Affordable Care Act: Cost effective or too costly for Georgia?

By Rick Badie

Today, we debate the potential economic impact of the Affordable Care Act to Georgia. A proponent of the health care plan calls it a cost-effective way to broaden insurance coverage statewide if Gov. Nathan Deal expands Medicaid. A family physician, who says insurance premiums and deductibles are already on an uptick, worries about medical inflation.

It’s wise to expand Medicaid

By Kim Anderson

Seldom does a state get the opportunity to solve major problems so cost-effectively. Federal funds have been set aside for Georgia under the Affordable Care Act to broaden access to insurance coverage under Medicaid. We can cover 530,000 adults who are not now eligible with federal funds paying the entire cost for the first three years, phasing down over time to 90 percent.

The offer is on the table. All we have to do is say, “Yes.”

At Families First, the largest and leading Georgia nonprofit serving children and families, we see what happens when parents lack insurance for themselves even though their children have Medicaid or PeachCare.

Without treatment for or detection of chronic diseases or mental health problems, parents are forced to miss work or drop out of school. Difficulty coping with stress and lowered earning potential lessens their ability to give their children the care and security they need and the future they deserve. Productivity drops, as do the taxes these working families can pay. It affects our entire community.

Saying “yes” to Medicaid expansion means real solutions to real problems. It will:

*Cover 530,000 more Georgians, improving health and saving hundreds of lives a year.

*Strengthen our health care system and help rural hospitals survive.

*Create 56,000 jobs, mostly outside Atlanta, lowering Georgia’s stubbornly high unemployment rate and generating an average $6.5 billion a year in economic output.

*Generate tax receipts to the state and local governments of almost $3 billion over 10 years.

Gov. Nathan Deal has worried about the cost to the state. However, the expansion would require only about a 1 percent increase in the budget over 10 years, yielding economic benefits of $30.45 for each dollar Georgia spends, even without considering such efficiencies as replacing millions of dollars in state-only mental health spending. Thorough analysis may show a net budget outlay of zero, or even the net savings other states have identified.

In any case, the impact on the state budget is not the only issue, nor is it the paramount one. Gov. Deal is obligated to look at the big picture. He has to consider the effect of decisions not just on government but on citizens, the economy and other institutions. He has shown this kind of leadership with such initiatives as reforming the criminal justice system to stop filling prisons and jails needlessly. He can and should do it again with Medicaid expansion.

Besides improving health, creating jobs and boosting the economy, Medicaid expansion will advance his criminal justice reforms by enabling adults diverted to accountability courts to receive treatment for mental health or addiction problems that fuel incarceration.

As Jan Brewer, the governor of Arizona who initially fought Obamacare, stated, “(We’ve) crafted a conservative plan that … pumps billions of dollars into our economy … protects hospitals … and keeps Arizona tax dollars in Arizona.”

Georgia should say “yes” to the Medicaid expansion as a wise investment in our state and its people.

Kim Anderson is CEO of FamiliesFirst.

 Who pays tab for uninsured?

By W. Scott Bohlke

With more than 7,000 members, the Medical Association of Georgia (MAG) is the leading voice for physicians in the state. I am proud to say that MAG has remained true to its mission of “enhancing patient care and the health of the public” in its advocacy efforts at the state and national levels.

MAG opposed the Patient Protection and Affordable Care Act (PPACA), but we did support certain PPACA provisions that reformed the health insurance industry in ways that safeguard people who are sick, as well as children with pre-existing conditions.

MAG does not believe that the country is on a sustainable track when it comes to its health care system – with or without PPACA. We are attempting to do too much with too little.

Medicaid, for example, will continue to fail unless changes take place. Georgians might be surprised to find out that Medicaid physicians in the state are paid at a rate that is less than the cost of delivering the services. There isn’t any business that can keep its doors open on that basis. This backdrop might explain why the number of Medicaid physicians in the state has declined by more than 15 percent since 2009, according to the Georgia Department of Community Health. The Medicare program for seniors, meanwhile, isn’t in much better shape.

