Politics Under the Gold Dome are Heating Up
Republicans and Medicaid Expansion – Is There a Spark of Interest?
There’s been some talk recently about a handful of Republicans in the Georgia House who’ve voiced support for expanding Medicaid. And indeed, the Speaker of the House, Jon Burns, actually brought up the subject in his speech at “Eggs & Issues.” But he only referenced the need to collect data.
If the Speaker needs data, we have plenty of it!
Still recovering from COVID Monday morning, I joined my Senate Democratic colleagues via Zoom for a presentation by the non-profit “Georgians for a Healthy Future” on prospects for expanding Medicaid in Georgia. North Carolina passed Medicaid expansion last year, partly by compromising on Certificate of Need policies, a system dating back to the 1970s that regulates supply and demand in healthcare. There has been much debate recently in Georgia about our Certificate of Need (CON) policies. Surprisingly, we were told Monday morning that Medicaid expansion does more to protect rural hospitals than CON regulations, where the data is mixed.
So if there’s room for compromise, we need to start looking at what kind of Medicaid model could pass in Georgia. The Governor’s “Pathways to Coverage” program, which is a small Medicaid expansion, has only enrolled a tiny fraction of Georgia’s low-income uninsured (2,350 out of 434,000). Because this small program does not draw down Federal dollars at the rate of full Medicaid expansion, Pathways costs Georgia, per person, five times what full Medicaid expansion would cost.
“The best plan is the plan that can get passed by this legislature,” said Laura Colbert, Executive Director of Georgians for a Healthy Future. She then went on to present the Arkansas private option model, where Medicaid premiums are used to pay for private market plans. There are some advantages to this plan in Georgia, the main one being that it gets around Georgia’s abysmally low Medicaid reimbursement rates, which could improve access to care.
While I think there is hope on the horizon for Medicaid expansion in Georgia, I don’t think we’ll get it this year, because, “it’s an election year.”
The Senate Gives Our Election System Third Degree Burns
I hear a lot of talk in the hallways about it being an election year. What this means in our Republican controlled legislature is that bills coming to the floor serve as a prelude to the battles that will be fought in Republican primaries. And sadly, these primaries have moved from battles of the far-right, to battles of bizarre conspiracy. By the end of the week, we saw this in full force in the bills that came to the floor.
Using their majority vote, Republicans appointed an election denier to the State Elections Board (SR 443), voted to remove the Secretary of State from the State Election Board (SB 358) and voted to ban ranked choice voting statewide, at all levels of government, except for overseas voting (SB 355).
Republicans also voted to create a special investigations committee to investigate Fani Willis (SR 465), which stated that verifying the truths of allegations about her romantic relationship with the special district attorney will “cast doubt as to the validity of the charges her office has brought in regard to the 2020 Presidential election.” But the low point came when our Lt. Governor prematurely cut off debate, silencing Democrats who had speeches planned. Debate is an essential part of any deliberative body, which is critical to a democracy.
Gun Safety, Mental Health & Reproductive Freedom – Putting Out Fires
On a more positive note, civic engagement is really up at the Capitol! I had the pleasure of attending three press conferences this week. The first was on Reproductive Freedom, where I explained to the press how the abortion ban law is impacting Georgia’s ability to train new ob-gyns. Because doctors-in-training can’t practice life saving procedures that involve abortion, I explained how when doctors choose not to train here due to our laws, they don’t end up practicing here either. Access to ob-gyns across the state will worsen. This caught the attention of WABE, where my explanation was aired. It’s a bit of an out-of-body feeling when I’m driving along the road listening to the news, and I hear my own voice. It’s like, “Oh, yeah, she has a point!”
I also joined a very well attended press conference on Mental Health, as well as one on Gun Safety organized by Georgia Majority for Gun Safety. The ability of these groups to organize citizens, unite voices and create a narrative in the press is impressive!
A Very Difficult Vote: HB 30
The week I faced the most difficult vote of all of my time in the legislature. HB 30 is the bill that attaches the International Holocaust Remembrance Alliance (IHRA) examples of antisemitism to Georgia’s discrimination and hate crime laws.
On the surface, it seems like it should be a simple vote. I stand against antisemitism, so I should vote yes. Yet it was not simple.
The war in Gaza brought out additional voices from people I represent. They told me that codifying the IHRA examples makes them feel fearful about speaking out against the war. Some of them have family and friends in Gaza and the level of death and destruction they have experienced is unimaginable.
On the other hand, antisemitic threats have increased and my Jewish constituents want more protection. Many of them also have family in Israel and are feeling grief and pain at losses incurred in the October 7th attack.
Inclusivity is one of my core values, and I have a responsibility to listen. This pushed me to carefully study the IHRA examples myself and I found some of the examples troubling, particularly the one about critiquing the behavior of the Israeli government. So I consulted an attorney, and was told that using the IHRA examples to determine intent depends on prosecutors and law enforcement acting in reasonable ways. This gave me pause, because in this day and age we don’t always get reasonableness where we should.
Codifying specific examples of hate into Georgia law has not been done before and I’m uncertain how it will play out. I don’t know if HB 30 will help or if it will cause further harm. It brings up questions of whether other groups should also codify examples, which groups those might be, or whether or not examples should even be codified. There are those that want to outlaw criticism and protest of our own government. Does this law provide a blueprint for them?
So with HB 30, I found myself in a situation with more questions than answers, and whether I voted up or down, I knew I would be hurting people I care about and want to protect. Abstaining was the only way I could recognize all the voices of my diverse district.
I remain committed to standing against damaging and hateful behavior. And I will always look deeply to find the voices of vulnerable people.