Gov. Nathan Deal delivers his State of the State address Thursday.
How to fund healthcare for 650,000 low-income Georgians is one of the biggest issues facing the state.
The state Senate could vote on Medicaid funding soon after the governor speaks.
Georgia House Speaker David Ralston said the state has to find some way to pay for 650,000 low-income Georgians and he supports the governor's plan to extend the healthcare provider fee.
"We have a lot of people in Georgia who depend on access to healthcare, particularly children," Ralston said. "The reality is without this, we've got a lot of hospitals in Georgia that face closure."
Most of the state's hospitals now pay about 1.4 percent of their profits to fund Medicaid.
The state uses that money to qualify for more federal aid.
Those funds are then given back to hospitals based on how much Medicaid care they provide.
Critics call the fee a bed tax.
Ralston rebuffed that claim.
"This is not just another tax. That is an assessment and it only applies to Medicaid," Ralston said.
The fee is set to expire this year.
A Senate committee on Tuesday approved the plan to extend it.
State Rep. Dee Dawkins-Haigler, who chairs the Georgia Black Legislative Caucus, said the state would not need to charge hospitals if the governor had expanded Medicaid under President Barack Obama's healthcare plan.
"The best way to fund Medicaid is through the Affordable Healthcare Act," Dawkins-Haigler said. "They're trying to fill a hole without accepting federal money."
Deal last summer rejected a proposal to expand Medicaid under the Affordable Healthcare Act, saying the estimated $4.5 billion it would cost was too expensive.
The Black Legislative Caucus is calling on the governor to expand Medicaid.
Ralston, however, said the state does not have the money.
"We cannot afford to expand the medicaid program at this time," Ralston said.
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