Medicaid expansion seen as a lifeline

Print Friendly and PDF By: Andy Miller Published: Feb 19, 2013

The economic arguments on Medicaid expansion have grabbed headlines in Georgia recently, from projections of the cost to the number of jobs created.

But a news conference Tuesday by advocates for expansion took a different approach. It highlighted the human side of the decision.

A number of uninsured men in their 40s are getting care in nursing homes because their hypertension went untreated and led to a stroke, said Dr. Harry Strothers of Morehouse School of Medicine, a family physician who practices in Atlanta and East Point.

Uninsured women in the Rome area who have massive ovarian cysts can’t get surgery now, said Marilyn Ringstaff, who runs a women’s clinic there. With expansion, women who are in low-paying jobs could get the medical services they need, she said.

And Cathryn Marchman of St. Joseph’s Mercy Care Services said most homeless people whom the nonprofit cares for now would get health insurance under Medicaid expansion.

On average, she said, homeless people die 30 years earlier than other Americans. Medicaid expansion could prevent many of those premature deaths, Marchman said.

As outlined by the federal Affordable Care Act (ACA), Medicaid expansion in Georgia would add more than 650,000 low-income residents to the program’s rolls.

Last year, the Supreme Court mostly upheld the controversial ACA but left the expansion decision up to individual states.

Some states have since balked at expansion, and Georgia is one of them. Gov. Nathan Deal has reiterated several times his opposition to adding to the Medicaid rolls.

Deal has cited a projected cost to the state of $4.5 billion over 10 years, and has pointed out that Medicaid is already a program in severe financial distress.

“When you’re having a tough time paying for what you already have, it doesn’t make a whole lot of sense to expand it and cost yourselves even more,’’ the governor recently told WABE.

But Tim Sweeney, health policy director at the Georgia Budget and Policy Center, told reporters Tuesday that the estimated state cost of expansion would be much less than that: $2.1 billion over 10 years.

Sweeney said the governor’s estimate included costs that will occur whether or not the state chooses to expand Medicaid. And Sweeney said that if tax revenues are added in, the net cost to the state is $353 million.

Sixty medical provider and consumer advocacy groups have formed Cover Georgia, which seeks to promote Medicaid expansion in Georgia.

Kathy Floyd, legislative director of AARP Georgia, a member of the coalition, said Tuesday that expansion ‘‘is the No. 1 priority’’ for her organization. Many uninsured adults aged 40 to 64 are just waiting to reach 65 – the eligibility age for Medicare.

Last week, a report from Georgia State University’s Bill Custer said an estimated 70,000 new jobs would be gained if Deal approved expansion.

The study, commissioned and released by Healthcare Georgia Foundation, also said expansion would produce an economic impact statewide of $8 billion annually.

Ronald Bachman, a longtime Atlanta-area health consultant, said last week at a Carter Center forum that the emphasis on bigger Medicaid programs is misplaced.

A better way to cover the uninsured is through the private market and health insurance exchanges, Bachman said. Not enough medical providers accept Medicaid because of its low payments, he said.

Republican governors have been among the strongest critics of Medicaid expansion. But some of them have recently decided to accept it. Under the ACA, expansion is paid for wholly by federal funds for the first three years.

Georgia will be at a competitive disadvantage if it doesn’t expand Medicaid while other states do, said Cindy Zeldin of consumer advocacy group Georgians for a Healthy Future.

Expansion would create a healthier, more productive workforce, she added.

Leslie Ellis, a clinical psychologist in northwest Georgia, said hospital emergency rooms in the state currently “are overrun with people who do not have alternatives’’ for services.

Georgia has among the highest rates of premature deaths from a lack of health insurance, said Morehouse’s Strothers.

Medical care that prevents strokes in at-risk patients “is a lot more efficient than [treatment] after their strokes,’’ he added.

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