Peach Tree Times

The head of a public-policy think tank in Atlanta said there are “mostly negatives” to the state expanding Medicaid, even as some legislators push Gov. Brian Kemp to address the issue during the special legislative session that started on Nov. 3.

Kyle Wingfield, president and CEO of the Georgia Public Policy Foundation, told the Peach Tree Times that “Medicaid is not a great form of insurance.” 

A joint federal and state program, Medicaid provides health coverage to over 72.5 million Americans, including "eligible low-income adults, children, pregnant women, elderly adults and people with disabilities,” Medicaid.gov said.

“To participate in Medicaid, federal law requires states to cover certain groups of individuals,” Medicaid’s eligibility requirements said. “States have additional options for coverage and may choose to cover other groups … The Affordable Care Act of 2010 created the opportunity for states to expand Medicaid to cover nearly all low-income Americans under age 65.”

Approximately 255,000 Georgians’ income is too low to get financial help to buy health insurance on the HealthCare.gov marketplace, but they do not qualify for Medicaid, the Georgia Budget & Policy Institute said. Another 219,000 uninsured residents make slightly more than the poverty line and most qualify for premium subsidies, but high deductibles or copayments may make the coverage too expensive to use.

State Rep. Matthew Wilson (D-Brookhaven) and other Democratic lawmakers on July 27 called on Kemp to expand the scope of the special legislative session by putting Medicaid expansion first on the agenda, a call that Wilson re-issued in an Oct. 19 Facebook post.

“Our state cannot miss this chance to help ensure everyone can see a doctor when they need to, no matter where they live or how much money they make. We MUST act to #ExpandMedicaidNow,” Wilson said in the post.

Expanded Medicaid in Georgia would be paid 100% by the federal government, 41 NBC reported Wilson as saying. In addition, he said, Georgia would net $700 million and create 64,000 jobs.

Wingfield said that in Georgia, Medicaid has a lower acceptance rate by doctors than Medicare or private insurance.

“That's a problem considering the people already on Medicaid in our state are our very most vulnerable residents, and adding more people to the rolls will only make it harder for these most vulnerable Georgians to get the care they need due to a crowding-out effect,” Wingfield said, adding that having bad insurance is better than no insurance. 

“The lower acceptance rate by doctors owes to the fact Medicaid reimburses healthcare providers at a much lower rate than they get from Medicare or private insurance.”

Wingfield said that a better program would be the Kemp administration’s Medicaid waiver that was approved by the Trump administration (awaits approval by the Biden administration). That program (including federal costs) “would spend less per newly covered person than Medicaid expansion,” he said.

“It would also seek to help people buy the insurance plan offered by their employer, if they have one, which would allow them better continuity of coverage and care should they get a raise and become ineligible for the program,” Wingfield said. “It would also be better to focus on getting uninsured Georgians into a direct primary care plan, which ensures they can see a primary-care doctor as needed.