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Georgians stuck without Medicaid increase

Friday, Jan. 10, 2014 7:37 PM
Last updated Sunday, Jan. 12, 2014 2:02 AM
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Around the clinic room at Medical Associates Plus at Belle Terrace, the small cluster of patients tell the same story – with different themes.

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Suzanna Mitchell (left) talks to Terri Gant about signing up for health insurance at Medical Associates Plus at Belle Terrace.  SARA CALDWELL/STAFF
SARA CALDWELL/STAFF
Suzanna Mitchell (left) talks to Terri Gant about signing up for health insurance at Medical Associates Plus at Belle Terrace.

They are uninsured and have spent hours online and making numerous phone calls trying to sign up through the Health Insurance Marketplace. They are in their 50s and early 60s and are being quoted monthly premiums around $500 or more, which they can’t afford. They are seeking care in the Emergency Room, where they feel unwanted.

If Georgia expanded Medicaid, all of them would be covered, but Gov. Nathan Deal said he will not do that.

“Deal is not dealing,” said Michael I. Everett, 57. “Deal is not giving us our due.”

A Deal spokesman said Friday that the governor did not create the problem and it is up to the federal government to solve it.

People who would have qualified for Medicaid if expanded are also not eligible for subsidies under the Affordable Care Act, which leaves them stuck paying the whole monthly premium or going without insurance. In Georgia, that is 409,000 people, or 22 percent of the uninsured, according to an analysis from the Kaiser Family Foundation. Deal spokesman Brian Robinson said they had estimated 620,000 would have been added under Medicaid expansion.

For many uninsured, buying health care coverage themselves is unrealistic. With a fixed monthly income of $1,300, Suzanna Mitchell said the premium quoted to her is $500 a month.

“How do they expect me to live?” she asked.

“Or get medications?” added Wallace England, 53.

Without Medicaid expansion, it is nearly impossible for an adult in Georgia who is not disabled to qualify for the program. Eligibility is limited to parents with incomes below 38 percent of the poverty level, or less than $9,000 a year for a family of four, according to the Kaiser Family Foundation report. Even allowing adults to qualify at the federal poverty level, $11,490 a year for an individual or $23,550 for a family of four, would cover 35 percent of the patients seen at Medical Associates Plus, CEO Janice Sherman said.

While patients pay a co-pay on a sliding scale to be seen at the clinic, it doesn’t begin to cover the actual costs of their care, she said.

“Not by a long shot,” Sherman said.

As a Federally Qualified Health Center, Medical Associates Plus gets a federal grant to help subsidize those costs, but that still means the costs are borne “by us,” she said. If Georgia expanded Medicaid, instead of getting a $25 co-pay, patients would bring about $117 from Medicaid. With that applying to more than a third of its patients, “it would be substantial,” Sherman said.

Everett is on unemployment but “once that unemployment runs out, I’m in a Catch-22,” he said. Unless he raises his income, he still won’t qualify for subsidies to buy insurance.

“To pay that $500 right off the bat ... ,” Everett said.

“Oh, that’s a lot,” said Janice Bailey, 63. She is facing the same thing and has gone through both the paper and online application process and the least she would pay is just under $500.

“They made it sound so easy,” Bailey said. “It gets you really confused.”

It is an issue that President Obama and Congress need to solve, Robinson said.

“There are numerous avenues the administration could take,” he said by e-mail. “It could allow the expansion population to buy private insurance on the exchange or it could block grant Georgia the federal share of the expanded Medicaid money.”

The U.S Supreme Court “said that states cannot be coerced into expanding Medicaid, yet that is exactly what federal policy is attempting to do,” Robinson said. “Gov. Deal simply cannot put Georgia taxpayers on the hook for the billions in new state spending that the expansion would require.”

WHY IS THERE A COVERAGE GAP FOR THE POOR IN GEORGIA?

