The legislation allows for an 1115 waiver to extend Medicaid coverage to some adults making up to 100% of the federal poverty level ($12,100 annually for an individual). This "partial expansion" would leave out thousands of Georgians who earn just above the poverty line and would be covered under alternate plans, including traditional Medicaid expansion or a broader 1115 waiver.

This legislation can play a critical role in Georgia’s ability to provide opportunities for substance use disorder prevention, treatment and recovery support services. We would like to see a fuller expansion that increases Medicaid coverage to individuals making up to 138% of the federal poverty level.

Georgia Council on Substance Abuse Executive Director Neil Campbell will offer the following testimony:

My name is Neil Campbell and I am the executive director of the Georgia Council on Substance Abuse, a non-profit organization with a mission to increase the impact of recovery in our communities through advocacy, education & training, and peer recovery support services. I am also a woman in long-term recovery, which for me means that I have not used alcohol or illegal drugs for over 28 years. I speak out about my recovery because I would like everyone to have the opportunities that I have had to get and stay well.

The past three sessions of the Georgia General Assembly demonstrated what can happen when our policymakers provide leadership and a sense of urgency to respond to individuals, families and communities struggling with substance use disorders. In that timeframe, they created and strengthened the Prescription Drug Monitoring Program, provided funding for babies born with neonatal abstinence syndrome, provided sixteen (16) communities with local, peer-run recovery resources and have supported efforts to increase services and supports to our returning citizens, many of whom have struggled with substance use disorders, mental illness, or both.

However, even with these positive efforts, our communities continue to seek solutions to, not only the current overdose crisis, but to the scourge that substance use disorders of all kind bring to bear.

Strengthening SB 106 will potentially provide an individual and his or her family with the crucial first step of affordable and accessible health insurance through expanded coverage, and can increase opportunities to help them live healthier lives. Just like people with other preventable, treatable, chronic health conditions, people with addiction need access to a broad range of services and supports.

Expanded coverage to the poor and low income in our State can provide people the individualized and comprehensive care they need. Preventing drug and alcohol problems before they begin is an important long-term strategy to combat addiction. Closing the coverage gap in SB 106 would increase prevention for many of the most vulnerable people in this state, including our youth. If youth and their families access routine primary care, early substance misuse can be detected and treated before significant problems develop.

Traditionally, we have used temporary, earmarked funds for addiction treatment and this does not replace providing people with insurance coverage, which allows them to seek care as needed — including care for mental illness and physical health issues that often accompany substance use disorders.

Effectively addressing addiction requires comprehensive approaches to coverage, treatment and supportive services. The number one cost to all businesses is employee retention. An investment in care of this sort on the front end is actually a pro-jobs investment on the back end. In order to be the #1 State for business we have to make our workforce stronger. We need healthy workers all over the State to do all kinds of jobs. People who get into recovery demonstrate that they can improve their lives by getting and staying employed, living healthier, and they also commit less crimes.

Currently, approximately 70 percent of jail inmates and 50 percent of inmates in state prisons have a substance use disorder. Since people returning to their communities from incarceration are at high risk of drug overdose, connecting them with health insurance can be lifesaving. Providing access to 3 care and treatment can be a deterrent to re-offending. States that have expanded Medicaid have seen their uninsured rate for formerly incarcerated people drop by 10 percent.

The opioid crisis is a public health emergency that will not be reversed overnight. Addiction is a pervasive issue but it can be prevented and treated. Recovery is not always a linear process and health coverage is part of the important continuum of care to support long-term recovery. Georgia can take an important and necessary step to stem the tide of this crisis by expanding coverage and providing life-saving health coverage to tens of thousands of residents.