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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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justthefacts
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justthefacts 01/13/14 - 09:24 am
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Too bad

I wish Obama had developed a plan to fix that issue for the 20-30-40 Million (whatever the number is now) without screwing up the healthcare system for the other 300 Million folks.

Dixieman
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Dixieman 01/13/14 - 10:26 am
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To happychimer:

You miss the point.
ALL governments have certain core functions. National defense is one of them. So is crime prevention and punishment, a fair court system, and a very few other things. No one can exempt himself or herself from paying for these few core functions.
However, redistributing income or assets by taking from one person and giving it to another is NOT a legitimate function of government. Any government. Especially the U.S. government.

JRC2024
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JRC2024 01/13/14 - 11:05 am
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Exactly, Dixieman.

Exactly, Dixieman.

Happychimer, your son and many other sons and daughters are being deployed because that is what the military does. I do however think we should fight to win like we did in WWI and WWII. Right now it seems that we are just fighting to slow down the advance of the Taliban. We should also close our immigration to any of the countries in the middle east. They are just not like us. But I am on the outside looking in just like you and most others.

WalterBradfordCannon
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WalterBradfordCannon 01/13/14 - 11:54 am
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@dixieman, the current system

@dixieman, the current system suffers from one major point. Hospital emergency centers are required by federal law to treat all in need of medical attention. Your uninsured receive no prophylactic care, and just show up at the ER when their need is great enough. EVERYONE with health care coverage pays for them.

The Affordable Care Act actually mitigates this redistribution by encouraging those on the lower end of the income scale to get a full health care plan including all cost-effective prophylactic care (like yearly physicals, flu shots, vaccinations, PSA if you are over 50 and male, mammograms, etc). What Nathan Deal has done is ensure that Georgia residents will continue to pay more for health care coverage, not less, because it leaves a large number of uninsured people in the state. Those people will avoid prophylactic care, and go to the ER when they are in true need.

ALL of the other top 20 economic power nations have nationalized health care, and ALL of the other top 20 economic power nations pay 60% as much for their health care as we pay for ours, and ALL of the other top 20 economic power nations have better medical outcomes than the USA despite the USA having a clear techological edge. The Affordable Care Act is just the first step in closing these obvious gaps. Look around at what other nations are doing. It works better than what we are doing. We need to change.

GACopprhed
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GACopprhed 01/13/14 - 12:40 pm
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Walter
Unpublished

're one hundred percent correct, but they will not accept it. I have posted the same fact multiple times, to once be told I lied, and from others who only read Tea Party websites for their info and talking points call the statistics "made up". They are blind AND ignorant, preferring to follow the ultra-rich who laugh at them, all the way to the bank.

lifelongresident
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lifelongresident 01/13/14 - 02:36 pm
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gov deal maybe a crook, a
Unpublished

gov deal maybe a crook, a scumbag, cold-hearted, or any other derogitory name, but the one thing he is not and that is a weak-spined governor only looking out for his political future/legacy...kudos to the governor for looking out for those who work for a change. while my heart goes out to those mentioned in this article and others but i am sorry you are not "due" anything. it is my money that i worked for and is taken in taxes to give you your "due"..the president the one who has the same pigmentation as yourself and who you blindly voted for (instead of reading and researching for yourself regarding the ACA)because he promised you more "free" stuff is the blame, it is not my, nor any other gainfully employed taxpayer's responsibility to "give you your due" you had years to work and/or get an education to make yourself marketable to have a decent job but forever reason you decided that you want to live off the gov't and now you are reaping what you've sown....no work/no medical care/no ability to afford medical care even though obama named his law the Affordable Care Act" well a suggestion to you why not call obama and ask him to pay for your medical care because i am sure when you blaindly pulled the lever marked "Barack Obama-President" you thought the sky would open up and all sorts of "free stuff" would just fall out of the sky into your lap...well "how's obamacare workin for ya?"

