Governor’s Vision for Georgia Omits Help for Struggling Health Care System

Gov. Nathan Deal delivered his final state of the state remarks yesterday without addressing Georgia’s growing rural health care crisis. Six rural hospitals have shuttered since 2013 across the state, leaving holes in local economies, and more than half of Georgia’s remaining rural hospitals are financially vulnerable to closure. Opioid abuse and unmet mental health needs are decimating rural Georgia communities, exacerbated by high uninsured rates among working Georgians who simply can’t afford access to care.

The problem is only getting worse. Already struggling to treat so many patients without health insurance, Georgia’s hospitals absorbed a crippling $1.74 billion in uncompensated care costs in 2015. By 2026, the uninsured rate in rural Georgia could climb to more than 25 percent. As communities, families and businesses in much-discussed rural areas struggle, images of Georgia’s withering rural health care infrastructure flash on national newscasts. This crisis requires urgency and bold leadership from officials at the state and local level.

No single solution exists for the complex challenges facing rural Georgia, but state leaders continue to ignore a major solution to alleviate the rural health crisis: closing the coverage gap. About 240,000 Georgians earn too little to get financial help to buy health insurance from the federal marketplace and also make too much money to qualify for Medicaid. The majority are working Georgians who are stuck without affordable health coverage through their employer and earn below 138 percent of the federal poverty line, about $16,640 for an individual or $28,180 for a family of three. Closing the coverage gap would bring in $3 billion federal dollars to Georgia each year, more than $8 million each day, to provide access to health care for hardworking Georgians. As taxpayers, Georgians have already invested in closing the coverage gap nationwide. By not acting to close the coverage gap, state leaders let the federal government keep the money — $12 billion so far — that’s been set aside to pay for Georgians’ health coverage and stabilize struggling rural hospitals.

Extending health coverage to the 240,000 Georgians in the coverage gap brings back billions of dollars to the state that would strengthen rural hospitals and create thousands of jobs each year. Georgia’s rural communities would gain 12,000 new jobs and $1.3 billion in new economic activity each year from closing the gap. Extending health coverage to Georgians currently stuck in the gap also opens a critical revenue stream that helps ensure rural communities maintain access to care. Hospitals in Arkansas and Kentucky realized uncompensated care cost decreases of more than 50 percent after closing the coverage gap. Georgia too can reduce the uncompensated care costs that burden hospitals and allow people to go to their doctor instead of the emergency room when they get sick.

Some Georgia leaders say the state cannot afford to close the coverage gap and help working folks afford health care. GBPI released a new fact sheet yesterday publishing revised estimates on how much it costs for Georgia to close the coverage gap. Compared with other spending choices state leaders made for 2018, like setting aside $309 million for insurance company tax breaks and $414 million for film tax credits, closing the coverage gap requires a smaller $136 million investment. While Georgia can afford to close the gap, Georgia’s rural communities can’t afford continued paralysis on this crisis.

Georgia can close the coverage gap to help hundreds of thousands of Georgians access health care, strengthen rural hospitals and bring in new resources to help address the opioid epidemic. So far, however, state leaders have chosen to delay taking the path that makes the best financial sense now, waiting for a new federal answer that never materializes. It is time for Georgia to seize the opportunity that sits there for the taking.

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