Some Georgia Lawmakers Eye Medicaid ‘Waivers’

Georgia is one of 18 states that did not expand Medicaid coverage under the law. 

Al Such / WABE

Over the past year, some Georgia lawmakers have been talking about Medicaid “waivers” to help bring more federal health care dollars to the state.

Earlier in the year, state Republican leaders said they’ll wait and see if Congress repeals and replaces the Affordable Care Act, or Obamacare.

Georgia is one of 18 states that did not expand Medicaid coverage under the law.

“The law remains in place and states are leaving a lot of money on the table and a lot of health on the table,” said Bill Custer, a professor at Georgia State University’s Institute of Health Administration.

Custer estimates Georgia has foregone about $12.5 billion in federal dollars through 2017 by not expanding Medicaid coverage.

Under Obamacare, 32 states have expanded Medicaid to use the government insurance program to include low-income adults. The federal government paid for 100 percent, and then most, of the newly insured population.

“So Georgia’s facing the issue of what to do about our coverage gap and the lack of Medicaid expansion. We’ve heard a lot of discussion about a variety of different programs,” Custer said.

About 240,000 people in Georgia fall under what’s known as the “coverage gap,” meaning they don’t qualify for Medicaid but also don’t qualify for tax subsidies to buy individual health insurance through the Marketplace.

Some state lawmakers have discussed wanting to access those federal expansion dollars through what’s called Medicaid “waivers.” The waivers allow states to waive some requirements under the federal law to use the money for their own approaches to Medicaid and insurance.

Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services, was in Atlanta last week. She said the Trump administration is open to “all kinds of different waivers.”

“We think that states are in the best position to think about what’s going to serve their populations best because they’re closer, they’re on the front lines,” Verma said. “So we’re here to support them.”

State Sen. Renee Unterman, R-Buford, who chairs the state Senate’s Health and Human Services committee, has talked about the potential for using a Medicaid waiver for targeted populations, including people with mental illness and substance abuse disorders.

Under a law the legislature passed in 2014, expansion of the Medicaid program would need the approval from the state legislature.

Miranda Hawkins contributed to this report.