The 2019 Session started slowly since it was interrupted by snow warnings and the Super Bowl. The pace has picked up and there are rigorous discussions about how to fix our healthcare system to make affordable care available to more Georgians. Possible reforms or repeal of the 1970s Certificate of Need Law (CON) has engaged most of the hospital lobbyists. My priority is to focus on how to get the uninsured covered by expanding Medicaid to ensure accessible and affordable healthcare to all Georgians. Here are some basic facts.
Georgia is only one of 14 states that has not expanded Medicaid
· Georgia has missed out on up to $3 billion for 9 years in federal funding that could cover Georgians and stabilize our rural hospitals
· Medicaid Expansion could create 56,000 new jobs in the healthcare sector
· Medicaid Expansion could cover 32,000 veterans and their spouses not able to get healthcare through the VA
· Even after nine years Medicaid Expansion is still the fastest way to provide relief for people who do not have health insurance.
There is a Democratic proposal HB 37 implementing full Medicaid Expansion and the Republican proposal SB 106 creating a Georgia specific waiver permission for families up to 100% rather that 138% of the Federal Poverty Level (FPL) and other limitations. The differences are outlined in this document created by the Georgia Budget and Policy Institute. GBPI.
We did pass the ’19 Amended Budget with some improvements for school based behavioral interventions and more relief for the farmers still struggling after the Michael Hurricane devastation. Here is a summary of that budget.
One aspect of the ’19 Budget highlights the most stunning example of why we need to take advantage of the federal dollars available to Medicaid services. Comparison of the Medicaid Budget in DCH and the State Mental Health Budget in DBHDD shows why our funding for behavioral health is among the lowest in the nation. These are my unaudited gross estimates.
Medicaid Behavioral Health
Federal $’s $7.8 Billion $ 149 Million
State $’s $7.8 Billion $1.2 Billion
Total $’s $15.6 Billion $1.4 Billion
Georgia has rejected the billions of dollars available from the Feds for behavioral health services and opted to use almost all state dollars to try to provide these services. The good news is that both sides are looking for was way to improve this picture. The bad news is that co-pays, work requirements, and how to protect the commercial insurers dominate the discussion rather than trying to improve and augment services. The hospital lobbyists are forced to focus on plans to repeal or revise the existing CON Law that regulates hospital expansions.