So far, six Republican governors have decided to buck their party and accept federal expansion of Medicaid coverage, concluding that the best interests of their state and its citizens outweigh the interests of their political party.
Gov. Nathan Deal of Georgia has made the opposite choice, and the damage inflicted on Georgia by his decision will be considerable.
Here’s the deal:
Under the Affordable Care Act, also known as ObamaCare, the federal government has offered to cover 100 percent of the costs of health insurance for an additional 620,000 Georgians. The deal is good for three years, from 2014 through 2016. In 2017, the federal government will still pay 95 percent of the cost, and the percentage will slide to 90 percent by 2020.
For every year thereafter, the federal government will cover 90 percent of the cost.
That would amount to an influx of $40 billion into the Georgia economy from 2014 to 2023, according to Bill Custer, a health economist at Georgia State University. That will boost the state’s economic output by an average of $8.2 billion a year. That in turn will create more than 70,000 new jobs in a state with the nation’s ninth-highest unemployment rate, Hudson estimates. That in turn will generate an additional $267 million a year in state and local taxes.
Many of those newly created jobs will be in the well-paying medical industry, which is particularly important in a state where the median household income had been dropping even before the recession hit. According to Custer’s analysis, 46,000 of those jobs will be created outside metro Atlanta, in areas where the health-care industry is barely hanging on because so many local residents do not have health insurance.
With the influx of federal money, rural hospitals that will otherwise be forced to close their doors would remain open. Those facilities will remain important economic generators for their communities, and they will also help to attract outside industry. Employers have little interest in locating in communities with no nearby hospital.
In addition, it should help lower health-insurance costs in general, because the rest of us won’t be paying for health care for the uninsured through our health-care premiums.
Most important, there’s the impact on those 620,000 Georgians. According to the Kaiser Family Foundation, some 22 percent of Georgians are without health insurance, the seventh highest rate in the nation. Ideology won’t cover their medical bills. Partisan politics won’t pay their surgeon or anesthesiologist.
Deal explains his refusal in a couple of ways. His administration estimates that it will cost the state some $4.5 billion to participate in the program from 2014 to 2023. That’s more than twice as much as other estimates, but let’s accept it as valid. Using Deal’s numbers, Georgia is turning down an offer to match each state dollar with 10 dollars in federal funding. That 10-1 match is far more generous than other federal programs that Georgia scrambles to tap. Turning it down means that billions of tax dollars will be flowing out of Georgia to support health care in other states; none of it will be flowing back in.
You can also think of it purely in investment terms: Every year, Georgia gives away hundreds of millions of dollars through economic development efforts that have far more risk and considerably less return than this program.
According to Deal, he also fears that the federal government doesn’t have the resources to sustain the expanded program. But it’s curious how that logic isn’t applied to, say, the deepening of Savannah Harbor, where Deal and others are pleading for hundreds of millions of dollars from that very same federal government. Or to the billions of dollars in federal loan guarantees to build new nuclear reactors at Plant Vogtle. Perhaps we should also discourage the location of the Army’s new CyberCommand to Fort Gordon near Augusta, where it iswould likely bring thousands of jobs.
ObamaCare isn’t going away. The Republicans have fought it all the way up to the Supreme Court, and they lost. They made its repeal a central part of their 2012 campaign, and they lost the presidential race, they lost Senate seats and they lost House seats. At some point, it’s time to accept reality.
– Jay Bookman