No Medicaid expansion is a bad deal for Georgia consumers

By Bill Rencher, JD, MPH

Director, Health Access Program

Last summer's Supreme Court ruling on the constitutionality of the Affordable Care Act (ACA) effectively made the ACA's Medicaid expansion optional for states.  Since that time, Georgia Governor Nathan Deal has made several general statements opposing expansion.  However, during a speech at Tuesday's Georgia Chamber of Commerce's annual Eggs and Issues Breakfast and during yesterday's State of the State address, Deal came down firmly against it, arguing that the state could not afford it and that it was an overreach of federal authority.  Coverage of the breakfast as well as a full text of the speech can be found here.  A full text of the State of the State address can be found here.

Georgia Watch disagrees with the arguments against expansion.  Not expanding Medicaid passes up an opportunity to cover a huge proportion of uninsured Georgians with the state only picking up a small percentage of the costs and the federal government pumping $33 billion into our economy.  (A more budget-oriented commentary by the Georgia Budget and Policy Institute can be found here.)  Furthermore, expansion would not only improve the health of those currently without insurance, but it would lessen their chances of devastating financial hardship leading to foreclosure or bankruptcy due to high medical bills.  Georgia currently has one of the highest bankruptcy rates in the nation, with health care the leading cause, so this is a critically important goal.  The expansion also would benefit Georgia consumers who already have insurance and who indirectly support the uninsured through higher health care costs and insurance premiums.  In fact, not expanding Medicaid will represent a double cost to the state's insured consumers:  they will continue to pay higher costs to support care for the uninsured, and their federal tax dollars will go to pay for and strengthen Medicaid expansions in other states, such as California and Maryland.

Governor Deal cited these reasons, along with the then undecided presidential election, at his post Supreme Court decision press conference last summer when he advocated a "wait and see" approach to Medicaid expansion in Georgia.  Since then, we have held out hope that Governor Deal would look at all the facts and make a pragmatic decision in the interests of all of Georgia's consumers.  This is the approach he has rightly taken on numerous other issues, such the hospital provider fee.  However, it appears now that Georgia will not be expanding its Medicaid program.  Therefore, we look forward to hearing what Governor Deal's plans are for insuring low-income working adults and reducing healthcare costs for those already insured.  Doing nothing is simply not an option.