Medicaid expansion would be good for poor . . . and Georgia

In the health care debates of recent months, we have seen people with disabilities, families of children with chronic conditions, seniors, people in recovery from opioid addiction, and others stand together to advocate against congressional proposals that would have made unconscionable cuts to Medicaid and repealed major provisions of the Affordable Care Act.

These advocates have thus far been successful because they have resisted efforts to pit one group against another and instead persevered with the shared understanding that all Americans rise or fall together on the strength of our health system.

Now that efforts to dismantle Medicaid and the ACA have hit a wall, our state has the opportunity to follow this example by working collectively to strengthen the health system for everyone by ensuring all Georgians have health care coverage.

There are an estimated 300,000 to 600,000 Georgians who are stuck in the state’s coverage gap because they do not qualify for Medicaid and are too poor to buy health insurance through the ACA’s insurance exchange.

Expanding our state’s Medicaid program, as 31 other states have done, would mean that these friends and neighbors would share the same ability to go to the doctor and benefit from financial protection from large medical bills as you and I.

Studies have shown that people covered by the Medicaid expansion seek more preventive care, visit emergency rooms less, and are more likely to receive regular care for chronic conditions. They also have fewer unpaid medical bills, and see their credit scores improve.

Even people with private health insurance benefit from Medicaid expansion. A 2016 analysis found that exchange premiums were 7 percent lower on average in states with expanded Medicaid programs, resulting in significant savings for consumers purchasing their own coverage.


Communities across the state, and especially those in rural areas, would feel the positive impacts of Medicaid expansion as well. An analysis from the Georgia State University Center on State and Local Finance predicts that the influx of Medicaid dollars as a result of covering more Georgians would bring $1.4 billion annually and an increase of 19,000 jobs to the parts of the state outside metro Atlanta.

As hospitals in other states have seen, both rural and urban facilities could expect reduced demand for free care to uninsured patients, and rural hospitals would be more likely to turn a profit, an important consideration for the many Georgia towns where the local hospital is the largest employer and the only source of health care.

All this would happen without harming the children, people with disabilities and seniors who make up the large majority of Medicaid enrollees.

In states that have expanded Medicaid, the availability of doctors’ appointments for those with Medicaid coverage increased to accommodate the influx of new patients, disproving worries that the existing health care workforce would be insufficient. In two-thirds of the same states, the number of people on waiting lists for Medicaid support services decreased, or the state had no waiting list at all, again negating concerns that current Medicaid beneficiaries would be pushed to the back of the line by those newly eligible.

To bring these wholly positive benefits to Georgia, our state would pay only 10 percent of the costs of the Medicaid expansion; and the federal government would pick up the remaining 90 percent. A small levy on the insurers and hospitals that profit from an increasingly insured population or a rise in Georgia’s exceptionally low tobacco tax would be sufficient to cover the state’s share of the costs and bring our federal tax dollars back to the state for all our benefits.

The opportunity we face now is clear. We must set aside some Georgians’  strategies that will produce negligible gains and instead move forward together to strengthen the health system for everyone, by ensuring that all Georgians have the health care coverage they need.

Medicaid expansion must be the first step in our collective efforts.

Laura Colbert is executive director of Georgians for a Healthy Future