Democrats want Georgia Medicaid expansion, but critics say it isn't free

(The Center Square) — As enrollment in a Georgia program offering Medicaid coverage to low-income Georgians remains low, some Peach State Democrats are reiterating their call for an outright expansion of Medicaid.

Instead of a full Medicaid expansion, the state launched the Georgia Pathways to Coverage program on July 1, 2023. It provides coverage to Georgians between 19 and 64 in households with incomes up to the federal poverty level who are not eligible for "traditional Medicaid."

According to the Georgia Department of Community Health, the total Pathways enrollment was 4,494 as of July 5. A spokesperson for the agency told The Center Square the tally has not been validated for its official reporting purposes.

"There are an estimated 290,000 who make too much for Medicaid and not enough to afford private health care," state Rep. Karen Bennett, D-Stone Mountain, said in an email to constituents. "This health care gap is largely due to Georgia's unwillingness to do what has worked for many other states – Medicaid expansion."

Under Georgia's Pathways program, participants must perform at least 80 hours of "qualifying activities per month," such as full- or part-time employment, vocational educational training or community service.

"Georgians are paying for Medicaid and are not receiving the benefits of Medicaid expansion," Bennett added. "With Medicaid expansion, the federal government pays 90% of the costs."

Bennett pointed to the Bridge to Medicaid Act, a measure introduced by U.S. Sen. Raphael Warnock, D-Georgia, and co-sponsored by U.S. Sen. Jon Ossoff, D-Georgia. It would ostensibly help Georgians "who cannot afford insurance" on the marketplace by extending "subsidies" for three years.

Proponents say that residents of "non-expansion states," such as Georgia, who make between 100% and 138% of the federal poverty level , would be eligible for the subsidies. Bennett said roughly 640,000 Georgians could receive coverage and that $1.2 billion in "federal incentives" is available for a full Medicaid expansion.

In remarks to the Georgia Hospital Association earlier this month, Republican Gov. Brian Kemp pushed back on "those who join the political pundits in promoting full Medicaid expansion." Instead, the state remains "committed to rolling out this Georgia-specific approach to health care that will help those in need get care while they pursue greater opportunities."

"Do we want to kick more than 700,000 Georgians off their private health insurance plan and place them on Medicaid?" the governor asked, according to prepared remarks his office provided to The Center Square. "Do we want to be like California, which is proposing raising taxes in the middle of an inflation crisis to cover the costs of a swelling Medicaid roll?"

While proponents of Medicaid expansion like to tout "free" federal taxpayer dollars to cover a Medicaid expansion, that's not the case.

"Expanding Medicaid to childless working-age adults comes with the one-two punch of crowding out the truly needy from resources with already existing waitlists, as well as further contributing to the national debt," Americans for Prosperity-Georgia State Director Tony West told The Center Square via email.

"Those that advocate for expansion under the guise of a low state budget impact never remember to mention that Georgians are taxpayers of both the state and federal government, and Medicaid expansion contributes to the unsustainable national debt that, if not addressed, could lead to a debt crisis," West added. "Instead of expanding Medicaid, lawmakers should give Georgians a Personal Option that creates more affordable choices and puts people in control of their health care."