Ga. can afford Medicaid expansion; it just won’t

1396055946000-AP-Tennessee-Daily-Life-1Earlier this week, Hillary Clinton urged Georgia leaders to set aside politics and ideology and approve Medicaid coverage for some 300,000 people in this state that have been left stranded without health insurance.

“Not only is it the right thing to do, it’s the smart thing to do because it’s good for rural hospitals, it’s good for doctors and nurses, and it will lead to lower costs and healthier Georgians,” Clinton said in a statement.

I’m sure that you will be shocked to learn that Gov. Nathan Deal and the state Legislature showed no signs of listening to the Democratic presidential candidate.

In his annual State of the State speech last week, Deal had already reiterated his continued opposition to expansion. “Had we elected to expand Medicaid, it would have required us to include approximately $209 million in this upcoming year’s budget alone to cover the added cost,” Deal explained to state legislators.

Now, $200 million is a good sum of money, but it’s useful to put it into context:

That $200 million needed to expand Medicaid to Georgia’s working poor, leverage billions of new federal dollars into the state, keep rural hospitals open, create thousands of jobs and improve the lifespan and quality of life for many Georgians would amount to 0.88 percent of the projected $23.7 billion state budget for 2017.

It amounts to less than a third of the $669 million in additional personal and corporate income-tax revenue projected to be collected in the next fiscal year.

It amounts to roughly $670 in state money to provide health insurance to a Georgian for a year.

In short, this is not a case of “can’t”; it is a case of “won’t.” It is a case of Georgia’s leadership feeling trapped into a bad decision by their own rhetoric. It’s bad politics getting in the way of good governance.

And of course, let’s not be naive: Clinton’s demonstration of concern is itself motivated by politics. I doubt that she’s trying to curry favor with Georgians in hopes of making the state competitive in the general election come November — if Georgia is in play by then, Clinton and her fellow Democrats don’t have anything to worry about nationally. Her interest is more immediate: The state presidential primary is March 1, and she’s trying to appeal to Democratic voters and officeholders in Georgia who could prove very important to Clinton in holding off a challenge from Sen. Bernie Sanders of Vermont.

But Clinton is also right. Take the situation in Ellijay, where there are indications that the North Georgia Medical Center is in danger of becoming the latest in a string of rural hospitals to close their doors. The facility provides some 300 jobs in that community, but may not have enough paying patients to keep afloat. (See update below)

The numbers explain why:

According to the Centers for Disease Control; the uninsured rate in Gilmer County is 28.1 percent, compared to 17.7 percent nationwide. And according to data compiled by the Urban Institute, some 48 percent of uninsured adults in that part of Georgia could get covered if Medicaid was expanded. Expansion may not solve all of the problems of the North Georgia Medical Center, but it would help.

And who represents that area in the Georgia Legislature? House Speaker David Ralston.

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UPDATE: According to Hannah Towns, marketing and public relations director for North Georgia Medical Center, the facility’s 50-bed inpatient hospital is expected to close but may provide rehabilitation services. Its 100-bed nursing-home operation will stay open, and a separate hospital company has applied with the state to take over operation of its free-standing emergency room.

Reader Comments 0

409 comments
Neal E. Stockmyer, Ph.D.
Neal E. Stockmyer, Ph.D.

It is over simplification to imply that rural hospitals in Georgia at risk of closing can be saved by Medicaid expansion.  The major issue is patient choice.  Many people in Georgia's rural communities, including Medicaid patients, choose to travel to larger hospitals with higher levels of technology and broader scopes of services than those usually found in a small rural hospital.

mphillips57
mphillips57

Georgia governor election, 2014: Deal (R, named most corrupt gov in USA): 1.34 million votes. Carter (D, promising to expand Medicaid): 1.14 million votes. Adult Georgians who did not vote: 5 million. If 1 non-voter in 25 had voted for Carter, we'd have Medicaid in Georgia.

rimsky
rimsky

Permissible level is the correct term.//////

There is no permissible level of heavy metals.  the numbers are there to dupe the general public.

tajjmoor
tajjmoor

Thanks, Jay. Should be noted that even after three years, the cost to the state is only 10% of the cost of expansion. We're paying the federal cost of Medicaid Expansion in other states. How short-sighted our leaders are in rejecting Medicaid Expansion! The cost of refusing it is far greater than the cost of signing on.

Mr_Snarky
Mr_Snarky

Ol' Shady doesn't give a damn about the poor...that much is clear.

ganymeade
ganymeade

At first the Gop rhetoric was, The Federal government could not be trusted to pay their share. My question is why do Republicans in the state think the Federal government will pay their share of the Savannah harbor deepening project. Or anything else for that matter?

