives would be part of a larger effort by Congress to address the consequences of the COVID-19 pandemic. The Democratic Aid Act covers everything from distributing vaccines to assisting transportation networks to distributing stimulus checks.

This health emergency has also changed government officials’ view of expanding health insurance eligibility, Rudowitz said.

“The pandemic has certainly highlighted the issues surrounding the need for health insurance, and you have more people [in states that haven’t expanded Medicaid] to no longer be insured in connection with the economy, ”said Rudowitz.

Even before the pandemic, Georgia’s uninsured rate was consistently among the highest in the country.

States can resist

Park said the federal government will pay for the expansion, and people who get health insurance will ask for fewer government services.

“The tax implications of [Medicaid] The expansion has always been positive … But some states may resist for ideological reasons instead of looking at the numbers. “

The House’s Energy and Trade Committee will hold a hearing on the proposed changes Thursday morning.

Other changes lawmakers are considering include measures to ensure that women maintain Medicaid coverage for up to one year after giving birth. Full coverage of COVID-19 vaccine costs under Medicaid; and inmates can qualify for Medicaid 30 days prior to their release.

Georgia Recorder Editor John McCosh contributed to this report.