Georgia officials working to expand Medicaid coverage to low-income adults got a jolt this week when a key element of Utah’s plan was rejected by the White House.

But Sen. Chuck Hufstetler, R-Rome, said he’s hopeful that there’s enough difference in the two plans to make a difference.

“It’s possible that we could be back at the table, but it isn’t the exact plan as Utah’s,” Hufstetler said Thursday. “And I do think there’s a difference in opinion with the federal government and (Centers for Medicare and Medicaid Services).”

Under the Affordable Care Act, the federal government paid all the cost for states that expanded Medicaid to residents earning up to 138% of the poverty level. The cost share drops to 90% next year.

Georgia — and a number of other Republican states, including Utah — rejected expansion, but are now seeking waivers allowing them to tailor the expansion to local needs.

Gov. Brian Kemp announced June 3 that consulting firm Deloitte would develop waivers acceptable to CMS that will reduce healthcare costs and expand Medicaid access to single adults.

A plan isn’t due until the end of the year, but Hufstetler said the Patients First Act — allowing Kemp to seek waivers — authorizes coverage for people earning up to 100% of the poverty level.

That’s the level approved for Utah in March, with a 70/30 cost-share.

The next step was to seek an increase of the federal share to 90% — but Gov. Gary Herbert announced Saturday that he was told it wouldn’t be approved.

“We will continue to work closely with the Administration to ensure that Medicaid expansion is carried out in a way that provides coverage for Utahns in need without creating an unsustainable financial burden on Utah taxpayers,” Herbert said in a joint statement with Senate President Stuart Adams and House Speaker Brad Wilson.

The Washington Post reported that two senior officials said the Trump Administration doesn’t want to offer the enhanced match for programs that don’t fill the coverage gap to 138% of the poverty level.

Hufstetler said Georgia’s plan would also subsidize private insurance for people earning between 100% and 138% of the poverty level. That could be enough of a difference to net the 90% federal match the state is counting on.

He said he pressed for waivers that would go up to 138% but he’s also happy with the Patients First Act plan.

“Data shows when we get people under preventative care, system costs drop,” Hufstetler said.

Hufstetler — who’s also an anesthetist at Redmond Regional Medical Center — chairs the Senate Finance Committee. He’s also been deeply involved in healthcare reform and spent nearly a year on a task force that heard from experts across the country on how to make state services affordable, accessible and sustainable.


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