Tue. Feb 25th, 2025

Our guest columnist opines that a few years ago, he rolled out a disastrous Medicaid “waiver” program that has proven to be a bureaucratic nightmare and administratively very expensive. Jill Nolin/Georgia Recorder

“It is unconscionable for Governor Deal to stand in the way of the availability of health care… We are paying the overwhelming cost of this program already through our federal taxes… (Georgia resident’s) taxes will fund health care for people in…other states that have opted in. Does our governor listen to the people who cannot afford health care and to others who are concerned about those folks? Give him a chance — but make sure he hears from you”. – Atlanta Journal-Constitution reader Truman Moore in 2013 letter to the editor.

Moore wrote his thoughtful letter in response to my 2013 AJC letter regarding the expansion of Medicaid (“Ideology in the Way of Creating Jobs.”  At the time, I had just completed two terms as a fiscally conservative Republican County Commissioner in rural Jasper County, as well as being the former chair of their Republican Party. Due to the reactionary nature of the GOP concerning social issues, as well as the abandonment of fiscal sanity by Trump’s GOP, I have since become an active Democrat. 

But the Medicaid issue remains the same- a political football used by Georgia’s GOP politicians to score points… while harming Georgia’s residents. However, this time the culprit is Gov, Brian Kemp. A few years ago, he rolled out a disastrous Medicaid “waiver” program  called Pathways that has proven to be a bureaucratic nightmare and administratively very expensive.  But Pathways covers only 4,700 Georgians- rather than the hundreds of thousands Kemp said would get coverage. Still, he wants to run for Senator. Therefore, Kemp will not acknowledge that with Pathways he made a very big mistake that has hurt his constituents. 

Further, when former Gov. Nathan Deal (a Republican, but former Democrat) was in office, he had the power to unilaterally expand Medicaid soon after the 2010 Affordable Care Act passed court scrutiny. He chose not to do so. Instead, Deal’s politically driven desire was to push the issue onto someone else. So, now the General Assembly’s approval is needed. Still, a full expansion would have gone through last year if not for Kemp’s opposition… driven by his ego and political ambitions. 

Georgia is now one of only 10 states not to implement full Medicaid expansion. Therefore, our state has 1.2 million uninsured. An astounding 14 % of residents have no insurance. That figure is much higher than the still unacceptable national rate of 10%. The Georgia figure is over 20% for those in many solid red rural communities like Whitefield, Atkinson, Webster, Candler and Gordon Counties. 

Back then, I also wrote the following to my colleagues on the Steering Committee of the Georgia Chapter of Physicians for a National Health Program- “Medicaid is clearly a poor substitute for (expanding) Medicare coverage, but it is all we have in the short run. And, thanks to reactionaries on the Supreme Court and weak politicians afraid of the Tea Party radicals, expansion in the neediest states is difficult.” And “expanding Medicaid would create…private-sector jobs in our state…generating hundreds of millions in state and local taxes.”  If we insert MAGA for Tea Party, my statements made over a decade ago are still 100% accurate. 

In conclusion, here is the situation over 10 years later. Georgia still is one of the worst states for insurance coverage – only Texas and Florida have more uninsured. The explanation is simple technically, and solely political in nature. There is an old Winston Churchill saying:  “Those that fail to learn from history are doomed to repeat it.”

Just how many times will our governor and General Assembly go down this same disastrous road, unwilling to admit the failure of the Pathways approach because of politics?  

The facts are clear to anyone of any party who researches the issue. Bury your political ideology and do what is right for the residents of Georgia — full Medicaid expansion.

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