FloydLiberal
FloydLiberal

In short, Georgia can not afford poor people. Even the working poor.

Infraredguy
Infraredguy

Well with the last 7 years of Obama's guidance in the economy, we better get ready for a lot more, even McDonalds has a limit on how many they can hire

_GodlessHeathen_
_GodlessHeathen_

I misspoke when I said "recommended level" of lead.  Permissible level is the correct term.  15 ppb in drinking water.  40% of the samples obtained in Flint exceeded this level.


donner1997
donner1997

Medicaid expansion slowly increases the cost to a State that agrees to expansion this story totally ignores this fact.  I am not sure the author is unbiased as he claims.  The federal implementation of Medicaid expansion has been done like the crack dealer on the street giving away samples until dependency has been achieved.  The full impact of this to the State's budget is an additional 20-30% increase in the State's Medicaid budget which is a big deal, however is not realized until like year 3.  


While I get there may be some savings to other State costs, dismissing both sides is condescending and partisan.  Medicaid expansion costs will start hitting other States budgets soon and we will better understand the long term impacts to these States budgets and yes the increases in state taxes.  I get that spending the "free" money from the Feds sounds great, but maybe we should remember also that 1) Federal money is still payed by someone, 2) Once provided is very difficult to reject as it is often considered an "entitlement" then and only evil GOP people take benefits away from the poor.

Wascatlady
Wascatlady

@donner1997 "Federal money is still payed(sic) by someone" including Georgians.


More people covered=increasing tax revenues from medical workers, etc.  


Not to mention it is the right thing to do. "The least of these, my brethren" and all that.

Infraredguy
Infraredguy

I always love the reply of Liberals " It's the right thing to do " as if that makes any stupid move ok and without regard to the economics

Infraredguy
Infraredguy

FYI, Healthcare is not a Human Right, if you think it is, just go over to the UK and find out how rationing works in a Universal Health care plan, I have a good friend who lives there and he's says if he had to depend on the National system instead of his private insurance, he would have been dead long ago.

1jeanie
1jeanie

@donner1997 Your opinion is bias and selfish! You nor the Georgia State legislature have the right to withhold health care from people. You all see yourself as losing something and these folks as winning something. Health Care is a Human Right. Good health care is the right of everyone not just those in our state, but everywhere. We are all on this earth together, and the sooner we stop being selfish and start sharing the products of "our" earth the sooner everyone will be able enjoy this life. 

ganymeade
ganymeade

@Infraredguy The British system works very well according to the recipients Also their results and costs are better than ours. But of course you knew that didn't you.

Jsquirrel
Jsquirrel

@Infraredguy And I always despise the ignorant comments by you GOP heartless "humans."  This is kind of like another story circulating about another Republican governor, Rick Snyder.  The basic premise of the Republican party is screw anyone that isn't an old white guy - including children - of ALL races:-(  Up all of yours!  Grow a heart Deal!  People before profits before the dooky really hits the fan.  It's coming...deteriorate the middle and lower classes just a wee bit more and we are gonna have some serious social unrest.  I'm with Stephen Hawking - we are going to do ourselves in sooner than we think.  Unless a meteor beats us to it!  On a positive note...Amor Vincit Omnia:-)  I'm not religious, but isn't this basically what Christ was all about - caring for and loving your fellow wo/man???

JohnnyReb
JohnnyReb

Libbies keep bringing up rural hospitals closing and blame that on Georgia not expanding Medicaid.

They never discuss how Obamacare has created the situation for the rural hospitals.

They never weigh the benefits of 17 million additionally insured, and all that has cost, against the hospitals being forced closed and the cost to those who no longer have a convenient hospital location.

IF, and that's a big IF, simply expanding Medicaid would fix everything then legislators would be falling all over each other to do it.

However, the truth is expanding Medicaid would only make the mess worse.

As I stated earlier, it's best not to make any changes until after the election and it is determined if ACA will continue. 

Cherokee51
Cherokee51

@JohnnyReb

legislators would be falling all over each other to do it.


With all due respect, that's nonsense.  Expansion of Medicaid was part of the PPACA, and Georgia's Republicans will never ever fall over each other to implement  anything remotely associated with Obama, no matter how much it would benefit the state.

Visual_Cortex
Visual_Cortex

@JohnnyReb 

 the truth is expanding Medicaid would only make the mess worse.

You do realize that this expansion is designed mainly to cover working Americans, yes?

KUTGF
KUTGF

Let's set the record straight:

4 dead in Benghazi.  GOP went nuts.  Calls for Obama to be impeached.  Millions spend for hearings and 8 investigations.  Hillary to blame per GOP.

