Bipartisan Cooperation on Health Care in Georgia, but not Medicaid Expansion
“One of the biggest concerns I have is our rural hospitals…. I have personally seen what happened when some of my friends in Dooly County, when their hospital closed. I had friends who worked there, doctors, nurses and so forth,” State Sen. Greg Kirk (R-Americus) said during a recent panel.
State Sens. Kirk and Emanuel Jones (D – Decatur), and State Reps. Lee Hawkins (R – Gainesville) and Debbie Buckner (D – Junction City), spoke at a panel discussion at the annual Georgians for a Healthy Future legislative breakfast on Thursday, January 14, 2016.
There have been five rural hospital closures since 2013, an issue that garnered a lot of attention from the legislators on the panel, as well as from House Speaker David Ralston (R- Blue Ridge).
Ralston recently addressed the struggles of rural hospitals during the January 05, 2016 Georgia Chamber of Commerce Eggs and Issues breakfast.
“Hospitals and doctors across Georgia, particularly in rural areas, are struggling to meet the needs of our growing population,” Speaker Ralston said.
“As much as we would like healthcare to be free market, and take advantage of the power of competition, hospitals don’t, by and large, get to choose their patients. It is incumbent upon us to devote the serious attention… that this issue deserves,” Speaker Ralston said.
In addition to rural hospital closures, the panel addressed a wide range of health policy topics.
“One [piece of legislation] that I am endeared to, since it’s my legislation, is the ABLE legislation. This legislation will allow those that are disabled to have more than two thousand dollars in the bank,” Rep. Hawkins said.
Currently, disabled Medicare recipients lose eligibility if they have more than two thousand dollars in assets.
Hawkins’s ABLE legislation received its first hearing on Monday, January 25, 2016, and lobbyists and disabled Georgians testified to the difficulties of building a personal, financial safety net to cover disability-related expenses with that limit in place.
“[The House has] got other pieces [of legislation] in there. I’ve got one that will give tax credits to the charity clinics, so that we can enhance the funds that we give our charity clinics,” Rep. Hawkins said.
The charity clinics bill, HB 834, was introduced and assigned to the House Ways and Means committee.
Both Republicans on the panel, Rep. Hawkins and Sen. Kirk, stated they support increasing the tobacco tax as a way to fund some of these initiatives.
“I am still in favor of [increasing the tobacco tax]. I think we could do it in a phased manner, and I would dedicate those funds to the mentally ill, ” Rep. Hawkins said.
“I support increasing the tobacco tax, that’s a no brainer for me,” Sen. Kirk said, citing Georgia’s cancer rate.
“Another thing in the Senate that we are looking at is our crisis pregnancy centers across the state – I believe there is forty some odd of them – looking at allowing them the opportunity to become Medicaid providers for the services that they provide in their communities,” Kirk said during the panel discussion.
This policy proposal is in line with the recently released Senate Republican Caucus’s legislative priorities, which include: “Protecting the Unborn – The Senate Republican Caucus will work to protect the unborn by expanding women’s access to pregnancy resource centers and their counseling and family planning services.”
Crisis Pregnancy Centers (also known as pregnancy resource centers) are not currently licensed by the State of Georgia to operate as medical facilities, although many offer free pregnancy tests, sonograms, and misleading pregnancy counseling.
Because CPCs are not licensed medical facilities, they are not required to have any sort of licensed medical personnel on staff or meet any medically established standards of care.
“I don’t see that as a viable approach for access to care… We want people to have medically appropriate care and there are some concerns that they aren’t going to get that there,” Cindy Zeldin, Executive Director of Georgian’s for a Healthy Future, said in an interview with Atlanta Progressive News.
In addition to support for CPCs, the Senate Republican Caucus features two other health-related priorities in their legislative agenda: “Protecting the Future of the Disabled,” and “Protecting Access to Care,” including rural healthcare.
Both the House and Senate Democratic Caucuses feature health care in their legislative priorities, including paid family/sick leave and Medicaid expansion.
“[T]he policy makers that we talked to, they are clearly thinking about healthcare and they clearly recognize, I think in both parties, that we have real challenges to solve around healthcare issues in our state,” Zeldin said.
“There are clearly differences in approach and preferences to that, but that was an important thing for me to hear, was that there is broad recognition that we do have health care challenges.”
DEAL CONTINUES TO REJECT MEDICAID EXPANSION
Gov. Nathan Deal’s State of the State address made clear that he believes Medicaid was too expensive a program as is, and that Medicaid expansion would bring with it boatloads of paperwork and bureaucracy.
Healthcare advocacy groups, like GFAHF, have been pushing for Medicaid expansion since 2014.
After some federal litigation around the Affordable Care Act (“Obamacare”) was resolved, it became even easier for U.S. states to reject Medicaid expansion. The original Congressional law stated that if states rejected the federal funding for Medicaid expansion, that they would lose their other Medicaid funding. However, the Supreme Court of the U.S. struck that down as a coercive use of the federal power of the purse.
Medicaid expansion would increase the population of Georgians who qualify for Medicaid, in order to help cover the gap between certain eligible low-income families who are able to receive Medicaid, on the one hand, and certain middle income families who are eligible to receive subsidies for private insurance through the ACA healthcare exchanges, on the other.
About 300,000 Georgians currently fall into this coverage gap.