Enrollment for Medicaid, PeachCare hits new high

Photo of the Georgia Capitol Building

Georgia enrollment in Medicaid and PeachCare has jumped to 1.8 million, a new record, state officials say.

Put in perspective, that’s nearly one of every five Georgians. It’s more than the population of several U.S. states.

And Georgia expects another 65,000 to enroll in Medicaid this fiscal year and the next one due to the Affordable Care Act, even though the state does not plan to expand its Medicaid program as envisioned by the 2010 law.

Georgia Medicaid chief Jerry Dubberly presented figures Wednesday on the growth and costs of the government programs to state lawmakers convening the first meeting of the Joint Study Committee on Medicaid Reform.

The panel was created by a house resolution passed this year by the Georgia General Assembly. Six members each from the House and Senate were appointed, as well as six non-legislator members named by Gov. Nathan Deal.

The panel’s goal is to study current policies and procedures of Medicaid, the federal expansion under the ACA, and models in other states so the General Assembly can determine appropriate levels of service and funding to ensure sustainability of the program. A report of the committee findings is expected by the end of the year.

Medicaid, jointly financed by the federal and state governments, covers the poor and disabled. In Georgia, it pays for more than half the births and for most nursing home patients.

“We want [Medicaid] to be fiscally sound and make sure we have good quality care,’’ said a co-chairman of the panel, state Sen. Tim Golden (R-Valdosta).

Another member, Sen. Jack Hill (R-Reidsville), added, “Medicaid is a huge part of our budget,’’ second only to education.

Dubberly noted that Medicaid and PeachCare enrollment had jumped from 1.66 million in fiscal year 2010 to 1.8 million now, and is projected to hit 1.88 million this fiscal year. That’s 18.56 percent of the state’s population, up from 11.56 percent in 2000.

Spending for Medicaid and PeachCare now takes up 15.57 percent of state revenues, versus 10.2 percent in fiscal 2000.

Still, the state has tightly controlled its spending on the two programs. In fact, Georgia spends less money per Medicaid enrollee than any other state except California.

Dubberly questioned whether it was good for the state to be at the bottom of that list.

The aged, blind and disabled (ABD) population in Medicaid “puts the most pressure on our dollars,’’ said Clyde Reese, commissioner of the Department of Community Health and a member of the new panel.

That segment represents 29 percent of Medicaid enrollment but 58 percent of spending in the program. The Department of Community Health (DCH) is implementing a voluntary case management system for these enrollees next year.

ACA implementation will cost Georgia $26.9 million in fiscal 2014 and $101.7 million in fiscal 2015, Dubberly said. Much of that will be from what he called “the woodwork effect’’ — with ACA outreach driving those who had already been eligible but not enrolled to join Medicaid or PeachCare.

The state expects a total of 65,000 over this fiscal year and the next one to join the two programs from the “woodwork effect.”

Tim Sweeney, director of health policy for the Georgia Budget and Policy Institute, said he was glad that the state’s presentation focused on how spending a low amount per beneficiary might not be in Georgia’s best interest.

“The idea that this is an unsustainable program is not true,’’ Sweeney said. “We have really high poverty [in Georgia]; that’s not DCH’s fault.’’

The rates paid to medical providers in the state are very low, he said. Doctors who treat Georgia Medicaid patients have not had a pay raise in more than a decade. (Here’s a GHN article about the pay raise issue.)

The state’s added costs on ACA implementation amount to “a pretty small number’’ amid the nearly $2.9 billion that the state now spends on Medicaid and PeachCare, Sweeney said. And with that new spending, he said, “they expect to serve more people.’’

Editor’s Note: This article has been revised to reflect the state’s clarification of enrollment figures that were presented Wednesday.