10 dead in Michigan, thousands poisoned for life and an actual cover up. GOP candidates mostly silent or claiming not to be up on the situation (that did not stop them with Iran).  Ineffective relief at state level on a worse level than Katrina.  Whines by GOP that some are politicizing this man made disaster.

When do we get a congressional investigation of what happened and who is to blame (in addition to the FBI investigation)...and that should include why the Federal EPA did not have a stronger response.  Where are the orange jumpsuits that some demand in Benghazi almost daily? 

rimsky
rimsky

Short answer: Georgia cannot afford Medicaid, period, end of story. >

In short people like you make the state of GA poor so it cannot support the population.

DS
DS

“Had we elected to expand Medicaid, it would have required us to include approximately $209 million in this upcoming year’s budget alone to cover the added cost,” Deal explained to state legislators.

Where did Deal come up with that number? 

The Federal government funds 100% of the cost of Medicaid expansion through calendar year 2016. After that, participating states will have to start sharing the cost, up to a 10% share in calendar year 2020.

Many Georgia hospitals are on the brink of bankruptcy. The cost of providing care for uninsured people is driving them under. Medicaid expansion would cover hundreds of thousands of people who used to be uninsured, which would save our hospitals, save lots of good paying jobs, and save lives.

How can Deal save our hospitals without Medicaid expansion?

Wascatlady
Wascatlady

@DS Northeast Georgia Medical Center (Hall County) isn't hurting.

PaulinNH
PaulinNH

@_GodlessHeathen_ @PaulinNH @Visual_Cortex  "Deflection noted".  Really???  Did you miss the bit "Like you I would rank the Aids epidemic waaaay above water quality in Flint"? You really do need to practice your English comprehension.

_GodlessHeathen_
_GodlessHeathen_

@rimsky @_GodlessHeathen_ 

Not so old to some of us. I had three great uncles who died in the flu epidemic.  They were healthy men in their 30's and all died in the same week.

PaulinNH
PaulinNH

@_GodlessHeathen_ @PaulinNH @Visual_Cortex   Nope - the comment was to note that government can be very slow to respond to medical problems when they hit unfavored groups - poor people in Flint today, people with Aids 30 years ago, malaria in the 3rd World for forever

PaulinNH
PaulinNH

@_GodlessHeathen_ @Visual_Cortex   And the modern era in CFB began in the 80s with Oklahoma & Georgia v NCAA.    Like you I would rank the Aids epidemic waaaay above the Flint Water Crisis.  On the other hand, back in the early 80's the US government was far more worried about some Legionnaires dying mysteriously than thousands of people dying of Aids

Bill OrvisWhite
Bill OrvisWhite

Short answer: Georgia cannot afford Medicaid, period, end of story. Georgia's common sense Constitution has a common sense mandate that this great state balance its budget. There's is NO DOUBT that if Georgia got swindled by Washington, 'she' would thrust upon this great state a massive deficit containing unfunded mandates. So, HELL NO! States with common sense like Georgia HAS EVERY RIGHT to stop Obamacare at Her borders. 


Now that those rightful thoughts are clearly stated her on this lefty blog, what about those rural hospitals? Guess what, McFlys, those hospitals would be just fine if health care providers could just compete in a free marketplace whereby costs would go down like any other goods. 


Pals, Obamacare is an anti-capitalistic/pro-Marxist illegal scheme that is controlled by Big Government. Historically systems like these collapse once The Regime has finally given up its power. One does not have to look any further than The Soviet Union. How did that one turn out, Pals?


Good night - common sense left the building along with Librul Jay who has 'his' head in a sandbox along with his friends Bernie Sanders and Cynthia Tucker right behind the AJC building.


Amen, Bill 

Kamchak
Kamchak

@Bill OrvisWhite 

 Georgia cannot afford Medicaid

Got proof?

Please, show your work.

Thanks in advance, sport.

stefpe
stefpe

@Bill OrvisWhite "Obamacare is an anti-capitalistic/pro-Marxist illegal scheme"

So devilish of that communist think tank, the Heritage foundation to come up with that plan.

Bill OrvisWhite
Bill OrvisWhite

@Kamchak The honorable Governor Deal and this gorgeous woman Jan Jones both say that the state cannot afford Medicaid - got anything? Thought so <crickets> LOL  You see the beautiful Miss Jan does not wish to borrow more money that we DO NOT HAVE! Again, Bill is a broken record here. Those hospitals would be open and doctors would stay in business if there was NO Obamacare and Medicaid expansions - this is simple math Pals!


Just read Liberal Jimbo's memo here: http://politics.blog.ajc.com/2014/06/19/from-jan-jones-a-counterpoint-on-medicaid-expansion/


Amen, 

Bill