When the Affordable Care Act was passed in 2010, a large amount of increased coverage for the uninsured was going to come from states expanding their Medicaid coverage. In many states, such as Georgia, childless adults without a disability have a hard time qualifying for Medicaid even if they are very poor. The Affordable Care Act would have encouraged states to expand Medicaid up to 138 percent of the poverty level (around $32,500 a year for a family of four), by paying 100 percent of the costs for the first three years and never less than 90 percent after that. The Secretary of Health and Human Services could also withhold Medicaid funding if a state did not expand. To presumably keep states from pushing Medicaid patients into the Health Insurance Marketplaces, the law also forbid anyone who qualifies for Medicaid from receiving subsidies in the marketplaces.

The U.S. Supreme Court ruling in 2012 that upheld the law also took away the ability of Health and Human Services to withhold Medicaid funding, which made expansion voluntary. Georgia, South Carolina and many other states chose not to expand Medicaid. Georgia Gov. Nathan Deal said it is not affordable, and instead wants the federal government to put the Medicaid funding into a block grant to allow the state greater flexibility with the program.

Source: Kaiser Family Foundation

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carcraft
20640
Points
carcraft 01/11/14 - 08:52 am
15
5

Welcome to a health Care

Welcome to a health Care system designed by a community organizer! The cost of insurance is out of reach even in states that have expanded medicare. Look up the lady in the state of Washington who emailed Obama thanking him for being able to afford health insurance only to find out the cost quotes were wrong. While we groan and lament the fate of the people in the article lets also remember the millions of people who HAD insurance but lost their insurance because of Obama care and are now unable to afford the new more expensive policies they can't afford.

Bodhisattva
4942
Points
Bodhisattva 01/12/14 - 06:22 am
4
12

Let crooked Nathan get his hands on Medicaid money? No Way!

Welcome to a state that has a Governor who fled Washington to avoid ethics charges, only to face ethics charges in Georgia. He jumped into action by firing the independent head of the State Ethics Commission, hand picking the successor, and cranking the the shredder and destroying evidence. Now, it turns out the new ethics chief, who was brough in to "right the ship", was FIRED FROM HIS PREVIOUS JOB FOR FAILURE TO MEET PERFORMANCE EXPECTATIONS. We can't fail to mention Nathan's Real PAC that's received over a million dollars from the health care and insurance industry, plus Ralph Hudgens, our beloved Insurance Commissioner who laughed as he set up road blocks to make it harder for people to get insurance, and who somehow is allowed to have his campaign funded by the people he regulates, like insurance companies. Now the FBI is on Nathan's back big time and he might not slither out of this one. Let's hope he doesn't. He's been a crook for years and now it's time to pay the piper. If anyone doesn't think Nathan doesn't want a block grant of Medicaid money so he can dole it out as political favors, I have some oceanfront land in Oklahoma to sell him. Maybe he should worry about getting $73.8 million in back taxes from the salvage yard that paid him and his parner, and are still paying him, but not the state.

Bodhisattva
4942
Points
Bodhisattva 01/12/14 - 06:50 am
5
14

Why doesn't the Chronicle mention the facts? They never do.

The Feds pay 100% of the Medicaid costs for 3 years then gradually reduce it until they're paying 90% of it in 2020. THE MOST THE STATE HAS TO PAY, AND NOT UNTIL 2020 IS 10%. That allows 400,000 of your citizens to be insured affordably, plus allows hospitals to be reimbursed, and will save several rural hospitals from having to close their doors forever. All of this because our crooked, hyper partisan, conspiracy theorist idiot of a governor hates the man in the White house so much that he'd rather see his constituents suffer, and the health care providers in the state suffer than to agree to the Medicaid expansion. For Medicare Part D, Governors that didn't support its passage still worked with the feds to help their citizens get on the program. Of course the Republicans forget about the major glitch that had states have to pay for the medications out of their budgets because the fed's glitch wasn't reimbursing them. A little tidbit of fact that you'll never see the Chronicle, or any Republican mention. Of course that would have been Democrats helping their citizens when there was a President of the opposing party in office. That went out the window with Obama. That was before the hate, the racism, the birth certificate, the meeting to plot to vote against everything, the put Americans, jobs, the economy, everything else on the back burner and make hate, make up lies, conspiracy theories, name calling, and pure out and out bull against this President job number one. It's sickening. Party above people. It's to the point where I almost think the Republicans would let Americans die in the streets if they thought it would look bad on Obama and help their political goals. Disgusting.

