Before the ACA (Obamacare) was enacted, one in five Georgians were without insurance, one of the nation’s highest rates. But Gov. Nathan Deal and...

Before the ACA (Obamacare) was enacted, one in five Georgians were without insurance, one of the nation’s highest rates. But Gov. Nathan Deal and state legislative leaders have opposed the law, refusing to put together a state insurance exchange to help our citizens to get affordable health insurance policies.

Jack Bernard

Jack Bernard

Deal and the legislative leaders also have blocked expansion of Medicaid, although 60 percent of Georgians support this measure (per Schapiro Group poll) and our state now has the second-highest rate of uninsured people in the nation.

The case for expansion becomes even more compelling when one considers that expansion is 100 percent paid for by the feds for the first three years, eventually falling to a 90 percent federal share permanently. Further, a Georgia State University study finds expansion would create 70,000 sorely needed jobs in a state that has one the nation’s worst unemployment rates.

We currently have more than 850,000 uninsured Georgians. In 2014, Gallup issued a report which showed that states with full ACA implementation had a drop in the rate of the uninsured that was over three times as fast as that in states like Georgia, where expansion is resisted and where there is a refusal to accept federal monies for expansion.

Lately, the situation deteriorated even further. According to Deal’s proposed budget (now modified by the House, see below), part-time “non-certified” public school employees would lose their health care benefits in 2016. Who are these 11,500 people? They are the folks driving our children to school every day (bless them) and serving their lunches.

To make matters worse, many of these employees are not eligible for Medicaid, because Georgia decided not to expand the program to more of the working poor. They will also be ineligible for federal insurance premium subsidies, because the ACA assumed all states would be required to expand Medicaid and therefore ended the subsidies. (The Supreme Court has since said expansion can’t be required.) The state’s failure to expand Medicaid created a “gap.”

What would this situation mean for these employees and their families? Let’s take a look at a few real-life examples from the Augusta area:

John Palmer

John Palmer

Employee 1: She is fighting for her life, having fought breast, ovarian and lung cancer. Treatment has become more expensive with each occurrence. She goes for chemo and scans, but still reports to work every day she can. If her insurance is lost, there will be no treatments.

Employee 2: A bus driver’s husband had six heart attacks within 48 hours. During his ICU stay, doctors found severe inherited arterial coronary disease. There is no cure, only constant monitoring by physicians and multiple prescription medicines.

Employee 3: She takes an array of medications for severe COPD, seeing specialists several times a year. Even a minor cold or allergy flare-up can force her into the hospital.

Under political pressure, the House has recently reworked this portion of the Deal budget, leaving the school workers’ benefits in, but dumping the cost ($102,825,000) on local governments and local taxpayers. Our state elected officials have generally managed to shortchange education, teachers and education support personnel over the last decade. This trend continues in the latest budget. We will soon see how the Georgia Senate will handle this item.

We all understand the need for fiscal responsibility, but do we want to balance the state budget on the backs of the working poor and educators? We can, and should, expect more from our elected officials.


Jack Bernard was the first director of health planning for the state of Georgia. He also was an executive with several national health care firms and an elected official.

John Palmer is a Georgia public school teacher and spokesperson for TRAGIC, an educational advocacy group.


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