The Supreme Court recently upheld the Affordable Care Act (ACA), but opened the door for states to opt out of the law’s Medicaid expansion clause.
    Medicaid is not a universal health care program for all poor people.  Poor children and pregnant women are covered, but most adults don’t qualify.  For example, two parents and a child in Alabama or Texas with a yearly income of $4,850 earn too much to qualify for Medicaid – same for a Georgia family of four who earns more than $500 per month. Families with no children do not qualify at all. 
    Under the ACA, all Americans will qualify for coverage if they are poor (earning less than 133 percent of the federal poverty line).  There were about 1.4 million Georgians on Medicaid in 2010, according to the state Department of Community Health.  The Kaiser Foundation estimates an additional 774,000 Georgians will be eligible for Medicaid under the new law.  Gov. Nathan Deal’s estimate is an additional 650,000.
    States currently pay 50 perc ent to 75percent of all Medicaid costs.  Under the ACA, the federal government would cover 100 percent of the costs of the Medicaid expansion for the first three years and at least 90 percent of the costs thereafter. The Medicaid expansion would bring tens of billions of federal dollars to states. 
    Even so, an increasing number of Republican governors have announced they will opt out of the ACA’s Medicaid expansion, Republican Governors Bobby Jindal of Louisiana and Florida’s Rick Scott being among the first.
    The consequences are enormous and not just for the uninsured.  According to the Atlanta Journal & Constitution, Georgia hospitals now lose an estimated $1.5 billion every year caring for the poor and uninsured who must use ERs instead of private doctors, for colds, sore throats, and costly complications of chronic diseases.  The rest of us pay for that care in our insurance premiums – an estimated $1,000 per year each.
    If Deal follows the lead of other GOP governors, Georgia stands to lose out on more than $25 billion in new federal Medicaid money over 10 years, according to Tim Sweeney, a health care analyst with the nonpartisan Georgia Budget and Policy Institute. 
    Aaron Carroll, a professor at the Indiana University School of Medicine, believes most governors will eventually opt in to the Medicaid expansion.  “It's hard to say no to a full funding of insurance for millions of constituents when it will cost you nothing. Moreover, it will be politically difficult to say no when so many other states are saying yes. There will also be enormous pressure from physicians, hospitals and other providers, who stand to lose a ton of money if people aren't insured.”
    What will Deal do?

Celia Murray is a member of the Morgan County Democratic Committee.

Printed in the July 12, 2012 edition