According to a Georgia State University report released recently, there is a relatively painless way to add 3,843 jobs in the greater Augusta region: expand Medicaid using predominantly federal dollars. But Georgia is one of a number of “red” states that are holding off doing so for primarily political rather than economic reasons.
According to a Kaiser poll, the majority of the country, 56 percent, wants the Republican party – my party – to get out of the way and permit the 2009 Affordable Care Act (Obamacare) to be smoothly implemented at long last. The voters are rightly tired of the constant bickering and partisanship that typified the last election and Congress.
VOTER DISILLUSIONMENT with political theater is why the 31st vote for repeal in the Republican House last year was counterproductive – as were Gov. Nathan Deal’s announcement at the Republican National Convention that he would not endorse the expansion of Medicaid in Georgia, and his more recent pronouncement that he would not set up a state insurance exchange. The feds will just set up the exchange, but Medicaid is another story.
Per a recent Supreme Court ruling, the Medicaid expansion provision of the Obamacare is now voluntary for each state. The feds cover 100 percent of the expansion expense for the first three years, falling to 90 percent permanently after a few more years.
Not surprisingly, expansion is being resisted by many GOP-controlled states where many of our poorest citizens without coverage reside. These are the very areas that need expanded coverage the most. Georgia, for example, has 22 percent of its population uninsured. Nearly half of our 1.5 million currently uninsured Georgians would be covered if we accept the federal government’s money to expand Medicaid.
The head of health policy for the Georgia Budget and Policy Institute said that Georgia’s $19 billion budget would only increase 2 percent by expanding Medicaid coverage under Obamacare.
Is this too much of an expense? Not when you consider that our hospital’s expensive emergency rooms already are seeing many of these lower income patients for free.
Well, not really for “free” – the expense is just transferred to those of us with insurance who do pay the hospital bills, and to Georgia’s taxpayers who pay for indigent care at their local public hospitals through their ever-increasing county property taxes. But when did fiscal rationality enter into politics?
MANY GOVERNORS turning down the Medicaid money are simply ideologues. They were so self-deceived that before the election they predicted an imminent Republican health-care revolution through Medicare vouchers and Medicaid block grants.
Medicare vouchers, promoted by Republican U.S. Rep. Paul Ryan of Wisconsin, just dump the cost increases onto the patient versus the government. There is no systemic change.
Medicaid block grants, still advocated by a Deal spokesperson, simply provide a way for states to cut services and beneficiaries, negatively affecting health-care delivery to the elderly and the poor who already have the worst health status of all Americans. For example, 55 percent of the patients served by Children’s Healthcare of Atlanta are on Medicaid. Do you really want to see them suffer because of fiscal shenanigans?
Because of the election, there is virtually no chance that Obamacare will be repealed or dramatically changed. So it is high time that we get with the program and evaluate the true costs and benefits of Medicaid expansion in Georgia.
Bill Cutler of Georgia State University did just that in his recent report. Dr. Cutler found that from 2014 to 2043 our state would get more than $40 billion in federal funds through Medicaid expansion. The economic activity related to the expansion would generate $275 million each year in local and state sales taxes. This is understandable when you examine the new jobs created – more than 70,000 statewide. And these are permanent private-sector jobs, not government, jobs.
GOV. DEAL SAYS that our share of the Medicaid expansion averages $400 million a year over time. Understandably, this upsets the single-issue “no new taxes for any reason” Tea Partiers. And that entails a political risk. But when you look at the benefits, the money coming into our state, the jobs created and the taxes brought in, the right choice should be obvious to our governor. Let’s hope he does the right thing.
(The writer, a former director of health planning for the state of Georgia, is a retired senior vice-president of a publicly held health-care company. He lives in Monticello.)