The figure surfaced in a letter Lt. Gov. Casey Cagle wrote Nov. 10 to U.S. Sens. Johnny Isakson and Saxby Chambliss that was recently obtained by Morris News Service. In it, Cagle wrote that the bill would cripple the state as it is trying to recover from a 22-percent one-year decline in the state budget.
Georgia's original budget for the previous fiscal year was based on tax collections of $20.1 billion, but current projections show collections may only reach $15.7 billion, Cagle wrote. A less ambitious version of health reform in the U.S. Senate that costs Georgia just $2 billion over five years will be nearly as painful, he said, because both measures require states to expand coverage of low- and middle-income people.
"In fact, if any of these massive unfunded mandates are enacted into law, our state will be forced to cut additional essential services," Cagle wrote.
Cagle, Isakson and Chambliss are all Republicans who have expressed general disagreement with the Democrats' health proposals.
Supporters of Democratic efforts at health reform applaud expanded coverage as a way to reduce the number of Americans who have no insurance at any given moment. The way to bring more of them into state coverage is by raising the income eligibility to 133 percent of the poverty level in the Senate version or to 150 percent in the House plan. The more generous House cutoff would allow a family of four to remain eligible until its annual income passed $33,000.
"Basically, what you're dealing with here are the usual GOP talking points, developed by their political team, with an assist from the health insurance companies," said Matt Weyandt, executive director of the Democratic Party of Georgia. "The truth is, Georgia saves money with health insurance reform, which makes it even more important after the way Republicans on the state level have run our budget into the ground."
Cagle relied on projections by the Georgia Department of Community Health which traced the impact of the House bill once the federal government turns over the cost of Medicaid expansion to the states in 2013. It also predicts more people currently eligible for Medicaid will decide to enroll so they can avoid penalties for remaining uninsured that are included in the reform measures, resulting in a 77 percent increase above the 1 million enrolled now.
Just processing the claims of the increased enrollment will add $37 million annually to the budget, money the reform legislation doesn't provide to the state, according to the department's analysis.
Isakson said Cagle's letter is just another reason to oppose the plan in the Senate.
"Lt. Gov. Cagle is absolutely right," Isakson said. "At a time when most states are already under tremendous budgetary stress, Georgia cannot afford the billions of dollars in massive unfunded mandates that are contained in the Democrats' flawed health-care reform bill."