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.