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Georgia Republicans Join Democrats in New Medicaid Expansion Effort

A group of rural Georgia Republicans, once firm in their opposition to Medicaid expansion, is now backing a fresh bipartisan effort to expand health care coverage for low-income residents. This new push, aimed at providing greater access to health care, signals a significant shift in the state’s political landscape.

The proposed legislation, filed in the Georgia Senate on January 28, 2025, would create a new program called PeachCare Plus, which would expand income eligibility and offer private insurance coverage to those who would otherwise be eligible for Medicaid under a full expansion. The plan uses federal funds to purchase private insurance for individuals on the marketplace, rather than adding more people to the state-run Medicaid program.

A New Path Forward

While Medicaid expansion has been a polarizing issue in Georgia for years, the current proposal has gained support from a handful of state senators, particularly those from rural areas. These Republican lawmakers, including Sens. Sam Watson, Russ Goodman, Carden Summers, and Billy Hickman, have signaled their willingness to engage in the debate and at least entertain the idea of a more conservative approach to expanding health care coverage.

“This bipartisan legislation can actually get passed,” said Senate Minority Leader Harold Jones, a Democrat from Augusta, during a press conference on January 28. His optimism reflects the growing interest in addressing the state’s healthcare challenges in a way that appeals to both sides of the aisle.

Georgia Medicaid Expansion

Senator Sam Watson, who represents Moultrie, expressed his openness to hearing both sides of the argument. “I’m open to the debate,” Watson said, signaling that he’s ready to discuss the merits of the proposal, even if it’s not yet clear how he’ll vote.

Senator Russ Goodman, a Republican from Cogdell, echoed similar sentiments, stating that while he couldn’t promise support for the bill, he wanted to engage in an “open and honest debate” about it. For Goodman, the issue is personal. His son was saved by local hospital care after a tragic accident years ago, and he believes expanding Medicaid could ease the financial burden on hospitals in rural Georgia, many of which are struggling with indigent care.

Addressing Rural Health Care Needs

For these rural Republicans, expanding Medicaid isn’t just a matter of policy—it’s about ensuring that local hospitals remain viable and can continue to provide lifesaving care to their communities. Goodman noted that local hospitals have voiced strong support for Medicaid expansion, citing its potential to ease the financial strain they face when treating uninsured or underinsured patients.

“Isn’t that kind of what we’re supposed to do up here?” Goodman asked, emphasizing the importance of having a debate on the merits of the proposal rather than letting partisan divides stand in the way of progress.

Despite the backing of several Republicans, however, Georgia’s Medicaid expansion proposals still face hurdles. While the new PeachCare Plus bill mirrors a plan used in Arkansas, which had previously caught the interest of GOP leaders, many prominent Republicans, including House Speaker Jon Burns, remain wary of full Medicaid expansion.

In the face of shifting federal priorities, Burns has signaled that he is focused on what’s politically achievable. The Georgia Pathways to Coverage program, which was approved under the Trump administration but is now being challenged by the Biden administration due to its work requirement, remains a key point of contention.

Governor Brian Kemp has expressed his support for Georgia Pathways and announced that the state would apply to renew the program, which is set to expire in September. However, Burns, while open to compromise, has stated that the state’s leadership is focused on what is politically feasible, even if it means sticking with the existing program rather than moving forward with full Medicaid expansion.

Political Hurdles Ahead

As the new bill gains attention, it’s clear that the road to full Medicaid expansion in Georgia remains complicated. While the bipartisan effort signals a shift in attitudes, many Republican lawmakers remain cautious, worried about the long-term implications of a major expansion of government-funded health care. The PeachCare Plus proposal is likely to continue to face significant political hurdles, especially with the ongoing debate about federal and state priorities.

The outcome of this effort will depend on how lawmakers across the state balance the need for expanded health care access with the political realities of Georgia’s Republican-dominated legislature. As Georgia grapples with health care reform, the next few months will be pivotal in determining whether this new proposal can build enough momentum to push past partisan divides and onto the governor’s desk.

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