This means that some of our neediest patients – especially those who live in rural areas – will ultimately suffer because it’s going to become increasingly difficult for them to find a physician. And, unfortunately, having a health insurance card doesn’t necessarily mean they will have access to care.

In addition, all you have to do is look at your paycheck stub or turn on the evening news to know that health insurance premiums and deductibles are on the rise. That’s because someone obviously has to pick up the tab for caring for millions of previously uninsured people.

PPACA’s tax burden — not to mention the possible fines and penalties — is big, and it’s only going to get bigger as new provisions kick in with each passing year. This affects a wide range of stakeholders, including individual patients and families and small businesses.

How can we preserve what I believe is the best health care in the world? We need to adopt policies that empower individual patients. Let them — versus the federal government or some big insurance company — decide how they’re going to spend their money and what doctor they’re going to see. We need to hold lawmakers accountable for fulfilling the promises that have been made to adequately fund Medicare and Medicaid. We need to expand the number of free clinics in Georgia, which already reach more than 15 percent of the state’s population and provide $200 million in free care each year. And we need to preserve the individual relationships between patients and their physicians.

W. Scott Bohlke is president of the Medical Association of Georgia.

28 comments Add your comment


May 8th, 2013
4:44 pm

Roger @ 2:07 pm – For a person who has been in healthcare (30) thirty years knows very little about what he speaks of. Roger is not being truthful to the Readers. There is no Surgery Center, or Imaging Center in Atlanta or anywhere else GEORGIA that will provide any services without verifying insurance coverage or without payment of the estimated amount of charges prior to the services being rendered. Why People write such Lies as Roger has done in his comment, is beyond ME.

Roger, Do you really believe those here would believe such falsehoods?

Even most Hospital Emergency rooms are demanding payment upfront unless the patient is presented in a true emergency condition.

Try going to Piedmont,Emory,Northside or Gwinnett Medical Center’s Emergency room for services and say you are without insurance coverage and without available money to pay at the time of service. You will find yourself in the Parking Lot, wondering what Do I do?, where Do I go?
To get Medical Attention, right NOW!


May 8th, 2013
2:07 pm

I have been in the healthcare profession for over 30 years, and have yet to see a Government Program that has not increased the cost and lowered the delivery of healthcare services. I don’t care what side your are on; we should all be concerned about this law. Most of the representatives are not even aware of what is in it; our HHS Secretary has admitted that implementation is much more difficult than they (The Federal Government) anticipated. The law leaves millions of Americans uncovered, increases the cost of coverage to all of us, including the states. As it is written, this is a disaster. Democrats and Republicans both express concern regarding this law.

I am sure you know that no American is refused healthcare. That has been against the law for years. ER’s, Surgery Centers, Imaging Center, and Physicians contribute millions each year in time and hard cost in Georgia alone. Tri-Care Covers all activity military, and all military retirees.

I am not saying that some changes do not need to be addressed, but expanding an already broken Medicaid system is not the solution to anything. Ask Medicaid patients what they think of the system, I spend many hours per week attempting to assist them in getting healthcare within the system. This is typically a Medicaid Administrative problem, not a provider or patient issue. I only see things getting worse before they can get better.

I usually read Healthcare blogs and stay out of the “fight”. This law will cost all of us access to services. It will be overhauled, I believe both parties are coming to that realization.


May 8th, 2013
12:44 pm

xxx @ 12:05 pm – Your Quote! “WHO uses EBT is not relevant to me”.

This was my point exactly! The selfishness, intentional blindness, non caring attitudes many Republicans like You, have for the Poorest among US!

You do not Care about our Soldiers’ families or anyone else for that matter.
How is it that we as a Nation, have arrived to such depths of Low Compassion for fellow Americans?

450 Million Dollars is a mere drop in the bucket for America. Especially, when we are more than willing to spend a few TRILLION in rebuilding IRAQ and AFGHANISTAN! As well as insuring the establishment of their healthcare systems too.

