Gov. Nathan Deal faced a choice. He could choose to be loyal to his party’s political ideology, or he could choose to be loyal to some 650,000 of his fellow Georgians in need of health insurance.
He has chosen loyalty to party, declining to let Georgia participate in the expansion of Medicaid coverage offered through Obamacare. The result will be unnecessary illness, unnecessary pain and yes, unnecessary death. That may sound harsh, but it is also stark reality: When you deny health -care coverage to hundreds of thousands of people, as Deal has decided to do, those outcomes are inevitable.
There will be other consequences as well. The decision blocks an influx of billions and billions of federal health -care dollars — an estimated $14.5 billion between 2014 and 2019 alone — that would provoke significant job growth. Georgia taxpayers will be paying to fund that expanded coverage in other states, most of which will take it eagerly, but their governor has decided that they’ll get none of the benefits.
Turning that money away will also raise the risk of closure by rural hospitals, which are already struggling under the financial burden of providing so much care to the uninsured. (Last year, Georgia hospitals lost an estimated $1.5 billion caring for people without insurance, and rural residents are more likely to be uninsured than their urban and suburban counterparts.)
Medicaid expansion would have been a lifesaver to those hospitals and to the doctors who practice there, but that lifesaver has now been yanked away. That will have significant economic-development implications for Georgia beyond the immediate loss of federal dollars. The availability of modern health -care facilities is a prime consideration for any business or industry looking to relocate. As rural hospitals close and doctors leave, employers will leave as well, taking with them the last hope of prosperity for many small communities.
In announcing his decision at the Republican National Convention in Tampa, Deal cited the potential cost to Georgia taxpayers, which his administration estimates at $4.5 billion over a 10-year period. However, independent cost estimates put the state’s share of expansion much lower. The Kaiser Family Foundation estimates it at $714 million for the first five years of the program, or roughly 0.17 percent of state GDP. The Urban Institute puts it at $716 million for the first six years.
However, as Tim Sweeney of the Georgia Budget and Policy Institute points out, even the governor’s figure of $4.5 billion “would represent only a 1.9 percent increase in total state spending.”
In assessing the costs, you also have to look at two other things: How great is the need for expanded health coverage in Georgia, and how much does the state already spend? Are we already spending as much if not more than other states?
Hardly. Georgia is 47th in state health spending per capita. It is 49th in the amount it spends per Medicaid patient. Twenty percent of our citizens are uninsured, the fifth-highest uninsured rate in the nation, and we stand at 39th in life expectancy. Yet according to the governor, we can’t afford to address any of those issues, even if it means a stronger state economy and better health care and longer lives for hundreds of thousands of Georgians.
We can, however, afford hundreds of millions of dollars to build a new Falcons stadium, not to mention billions of dollars in tax breaks to businesses. Priorities, you know.
– Jay Bookman