Medicaid Expansion Was Critical Issue in Georgia Governor’s Race

Published December 17, 2018

In the run-up to Election Day, Democratic gubernatorial candidate Stacey Abrams said expanding Medicaid was a top priority of her campaign.

“Medicaid expansion will provide access to health care for 500,000 Georgians, create more than 50,000 jobs across the state, expand mental health supports, and protect rural hospitals from closure,” Abrams told The Gainesville Times.

Her opponent, Secretary of State Brian Kemp, said he was opposed to Medicaid expansion because it would add significant costs for the state and would increase government dependency.

Kemp won the governor’s race by little more than 1 percentage point.

Unexpected Costs

Charlie Katebi, a state government relations manager at The Heartland Institute, which publishes Health Care News, says the unexpectedly high costs associated with Medicaid expansion are well documented and prohibitive for states that hope to maintain a reasonable budget for health care.

“Medicaid expansion allowed many states to sign up huge numbers of young, relatively healthy individuals, which violates the spirit of what the program was created to do,” Katebi said. “Medicaid is supposed to care for people who are indigent or have financial difficulties or who are elderly and already ill. When it expanded, more people that did not meet those requirements signed up, and states have had trouble meeting the cost of paying for all the new recipients.

Georgia policymakers should be wary of promoting the idea that expansion will be good for anyone in the state.”

‘A Broken Program’

Kyle Wingfield, president and CEO of the Georgia Public Policy Foundation, says expanding Medicaid would not have increased the availability of quality health care in the state.

“Pouring more money into a broken program doesn’t help patients,” Wingfield said. “A quarter of a million people who already have private insurance would go onto Medicaid if Georgia were to expand Medicaid under Obamacare. Roughly one-third of new recipients already have insurance.

“If we’re talking about increasing the number of insured, that’s a pretty inefficient and non-targeted way of doing it,” Wingfield said. “People already paying for insurance would be added to taxpayer funded insurance.”

Expanding Private Insurance

The Trump administration is encouraging states to apply for federal waivers that “allow states to implement innovative ways to provide access to quality health care that is at least as comprehensive and affordable as would be provided absent the waiver, provides coverage to a comparable

number of residents of the state as would be provided coverage absent a waiver, and does not increase the federal deficit,” according to the Centers for Medicare and Medicaid Services.

Wingfield says improving Georgia’s health care system, especially in rural areas, doesn’t begin with more Medicaid but with greater freedom to innovate, which the waiver process makes possible.

“If we didn’t have to ask for permission for each little bit of flexibility we seek, then you’d see a lot more innovation, creativity, and good policy, and the states are ready to do that,” Wingfield said. “We just need the authority to do it.”


Joshua Silavent, “How Medicaid Expansion Has Candidates Divided on Health Care,” The Gainesville Times, October 8, 2018: