Will we finally expand Medicaid in Georgia?

“Medicaid still remains a top priority in this state… It continues to be a priority and will be a day-one priority for me to prepare our state agencies for that expansion.”- Gov.-elect Keisha Lance Bottoms

I’m the increasingly rare Georgia bird: a proven fiscal conservative and social liberal. Take a picture before we go extinct. I’m OK with expending tax money. But it must be for a good cause and we must budget for it.

Georgia has the third highest rate of uninsured in the nation. It is simply unacceptable that 14% of Georgians under 65 are uninsured compared to a national rate of 8% in states with full expansion. That’s why I have supported full Medicaid expansion in our state as  envisioned in the Affordable Care Act.

We are one of the nation’s best states for business, which may or may not have much to do with our governor doing things like preventing state taxation of Georgia’s data centers. However, we are one of the worst for healthcare coverage directly due to Gov. Brian Kemp’s policies. To the benefit of Georgians, that Kemp era – notable for him willfully ignoring our healthcare deficiencies – will come to a halt very soon. Gov.-elect Keisha Lance Bottoms has said she will make expansion a priority.

Many Georgians are not aware that Georgia originally refused to accept federal money to expand health insurance via Medicaid with no matching requirement for the first three years. It was a major mistake on the part of both the Legislature and Kemp, one that he purposefully continues to ignore to this day. And one that will haunt him if he makes a run for the GOP nomination for president in 2028.

Why are we among the worst states for healthcare coverage? The short answer is partisan politics. Several years ago, Kemp submitted a waiver to the Affordable Care Act. That waiver became the disastrous “Pathways” program.

The purpose of Medicaid expansion is to provide insurance coverage, but the overly complicated waiver implemented by the governor doesn’t do that to the extent it should. Normal expansion would have provided coverage to nearly a half million uninsured Georgians…most in working families with low incomes. Instead, the Kemp administration chose to cover only 13% of them, or 18,527 people, as of June.

Medicaid expansion caused the rate of uninsured to go down dramatically in 40 states while ours has not. Every state that refused to expand is red, including most of our neighboring states. Thus, the short-sighted, ideological views of Kemp and our MAGA politicians caused federal tax money (billions of our dollars) to be spent in New York, California and other states rather than here.

It’s not possible in this short commentary to go into detail as to costs and funding sources. But funding full Medicaid expansion in Georgia is financially feasible, if we have the will. Much of the expense is picked up by the federal government and we have a large budget surplus.

Our choice is either to expand Medicaid or to let lower income people, most in working families, continue to go without needed healthcare. Is that what we really want in our thriving state? With the recent blue tsunami in Georgia and the election of Governor-elect Bottoms, I remain hopeful that Medicaid will be fully expanded in Georgia.

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