Valdosta Daily Times

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February 14, 2014

Ga. GOP wants vote to deter Medicaid expansion

ATLANTA — Republican leaders are trying to add another barrier to the Democratic health insurance overhaul by requiring that the GOP-dominated Legislature get the final say on whether to allow more uninsured people to get coverage from the government.

The proposal this week from House Speaker David Ralston, R-Blue Ridge, would block Georgia’s state government from changing the rules for the Medicaid program so more people could enroll unless the Republican-dominated General Assembly approved it.

“These kinds of decisions can have very far-reaching implications for the budget,” Ralston said in an interview. “... Decisions like this should be reserved solely for the Legislature to make determinations.”

The health care law backed by President Barack Obama’s administration required nearly everyone to get health insurance. Under the original plan, people too poor to pay for subsidized insurance would be allowed to join the Medicaid program, which now pays for health care for the poor, elderly, disabled and low-income families with children. The Medicaid system is jointly funded by the state and federal government.

However, the U.S. Supreme Court ruled that the federal government could not force states to expand their Medicaid programs. Georgia and 24 other states have either refused to expand their eligibility rules or are still debating it, according to a tally by the Kaiser Family Foundation.

The federal government has offered to pay the full cost of expanding state Medicaid programs for three years before reducing its share to 90 percent.

Republican Gov. Nathan Deal supports giving the General Assembly a vote on the issue, his spokesman said. Deal has repeatedly said that Georgia cannot afford the long-run costs of enlarging its Medicaid system. His administration projects that an expansion would cost Georgia roughly $48 million in the first full year, or less than 1 percent of the proposed state budget. Deal’s administration projects those costs would rise to nearly $498 million by 2023.

There are political calculations as well. Deal faces two long-shot candidates in the Republican primary, but then will likely face Democratic state Sen. Jason Carter, the grandson of former President Jimmy Carter, in the general election.

Carter said in an interview Thursday he was surprised Deal was for the bill.

“I can’t imagine another governor saying this particular decision is too big for me, let’s give it to the Legislature,” Carter said. “He does not want to make this decision. He wants to give it away.”

Asked about his stance on Medicaid expansion, Carter said his main concern is bringing federal tax dollars back to Georgia and would be open to alternatives similar to those implemented in states such as Arkansas. Arkansas is using federal money to purchase private insurance for those newly eligible under the health care law.

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