Dixieman
10350
Points
Dixieman 01/12/14 - 06:52 am
16
4

Nonsense

"People who would have qualified for Medicaid if expanded are also not eligible for subsidies under the Affordable Care Act..." Um, what? This sentence doesn't even mean anything.
If you get sick, YOU should be responsible for paying to get well. Not the government (which has no money but what it takes from others). Not your boss. Not me. You.

Bodhisattva
4942
Points
Bodhisattva 01/12/14 - 07:07 am
4
12

Congress should immediately

Congress should immediately pass, and the President should sign a bill that says: Henceforth, all health insurance companies in the United States shall be immediately dissolved. If you get sick, YOU should be responsible for paying to get well. Not the government (which has no money but what it takes from others). Not your boss. Not me. You. There shall be no more shared risk pools in insurance companies. You alone are responsible for all of your health care costs. Good luck. You'll need it.

Junior Dawg
279
Points
Junior Dawg 01/12/14 - 09:32 am
11
5

Why all the hate?

Bod and Gac, please calm down. Stop blaming everyone else and realize that the Dems passed this horrific law and your messiah signed it. And stop acting as if we the people can afford to put millions more on the Medicaid rolls. Yes the republicans are bad, but they are the lesser of two evils when compared with liberals.

Bizkit
21852
Points
Bizkit 01/12/14 - 09:58 am
8
4

What's this "under insured"

What's this "under insured" nonsense-it's a free market system that people got what they wanted. That's just a made up myth. People complained of their cost not their service. Bod the fed always cuts the funding short in a shorter period-bottom line the state will be stuck with a huge cost it can't afford because it was coerced to expand this by the fed. That's why numerous states are stuck with these large cost programs they didn't even start-the fed did. It's ridiculous the ACA will save, at most 100 billion in ten years, yet Obama to reach his hopeful just 744 billion deficit for the 2014 budget will over spend 2 billion a day. The man is an economic idiot and lives in some delusional "fairy land" utopia from watching' too much Star trek-wars (the idiot doesn't know the difference). Some 6 million have lost or had their insurance change to a higher cost plan-the majority of people will pay more for their health insurance from the recent study.

avidreader
2606
Points
avidreader 01/12/14 - 10:04 am
11
4

Sad!

As much as I dislike Mr. Obama and his socialist schemes, I sure hate to see impoverished people suffer. It's sad. The entire Obamacare process is a big mess, and this news article portrays it.

Maybe Gov. Deal is a creep, but so is Mr. Obama and our entire federal and states legislatures. It's sad!

dichotomy
26573
Points
dichotomy 01/12/14 - 10:21 am
14
5

"Deal is not giving us our

"Deal is not giving us our due"

And therein lies the problem with the entitlement mentality. You are not "due" anything from out of my pocket. I should not have to pay more for anything so that you can get it for free and I should not have to pay more federal OR state taxes so that the government will give you something for free. Regardless of who is paying 100% this year and 90% vs. 10% in the future, IT IS ALL COMING OUT OF MY POCKET. That is MY money....my family's money. YOU ARE NOT DUE ANY OF IT.

deestafford
18118
Points
deestafford 01/12/14 - 11:13 am
11
3

Dichotomy is right on point.

Dichotomy is right point. Gov Deal is looking out for the taxpayers/producers of Georgia and trying to see they are not stuck with millions of dollars of additional medicaid funding in the future. The feds are hooking some states as a heroin dealer hooks addict by giving some free samples now and making them pay for it in the future after they are hooked.

Let's get this straight. People are not going without HEALTHCARE. They may not have insurance but by law they have to be treated at the ER if they go there. So, they don't welcome you with flowers and a smile and you feel unwanted? So what? If you are sick or injured you are there to get fixed...free.

Where is the husband? How many children by different fathers? These people deserve some compassion and society gives them that in many, many tangible ways of welfare support. However, let's not forget it's their life choices that put them there. If one graduates from high school, gets a job--any job, gets married, and then has children when they can be taken care of the chance of being in poverty is in single digits. It doesn't matter if you are black or white that statistic holds true.

