Medicaid Expansion Still Georgia’s Best Way to Bridge Coverage Gap

Tim SweeneyAs published in the Atlanta Journal-Constitution on May 11, 2014

A quick scan of recent headlines could leave you with the impression two state laws approved this year all but end any conversation about Medicaid expansion in Georgia. Fortunately that isn’t the case, for the sake of more than 500,000 uninsured Georgians, the state’s health care providers and its economy.

No question, the new law to require approval of Medicaid expansion by state lawmakers to prevent the governor from acting on his own adds another step in the path to adoption. And a related law is designed to make it more difficult for government employees to say positive things about the federal health care law.

But clinging to the status quo in Georgia is not a realistic or humane option. Georgia, after all, is the state with the country’s fifth largest number of uninsured people. Many of them wind up in emergency rooms after postponing treatment because they can’t afford it. Hospitals are obligated to treat a sick person who can’t pay, which causes financial struggles for many of Georgia’s care providers.

These problems did not go away April 29, when the governor signed off on the two new laws.

State lawmakers said they should be included in any discussion about expanded Medicaid eligibility, so let’s hope they start a serious conversation about ways to improve access to health coverage for Georgians who go without it. To date, state leaders haven’t presented an alternative to Medicaid expansion that systematically increases access to health care for low-income, uninsured Georgians.

Any new competing plan should be evaluated against the great health improvements people in other states are getting through expanded coverage.

Massachusetts provides a great example, with its eight-year track record of health reforms that served as the universal coverage model echoed by the national health care law. Coverage expansion in Massachusetts reduced “mortality amenable to health care,” or deaths that could be prevented by medical care, by 4.5 percent, according to a study just published in Annals of Internal Medicine.

The study’s authors found mortality improvements are greatest in areas with higher uninsured rates and lower incomes prior to the coverage expansion. Georgia’s policymakers should find this compelling, as it suggests people in Georgia’s communities with the greatest needs stand to gain the most from expanded coverage.

Georgia lawmakers often limit the Medicaid expansion conversation to affordability within the state budget. No question, it is their responsibility to make sure the state can afford it. I’ve done the math. The feds will pay at least 90 percent of the cost of expanded eligibility. That’s a great financial deal for Georgia.

The Massachusetts example shows expanding health coverage can make a real difference in people’s lives.

More than 500,000 low-income Georgians in communities from Blue Ridge to Valdosta now go without health care coverage. Medicaid expansion promises them better access to health care for prevention and after they get sick. It could even help them live longer.

That should also be part of the conversation when lawmakers tackle the future of Georgia’s health care policy.

Tim Sweeney is Director of Health Policy for the Georgia Budget and Policy Institute.








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