ATLANTA — Georgia's newly elected Republican governor announced during his State of the State speech Thursday that he was setting aside $1 million to create a waiver plan that would give the state more flexibility in using federal Medicaid funding.
Gov. Brian Kemp, who has frequently assailed Medicaid expansion — a keystone of his defeated Democratic rival Stacey Abrams' platform during their 2018 gubernatorial race — said the waiver would "expand access without expanding a broken system that fails to deliver for patients."
Kemp did not elaborate about what the waiver might include and questions emailed to his office were not answered.
His office instead sent a statement saying that the funding was for a consultant to assist in reviewing options and developing a plan and that the "ultimate goals are lowering costs, increasing choice, and improving quality and access."
Medicaid strategies that some Republican-led states have talked about include partially expanding the program to cover only residents below the poverty line, a less generous option than provided by the 2010 Affordable Care Act, which extended eligibility to many people just above poverty as well.
Partial expansion would be less costly for states, but it's unclear whether the federal government has the legal authority to grant such a waiver. It would almost certainly draw a court challenge, as have some Medicaid work requirements approved under the Trump administration.
Georgia is one of just 14 states that have not yet expanded Medicaid as prescribed under the ACA, also known as "Obamacare."
The expansion of Medicaid was initially intended to be national, but a 2012 ruling by the Supreme Court made it optional for states. Most of the states that have not taken up expansion are Republican controlled.
Georgia's previous Republican Gov. Nathan Deal opposed Medicaid expansion on the grounds that if federal funding ceased, the state would be left to fully pay the costs.
Kemp said the state of health care in rural Georgia was particularly concerning.
"Seventy-nine counties have no OB/GYN. Sixty-four counties have no pediatrician. Nine counties have no doctor," Kemp said.
Some Republicans in Georgia have become more receptive to the idea of expanding Medicaid access by seeking a waiver in recent years but have also called for restrictions like a work requirement.
Democratic lawmakers say they are pushing for wholesale expansion of Medicaid.
Democratic state Sen. Harold Jones said in response to Kemp that Medicaid expansion, not a waiver, was the right path forward for Georgia, according to a transcript of his remarks published by the Atlanta Journal-Constitution. Jones said expansion was the only way to help struggling families and struggling hospitals.
Kemp also touched on previously unveiled plans to increase teacher pay, funding for school safety and resources for combatting gang activity in his speech.
Kemp laid out a proposal to permanently increase teacher salaries by $3,000 for all certified Georgia teachers, which he said was a "sizeable down payment" on his campaign promise to raise pay by $5,000.
Kemp touted plans to allocate money to each Georgia public school for safety measures and an anti-gang task force within the Georgia Bureau of Investigation. He's seeking $30,000 for each public school in the state — a total cost of $69 million — to enact safety measures determined at the local level. Kemp also said he plans to address mental health within schools and provide extra resources.
Kemp said he wants to put $500,000 in initial funding toward the new GBI anti-gang task force.
Kemp's address avoided some of the more controversial conservative pitches of his primary campaign, including pledges to sign tough abortion restrictions, sign a "religious freedom" bill that critics says allows discrimination against gays and lesbians, and to "track and deport criminal illegal aliens."
The last pitch morphed into "track and deport drug cartel kingpins" in his State of the State address, while the other issues went unaddressed.