Politics

Governor Kemp Calls For More Flexibility In Georgia’s Medicaid Program

Gov. Brian Kemp included  "$1 million in the Department of Community Health's budget to craft state flexibility options for Georgia's Medicaid program," he said Thursday.
Gov. Brian Kemp included "$1 million in the Department of Community Health's budget to craft state flexibility options for Georgia's Medicaid program," he said Thursday.
Credit John Amis / Associated Press

Gov. Brian Kemp said Thursday he wants the state’s Medicaid program to have more flexibility.

That could open the door to covering more Georgians under the healthcare program for low income people.

Kemp made the announcement to members of the Georgia House and Senate during his first State of the State address as governor.

“I have included $1 million in the Department of Community Health’s budget to craft state flexibility options for Georgia’s Medicaid program,” Kemp said. “We will expand access without expanding a broken system that fails to deliver for patients.”

When lawmakers talk about flexibility, they’re often talking about waivers. Those allow states permission to tweak how they administer the Medicaid program.

Kemp drove his point home with the release of his first budget report as governor. A line item in the document lists “funds for an external consultant to review and analyze Medicaid waiver options.”

But that’s where the specificity ends, because Medicaid waivers can take any number of forms.

“Waivers have been granted to cover special populations, people who have HIV, for example. Waivers have been granted under Medicaid expansion to have work requirements,” said Bill Custer, who studies health policy at Georgia State University.

In Georgia, the Department of Community Health is responsible for pitching waivers to the Centers for Medicare and Medicaid Services, the federal agency that manages Medicaid.

Kemp’s proposed $1 million would help the department study different waiver plans.

“There has to be a program design that specifies what services are going to be covered and justifies that to the federal government as a way the federal government should spend their money,” Custer said.

Waivers could provide Georgia a pathway to expand Medicaid under the Affordable Care Act, an idea that Kemp’s predecessor in the governor’s office, Nathan Deal, was long wary of.

But not all waivers are tied to Obamacare; some have been a part of the Medicaid program for decades.

And not all waivers expand coverage, says Laura Harker, a health policy analyst for the left-leaning Georgia Budget and Policy Institute.

“A waiver is meant to be a pilot program, a demonstration project where states can test out new ideas,” she said.

Harker said waivers can help states cover more people under Medicaid or lower insurance premiums. But waivers can also end up shrinking states’ Medicaid rolls.

Harker points to a waiver that allows Arkansas to impose work requirements for Medicaid recipients. The Kaiser Family Foundation reported that waiver has caused thousands to lose coverage.

And there’s still lots of uncertainty about what a Georgia waiver might look like.

That’s perhaps why state Democrats, like House Minority Leader Bob Trammell, were less than impressed by Kemp’s proposal.

“The million dollars to explore a waiver just sounds like additional delay at this point. So, Medicaid expansion remains the solution that Democrats in the House and Senate believe is the right way for Georgia,” Trammell told reporters after Gov. Kemp’s address.

But that issue seems like a non-starter. Kemp has consistently opposed Medicaid expansion as outlined in the Affordable Care Act.