Are not AMERICANS just as important? Are Not the millions of American children entitled to health care at home? Should these children and their parents move to IRAQ or Afghanistan, in order for you to see their needs clearly?

It is past time for America to take care of its own needs, First!

The Expansion of the Medicaid Program is one of those times. President Obama has provided a way for these so called Patriotic Governors to make the cost bearable and yet they still refuse. These Governors have No Individual or Group plan on the Table, that comes close to such coverage for our neediest citizens. These Politicians, do not care nor do they have any plans to present a program that will deal with this issue of Lack of Health care.

Like you! The Governors are only thinking of themselves. They are also only thinking of their NEXT political campaign to achieve their own personal political ambitions.

Maybe we should start thinking of saying “NO” to their political ambitions. We should if they are not thinking about nor care to provide sensible solutions to OUR own Heathcare System.


May 8th, 2013
12:05 pm

WHO uses EBT is not relevant to me, it seems to be for you, Bernie, Funny how you balk at even a hint of a contribution from these folks for their healthcare, but don’t mind signing the rest of us for more. I didn’t see a solution for the additonal 450M tax burden you are advocating, did it slip your mind during the rant?


May 8th, 2013
10:53 am

xxx @ 8:46 am – One of the primary USERS of the EBT card is the families of young enlisted Active Duty Service Men of the United States Armed Services.

We are talking about the family members of those who remain home, of the Brave Men & Women who protect this Nation and its fellow citizens with their Lives everyday of the week, 24/7. Surely you are not advocating that we charge these Family’s a $10 fee for such needed assistance?

Secondly the largest Group of users of this aid is White Working Females with on average two (2) kids. The Names on these Rolls are typical American names you would find all across this great Nation.

Names like Johnny,Timmy,Bobby,Sean,Junior,Skipper, Terry, Kathy,Cathy,
Piper,Karen, Janet,Kim,Carrie, Barbara,Penny, and Cheryl. Many with Blond hair and Big Blue Eyes. Are we to withhold such aid from them as well? The poorest and the most innocent among us?

I have All of you to know. These are the Very Americans, Millions of them, who are at this moment without the much needed medical care our Republican Politicians are refusing to Care for. Now again, tell me just how such a God Fearing political party with so called Family Values and Morals
Are behaving towards the Children of America!

It is Disgustingly Shameful, No matter what prism it is viewed through. America the Richest Nation on Earth, refusing to care for their own children. We are a Very Lost Generation of Selfish and Arrgorant Americans to allow such behavior to continue.


May 8th, 2013
10:20 am

The health insurance premiums for my family have almost doubled. I think it’s disgraceful that the government does not provide health care for its citizens, but I did NOT support the Affordable Care Act. We should just make everyone eligible for Medicare.

Mary Elizabeth

May 8th, 2013
9:52 am

Correction: “Republican political leaders are hoping to insure that the federal government will not have the funding necessary to establish these state exchanges. . .

Mary Elizabeth

May 8th, 2013
9:46 am

@ GB101, 6:41 am

“Mary Elizabeth
No state has and no state can reject Obamacare.
Many states have chosen not to create state-run exchanges, but there will be exchanges. . .”

GB101, do you not find it quite telling that these “many states” that have chosen not to create state-run exchanges are controlled by Republican polilticians? Simple coincidence? I don’t think so. Republicans are known to have rejected not only President Obama, but also the programs which he has initiated.

Ironically, these “many (Republican) states” that have rejected state-run health exchanges will only hasten universal health care for all Americans because the federal government will establish the exchanges to be run in the states which will not establish their own exchanges. Republican political leaders in these states are hoping to insure that the federal government will not have the funding necessary to establish these state exchanges, as another tactic to dismantle Obama’s ACA universal healthcare plan for all Americans, but they will not be successful in their regressive plans.

In all due respect, GB101, it appears to me that you are in denial as to the underlying truth of what is really happening regarding the attempts to dismantle and to repeal ObamaCare – in terms of the political maneuverings that are well underway.