A few weeks ago, this column speculated as to what decision Gov. Nathan Deal would make with regard to an expansion of Medicaid in Georgia. The Supreme Court upheld the Affordable Care Act (ACA) and also opened the door for states to opt out of the law’s Medicaid expansion.
There were about 1.4 million Georgians on Medicaid in 2010, according to the Georgia Department of Community Health, and Gov. Deal estimates an additional 650,000 Georgians would be eligible under the expansion.
Now we know Deal’s decision. The Governor told reporters at the GOP convention that he will not expand the program, firmly stating, "No, I do not have any intentions of expanding Medicaid. I think that is something our state cannot afford.”
How can Georgia NOT afford the expansion? 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 mean more than $25 billion in new federal money to Georgia over 10 years.
According to the Atlanta Journal-Constitution, word of Deal’s decision set off a wave of anxiety among hospital officials and patient advocates in the state, with one saying that the governor is “certainly putting hospitals at risk,” and others calling the decision a “mistake” and “short-sighted.”
Deal’s decision is a disaster for all Georgians. Here’s why:
• Hospitals need it. When the health law was passed, hospitals agreed to accept cuts in payments that help cover the cost of providing care to the uninsured. If almost everybody had insurance, as envisioned by the law, hospitals could afford to take those cuts. Without the expansion, however, hospitals will be stuck providing care to the one in five Georgians who lack insurance.
• We all pay. Those without insurance rely on emergency rooms – very expensive care. Georgia hospitals provide between $1 billion and $1.5 billion in uncompensated care each year. The rest of us pay for that care – an estimated $1,000 per year more in premiums to pay the higher rates hospitals charge to make up for their losses in providing care to the uninsured.
• Grandpa needs it. According to the Kaiser Commission on Medicaid and the Uninsured, 70 percent of Medicaid dollars are spent on the elderly and disabled, primarily in the form of nursing home care. Medicaid is the nation’s single largest purchaser of long-term care services, accounting for 46 percent of all nursing home spending.
• It’s short-sighted. The uninsured often don’t see a physician until the condition is critical. The working poor, but uninsured, diabetic who gets proper wound care won’t end up losing a leg and seeking Social Security Disability, costing taxpayers far more.
• No savings for Georgians. Even the Governor has acknowledged that if Georgia doesn’t join in the Medicaid expansion, our residents will be paying for expansions in other states.

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

Printed in the September 13 edition.