Handful of rural Georgia Republicans join with Dems to give full Medicaid expansion another go

by Jill Nolin, Georgia Recorder
January 29, 2025

A handful of Senate Republicans from rural Georgia have signed onto a new bipartisan attempt to fully expand Medicaid through a conservative-friendly option that gained traction last year after a decade of firm GOP resistance.

Four state senators hailing from south Georgia lent their names to a new Senate bill filed Tuesday that would expand health care coverage through a program that uses federal funding to purchase private insurance for individuals on the marketplace instead of adding more people to the state-run Medicaid program.

The bill would create a program called PeachCare Plus that would expand income eligibility to those who would be covered by traditional expansion, and it would create an advisory commission that would help guide the development of the program.

“We believe that this bipartisan legislation can actually get passed,” Senate Minority Leader Harold Jones, an Augusta Democrat, said at a press conference Tuesday.

Sen. Sam Watson of Moultrie said Tuesday that he is “open to the debate,” and Sen. Russ Goodman of Cogdell made no promises that he would vote for the bill if it makes it to the Senate floor but said he wants to have an “an open and honest debate about it.”

Cordele Sen. Carden Summers, who supported a similar proposal last year, and Statesboro Sen. Billy Hickman also signed the bill.

Goodman said his son was electrocuted in their swimming pool several years ago when he was 11 after lightning struck the pump house and damaged safety features. He credits his local hospital, which is about 10 miles from his blueberry farm, for saving his son’s life.

He said hospitals back home have told him that expanding Medicaid would help them ease the burden of indigent care.

“I think the main thing is to have it be argued on the merits,” Goodman said. “Isn’t that kind of what we’re supposed to do up here?”

Like last year’s bill, this proposal is patterned after the Arkansas model that intrigued the state’s GOP leaders, like House Speaker Jon Burns. But those same leaders had appeared to publicly cool to the idea.

Speaking to reporters early this month, Burns pointed to two factors that are shaping his current outlook on the issue: the governor remains a “steadfast” supporter of Georgia Pathways and the change in administration on the federal level.

Georgia Pathways to Coverage was approved by the Trump administration and then challenged by the Biden administration over its work requirement. Gov. Brian Kemp announced this month that the state will apply to renew the program, which would otherwise expire this September.

“We’re focused on what’s politically possible,” Burns said early this month. “And what we want to do in the House is help as many Georgians as we can, and if that’s the Pathways program, we’re all in.”

The state submitted its application to keep Georgia Pathways going for another five years last week.

Kemp has proposed a few changes, including making parents with children younger than six exempt from the requirement that participants complete 80 hours of work, job training, community service or another qualifying activity.

Two hearings, on Jan. 31 and Feb. 10, have been set to gather public input on the proposal.

Natalie Crawford, the executive director of Georgia First and a former Republican commissioner in Habersham County, said the governor’s revised Pathways plan is an improvement but said it still forgoes billions of federal dollars and misses out on the economic perks of full expansion.

She also argued the plan still omits key groups of Georgians.

“We’ve got a qualifying activities exemption for caregivers of children six and under, but what about family caregivers for aging and ailing parents? I mean, we Republicans are the party of family values. That’s a pretty big miss,” Crawford said.

Democrats also argue Kemp’s program cannot be fixed and say it’s time for Georgia to join the other 41 states that have fully expanded Medicaid under the Affordable Care Act signed by former President Barack Obama in 2010.

“One of the issues about the governor’s plan is you’re basically trying to create a job program and a health insurance program combined,” Jones said. “That’s really the key part about that plan that becomes difficult. It’s an administrative nightmare.”

As of early January, about 6,500 people were enrolled in the program – which is well short of the nearly 100,000 the state said could sign up and the 345,000 total people who were thought to be eligible.  

House Minority Leader Carolyn Hugley, a Columbus Democrat, said Democrats have a “moral obligation” to continue to push the issue.  

“The greatest failure of Republican leadership is the lack of providing access to health care to Georgia citizens,” Hugley said.

Both Democratic chamber leaders said they believed the governor could be convinced to change his mind. But Kemp, whose term ends next year, has repeatedly reiterated his staunch opposition to full Medicaid expansion, including as recently as this month. 

Georgia Recorder is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Georgia Recorder maintains editorial independence. Contact Editor John McCosh for questions: info@georgiarecorder.com.

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