Medicaid expansion debate revived as Kemp tosses Grady $130M lifeline

The governor has directed $130 million in federal aid toward expanding Atlanta’s Grady Hospital as it scrambles to absorb more patients once Wellstar Atlanta Medical Center shuts its doors on Nov. 1.

Wellstar’s stunning announcement last month that it would close the Atlanta campus, which is a Level 1 trauma center with 460 beds, created uncertainty in Georgia’s capital city, and politically, it has thrust the issue of health care access back to the center of the governor’s race.

Gov. Brian Kemp stood with the Democratic leaders of Fulton and DeKalb counties at the state Capitol Thursday as he publicly unveiled a plan to give Grady Memorial Hospital $130 million in federal funding from the American Rescue Plan Act to help fill the void in the near term. Grady, which was already in the process of adding 40 beds, will use the money to gradually add another 200 beds as it moves into its new surgical tower next year.

His proposal also allows Grady to use temporary medical space set up early in the COVID-19 pandemic, and the governor touted a little-known change completed in July that increases reimbursement rates for patients on public health programs being treated at Grady and Augusta University Health Systems.

Kemp said the aid is a recognition of Grady’s importance in not just the region but as part of the state’s health care provider makeup. Grady will also become the only Level 1 trauma center in metro Atlanta after AMC closes. 

“These are not Band-Aid solutions. They are meaningful, carefully thought out and implemented measures designed to ensure this cornerstone of Atlanta’s health care network is on solid footing for many years,” Kemp said.

His Democratic opponent this fall, Stacey Abrams, blasted the governor’s plan to expand Grady’s bedspace as a “stopgap measure to mollify the crisis that is occurring with health care in Georgia.” Abrams is a long-time proponent of Medicaid expansion – which Wellstar officials have said alone would not have prevented the closure of Atlanta Medical Center.

“This is a cumulative issue,” Abrams said. “Adding 200 beds at Grady cannot solve a systemic collapse of public health, and the decision to only draw down the Medicaid equivalent of 50,000 patients versus drawing down the Medicaid equivalent of half a million patients is a seismic exponential difference, because we have to remember that the monies that come down are not one-time dollars, which what’s been proposed by the Governor. We’re talking about $3.5 billion every single year,” Abrams said.

Georgia is one of 12 states that have not fully expanded Medicaid under the Affordable Care Act, which could extend health care coverage to about a half million people here. 

Kemp says he will continue to push plans blocked by feds

Kemp gave a blistering response when asked Thursday whether Medicaid expansion would have made a difference.

“Look, you may not like every position I’ve taken, but I’m not going to lie to you as your governor, and people that are saying that this hospital closed because there wasn’t Medicaid expansion, they are lying to you,” he said.

He pointed to the growing number of Georgians with private insurance and the hundreds of thousands of people who have been covered by Medicaid thanks to a federal pandemic-era requirement that people maintain coverage, which will go away when the federal public health emergency ends. About 245,000 children and adults could lose coverage.

“If that was the solution, then why did the hospital close,” Kemp said.

The governor announced health care plans during his first year in office – including one that would have slightly expanded Medicaid for about 50,000 people if they met certain conditions, like a work requirement. But they have been held up by the Biden administration. Kemp said Thursday he intends to continue to press forward with those plans.

‘A stepping stone’

Fulton County Commission Chairman Robert Pitts, who is a Democrat, said Wellstar made a “business decision,” but one that will hurt the community. Pitts said he was grateful for what he called a short-term solution. Long term, a new facility will likely be needed, although it may need to be built at another location in south Fulton County, he said.

“We have agreed to build a new jail to the tune of some $500 million plus, and I have to believe that if we’re able and want to build a new jail for law-breakers that we can come together to build a new medical facility for law-abiding citizens in Fulton County,” Pitts said.

DeKalb County CEO Michael Thurmond, who is a Democrat, called the federal aid “a reprieve and not a bailout,” meaning there’s much more work to be done to shore up metro Atlanta’s health care system. 

Thurmond made a bipartisan appeal to approach health care differently and to curb the gun violence that is contributing to the strain on health care systems across the state and in Atlanta. 

“We can use this as a stepping stone to arrive at a point in the history of our state where we recognize that health care should be depoliticized, that healthcare and access to quality affordable health care is not about Republicans and Democrats. It’s about saving lives and maintaining the quality of life for all of our citizens,” Thurmond said.

“The one lesson from this day’s press conference from my perspective is that when you seek to do the right thing in the right way at the right time, we can transcend the political divide,” he said.