GACopprhed
2136
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GACopprhed 01/13/14 - 03:53 pm
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"I don't think the trashing
Unpublished

"I don't think the trashing of libs and Obama is going away. It is going to get worse and more wide spread." At least not until your heads explode because you, as a minority, will continue to lose, and none of you can stand not having your way. The government was elected to do exactly what it did. It will continue to, and the more obstructionist the Tea Party gets, the more frustrated and less tolerant the Republican party will be. soon it will be relegated back to the deep south, back woods areas that it crawled out of. The Civil War was fought in the 1860s, and the south lost, rightfully. It will continue to lose, because the rest of the nation refuses to go back to 1776.

corgimom
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corgimom 01/13/14 - 04:12 pm
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"I don't think the trashing

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

Trash people all you want, trash the President all you want. What counts is who wins elections, and the way it's going, there is going to be YET ANOTHER Democratic president.

The Democrats outnumber Republicans, and no amount of "trashing" is going to change that. And America is becoming more and more minority in demographics, and no amount of "trashing" is going to fix that.

Now, I know some of you bloggers won't believe this, but your anti-Obama rants are not shared by many in this country. It is human nature to think that everybody thinks the way you do; but results don't lie, and Obama got elected during the worse recession in 75 years, and Mitt Romney got defeated even with the immense power and wealth of the LDS church behind him.

And that should give everyone pause.

teaparty
11313
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teaparty 01/13/14 - 05:07 pm
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"The Democrats outnumber
Unpublished

"The Democrats outnumber Republicans, and no amount of "trashing" is going to change that."
corgimom, I afraid you are correct. But it is easy to trash the democrats because the party is make up of mostly trash, moochers and deadbeats. The few good people that are members have been brainwashed by the Marxists/communists from 60s and 70s and their students like Obama. The republicans are a bunch of self serving morons but the democrats are well on the way to destroy this country.

corgimom
32611
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corgimom 01/13/14 - 05:17 pm
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teaparty, make ridiculous

teaparty, make ridiculous stereotyped statements much?

There are good, bad, and indifferent people in every political party, and that includes the Tea Party too.

And if you think the country is being destroyed, nobody is making you stay.

teaparty
11313
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teaparty 01/13/14 - 05:32 pm
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"And if you think the country
Unpublished

"And if you think the country is being destroyed, nobody is making you stay."
corgimom, yes there is because I will do all I can to fight the trash, moochers and deadbeats with my last breath.

corgimom
32611
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corgimom 01/13/14 - 08:49 pm
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There has been people like

There has been people like that since Biblical times, this is nothing new.

But you fight them, good luck with that.

But what I know is that many people that are described as 'moochers" are really people that suffer from mental illness and emotional problems. We do a terrible job in this country of treating those problems. But it's just easier to call them "trash".

Ronald Reagan is the one that really kicked this up when he closed the mental hospitals. It was one of the most short-sighted, foolish decisions ever made in this country.

He was suffering from the start of Alzheimer's, and somebody should've had the good sense to stop him.

The homelessness, the explosion of welfare- it all goes back to that.

That's why I want to puke when people talk about what a great President he was. No, he wasn't, he did a lot of damage in California and then in the nation with his "ideas".

teaparty
11313
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teaparty 01/13/14 - 09:23 pm
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corgimom, I am not surprised
Unpublished

corgimom, I am not surprised because it is obvious you are a diehard progressive/Marxist. Marxism has failed everywhere it has been tried, CA is a great example.

teaparty
11313
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teaparty 01/13/14 - 09:39 pm
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"He was suffering from the
Unpublished

"He was suffering from the start of Alzheimer's, and somebody should've had the good sense to stop him."
corgimom, he might have been suffering from Alzheimer's but he was still much smarter than any democrat. Yeah old Jimmy Carter was genius wasn't he.

teaparty
11313
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teaparty 01/13/14 - 09:46 pm
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"But what I know is that many
Unpublished

"But what I know is that many people that are described as 'moochers" are really people that suffer from mental illness and emotional problems."
corgimom, I agree most democrats are 'moochers' and 'suffer from mental illness and emotional problems'.

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