Lawmakers Can Use Legislative Offseason to Get Serious About Health Care

Education reform? Check. More revenue for transportation maintenance? Check. What’s missing here?

Ahhh, Georgia’s ailing health care system didn’t get much attention from state lawmakers as they wound down the 2015 session this week. Kudos to House and Senate leaders who compromised on a transportation plan.  We can all agree improving the opportunity for Georgia’s schoolchildren to learn is a worthy goal, wherever you stand on the substance of this year’s education reform legislation.

Lawmakers missed another opportunity to develop sustainable solutions to problems in Georgia’s health care system.  Hundreds of thousands of Georgians don’t have health insurance.  An estimated 15 rural hospitals are in a financial struggle to survive.

Notably, last week marked the fifth anniversary of the Affordable Care Act. While the heated rhetoric that accompanied the law is somewhat calmer now, state leaders remain on the sidelines when it comes to big-picture health care issues. On the plus side, this year at least lawmakers did no harm. Last year the General Assembly added new barriers aimed at preventing the state using tools in the Affordable Care Act to address key health care issues.

How is the five-year-old federal health law working for Georgians, despite inaction at the state level? More than 540,000 Georgians enrolled in a health plan through the federal health insurance marketplace in 2015. The outreach and attention paid to the federal health insurance marketplace spurred 120,000 more children in Georgia to get coverage through Medicaid or PeachCare than before the October 2013 roll out. The increase came without a change in the eligibility-levels for children in Georgia and should be applauded. In 2013 Georgia was home to the fourth largest population of uninsured children of any state in the nation.

Still, nearly 300,000 Georgians remain stuck in Georgia’s coverage gap, uninsured and ineligible under Georgia’s relatively stringent Medicaid eligibility guidelines. At the same time they earn too little to receive federal tax credits through the health insurance marketplace. Georgia is now home to the second highest adult uninsured rate in the country, trailing Texas.  Georgia policymakers can close this coverage gap by crafting a plan to extend Medicaid to more people and inject new federal money into Georgia’s health care system.

Georgia’s leaders need to take a closer look to see how much expanding access to health coverage in Georgia and increasing funding for our health care system benefits the state. Other states are creating a growing number of success stories.

A comprehensive report examining the first year of Kentucky’s experience with Medicaid expansion now predicts the state will benefit from more than $900 million in new revenue or reduced spending from 2014 to 2021 than if it hadn’t expanded.

Hospitals in states that expanded coverage through Medicaid see fewer uninsured patients and experience a much greater drop in uncompensated care than in states that resist expansion.

Governors and lawmakers from both major parties are examining thoughtful proposals in Utah, Tennessee, Montana, Florida and elsewhere to close their state’s coverage gap through the extensive flexibility built in to the Medicaid program. The success of the “private option” in Arkansas was recently highlighted by a series in the AJC, while earlier this year Indiana reached agreement with the Obama Administration on its coverage expansion.

It is well past time for Georgia to find a way to take advantage of substantial federal funding that could insure 500,000 people. An added bonus is this new money would help strengthen the state’s health care delivery system and increase its capacity to serve people all over the state. Even expansion opponents seem to agree doing nothing is not a viable solution to the challenges plaguing Georgia’s health care system. It’s time for serious talk about expanding access to health coverage. It is time to figure out how to use the federal resources at our disposal. It is far past time to stop pretending Georgia can solve its health care problems on its own.