It's not society's fault people have children they can't afford and then
they want to complain they are not getting their due!! In reality they are not DUE anything. They get what is taken from the producers by the government and what charity the producers freely give. I hope they are not teaching their children that they are DUE a free life without working and getting an education, but I bet I'm wrong on that.

JRC2024
6954
Points
JRC2024 01/12/14 - 11:22 am
7
3

To the people at Belle

To the people at Belle Terrace-You are not due my monery that I work so hard to get. I do not mind paying some to help but you are not due.
To Bot and GCC, for your info I applied for Medicare because I will be 65 Jan 24 and went off my wife's health insurance this year. Her premium shot up approx. $200.00 a month this year and my Medicare premium and part D is $470.00 per month. Our original was $1124.91 and our new combined is $1190.00. So much for being a better deal.

raul
3350
Points
raul 01/12/14 - 11:41 am
6
2

@Bod. "The Feds pay 100% of

@Bod. "The Feds pay 100% of the Medicaid costs for 3 years then gradually reduce it until they're paying 90% of it in 2020. "

And who do you think pays the Fed? Jackwagon.

talkrightmommy
41
Points
talkrightmommy 01/12/14 - 11:59 am
8
2

Question:

I guess we're supposed to be outraged about a healthcare "gap" created by Governor Deal who decided Georgia won't participate in Medicaid expansion. But with an income of $1300/month, the person in the story wasn't eligible for Medicaid before ObamaCare and probably still wouldn't qualify if Georgia opted for Medicaid expansion. Meanwhile this lady gets practically free healthcare just as she did before ObamaCare. And yet she is angry....

happychimer
13231
Points
happychimer 01/12/14 - 01:05 pm
2
15

Where is the outrage to wars?

Where is the outrage to wars? Our tax money is paying for wars that I don't want to support. I would much rather that money went for healthcare. I am sick and tired of hearing liberals this and liberals that, and the trashing of our President. Get a life! Governor Deal will never get my vote. He is a sorry governor.

allhans
21928
Points
allhans 01/12/14 - 01:42 pm
9
2

What were these folks doing

What were these folks doing for health care before this? If they had Medicaid before, then they are still eligible.
Sounds just a little made up to me.

Anyhow...I assume they were expecting FREE health care, just as their Obama promised....join the crowd...he has never known a promise he would keep.

scoobynews
3697
Points
scoobynews 01/12/14 - 02:13 pm
7
3

Wars?

Oh that's right it's all Bush's fault? Sorry folks that won't wash anymore. We are currently not at "war" with anyone.

KSL
105558
Points
KSL 01/12/14 - 02:20 pm
8
3

I don't think the trashing of

I don't think the trashing of libs and Obama is going away. It is going to get worse and more wide spread.

KSL
105558
Points
KSL 01/12/14 - 02:22 pm
5
3

allhans

Good question. What were they doing?

Sweet son
8213
Points
Sweet son 01/12/14 - 02:32 pm
9
2

dichotomy beat me to it!

What a statement:“Deal is not dealing,” said Michael I. Everett, 57. “Deal is not giving us our due.”

I bet Everett is not 'due' anything because he didn't put anything in in the first place. Entitlement mentality; gotta love it!

curly123053
3192
Points
curly123053 01/12/14 - 02:36 pm
9
2

Wrong !!

Every US Senator and member of the US Congress who blindly voted for this bill without knowing what was in it need to be incarcerated at Gitmo in my opinion! When the Congress and Senate passed a bill without the knowledge of it's consequences on the American public that was a criminal act in my opinion. The President and those who blindly voted this blank check against We The People need their suites at Gitmo occupied ASAP. And, all those sheeple who are still blindly following the poison apple around the track in support of this idiotic law need to join them. This law got rushed through and voted on so fast because the government knew the people would have been screaming "NO" had we all known what the ramifications of the bill was. The President, Senate, and Congress committed FRAUD against the people of America as they passed this socialist act. That is where the only fault lies! Not with any state or governor, but with the Federal government!.

KSL
105558
Points
KSL 01/12/14 - 02:45 pm
6
1

happy

I suppose that you have all along objected to all the billions of aid (military equipment) we have provided Egypt, including that since the coup.

SemperParatus
3225
Points
SemperParatus 01/12/14 - 05:35 pm
2
0

I am asking a simple question

I am asking a simple question and would appreciate an uncomplicated answer. I am told that University Hospital is the ONLY hospital in the CSRA that is required by law (don't know the law) to accept and treat anyone reporting to its emergency room whether or not the person has insurance or cash including Medicare and Medicaid. Is this true? Yes or no? And as a follow up, is it true that University Hospital is required to treat this person regardless of place of residence? I'm told that patients go to University from Aiken County, Columbia County, Burke County, etc. Not sure I understand that since University is owned by Richmond County.

JRC2024
6954
Points
JRC2024 01/12/14 - 08:27 pm
8
1

Happy, Is he a sorry governor

Happy, Is he a sorry governor because he is not liberal and is trying to look after the taxpayers of Georgia and not as much for those with their hands out?

happychimer
13231
Points
happychimer 01/12/14 - 09:28 pm
1
5

Scooby says we are not at war

Scooby says we are not at war with anyone. If that is true, then what is my grandson doing? Why is he being deployed? He is going to fight a war! Our tax money is going to fight a war. Where is the outrage? Where?

happychimer
13231
Points
happychimer 01/12/14 - 09:32 pm
1
6

Nathan Deal is not looking

Nathan Deal is not looking out for tax payers. what's wrong with liberal? Not a dang thing. I am so thankful I am not filled with hate like some.You think your way or the highway. This would be a dull world if everyone were the same. Hey. Yes I am liberal. So what!

Dixieman
10350
Points
Dixieman 01/12/14 - 10:36 pm
5
1

happychimer:

Please be just as liberal as your lil' ol' heart wants to be, and God bless you. Just don't say you have the right to confiscate my hard-earned money to implement your agenda, with which I disagree. (I don't think it is possible to be a liberal and adhere to the second sentence).
========================
This whole thing is immoral. A, B and C are three individuals who are the only inhabitants of a desert island. They form a government. A is hungry. A and B then vote to take away some of C's coconuts and give them to A. Majority rules. Where is the justice in that? Is THAT really what we want government to be able to do to us? Liberals posting here -- please explain.

happychimer
13231
Points
happychimer 01/12/14 - 11:20 pm
2
2

Dixieman I don't want my

Dixieman I don't want my money sent to fight other country's wars. The point is we don't have a choice. If I could, I would stop the wars. I do not want a penny of my money going to pay for wars.

skeptical
81
Points
skeptical 01/13/14 - 06:16 am
1
0

Univ Hospital status

Semper:
1) UH is not owned by Richmond County; it was historically established as a public entity owned by the Richmond Co Hospital Authority; it now functions as a private not-for-profit entity (University Health, Inc) - see http://www.universityhealth.org/body.cfm?id=39164&oTopID=38941#.UtO7fXmAUgp for a list of its various boards. Note that not-for-profit does not mean non-profit!
2) I don't believe that UH is required to treat 'anyone reporting to its emergency room.' ERs are required to carry out a medical screening exam and to treat all who are determined to have a bona fide emergency condition, irrespective of residence or ability to pay. That's true of UH, Ga Regents Med Center, Trinity, Doctors . . . You might read this: http://www.acep.org/content.aspx?id=25936

corgimom
19199
Points
corgimom 01/13/14 - 08:03 am
2
2

"Let's get this straight.

"Let's get this straight. People are not going without HEALTHCARE. They may not have insurance but by law they have to be treated at the ER if they go there. So, they don't welcome you with flowers and a smile and you feel unwanted? So what? If you are sick or injured you are there to get fixed...free."

What the law says is that anybody can go to University to be treated, and they will be treated until they are stabilized, then they are released, to be seen privately. And that's when the ball gets dropped.

They do not get to be treated for chronic illnesses. They do not get free medical care for preventative services, they do not get medication for chronic illnesses, etc.

Many people do not understand this critical difference, including Dee Stafford.

corgimom
19199
Points
corgimom 01/13/14 - 08:05 am
2
2

But that is why those sick

But that is why those sick people keep showing up in the ER again and again and again, and why our medical costs are so high.

They just keep bouncing from crisis to crisis to crisis, because they don't have access to medical care to keep the crises from happening.

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