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By Visitor Columnist JOHN BARROW, former consultant of Georgia’s Twelfth Congressional District.
Twice within the final six months I’ve heard Andy Younger inform an viewers that any time the federal authorities presents to pay you 90 cents on the greenback to do one thing you should do anyway, it’s like being given “free cash.”
He was speaking in regards to the time within the Nineteen Seventies when the federal authorities wished to spend money on city airports a lot that it was prepared to pay any metropolis 90 cents on the greenback for expansions and upgrades. Sam Massell was the one large metropolis mayor who took the federal authorities up on that provide, and the result’s the Hartsfield-Jackson Worldwide Airport we all know at present.
The largest challenge in Georgia’s gubernatorial contest is whether or not Georgia ought to settle for the identical supply. That’s the price to Georgia of Medicaid enlargement below Obamacare — 10 cents on the greenback. Stacey Abrams is in favor of it, and Brian Kemp is opposed. However not like the chance seized by Massell, the price of Kemp’s refusal to take the same deal is measured in additional than misplaced financial alternative — it’s measured when it comes to illness and loss of life.
Right here’s the deal: In change for 350 million {dollars} from Georgia’s state authorities, the federal authorities would pump 3.5 billion {dollars} into Georgia – principally rural Georgia. The “multiplier impact” of well being care spending on that degree is staggering. That’s a 4 billion greenback financial stimulus plan, a jobs program, a workforce improvement plan, and a well being care “Marshall Plan” — all rolled into one. With the feds choosing up virtually all the tab.
John Barrow represented Georgia’s Twelfth Congressional District for 10 years. He opposed a lot of Obamacare, however he supported the Medicaid enlargement a part of the invoice.
In contrast to Medicare, Medicaid is a cost-sharing program between the federal and state governments, below which the feds present many of the cash however the states get to resolve who is roofed, and the way good that protection is.
Georgia is among the many stingiest states within the nation with regards to who is roofed by Medicaid. No able-bodied grownup is roofed — none — except they’ve a baby within the family. And in the event that they do have a baby within the family, they lose their Medicaid when their family revenue goes over 36 % of the federal poverty degree. For a single guardian, that’s $6,600 a yr.
Georgia can also be among the many stingiest states within the nation with regards to what it pays medical doctors and hospitals. Georgia Medicaid pays medical doctors a lot lower than non-public insurance coverage or Medicare that many medical doctors merely received’t take any Medicaid sufferers. In any respect.
In the meantime, hospitals lose cash on each Medicaid affected person. In consequence, the hospitals that undergo essentially the most are these with excessive concentrations of Medicaid sufferers — particularly, these in rural Georgia, and those who serve the poorer populations of our large cities.
This is the reason rural hospitals in Georgia are closing left and proper — and why even large trauma facilities like Atlanta Medical Heart are closing down, and Grady goes on the “watch record.”
Obamacare mounted the Medicaid drawback, not solely in Georgia however all around the nation. It did so by paying the states 90 cents on the greenback to develop Medicaid protection of their states as much as a brand new nationwide customary – 138 % of the poverty degree — at a price to the states of simply 10 cents on the greenback. At that time, the feds present a brand new “sliding scale” program of personal insurance coverage premium subsidies, primarily based on the power to pay.
Mockingly, states with the worst information below conventional Medicaid – like Georgia – have been going to be the most important beneficiaries of Medicaid enlargement. We have been going to make use of federal {dollars} to develop Medicaid protection to individuals between 36 % of the poverty degree and 138 %. It was virtually as if Georgia was going to be rewarded for our management’s previous hard-heartedness.
To date, 38 states have accepted Medicaid enlargement. Solely 12 states — together with Georgia — are nonetheless holding out.
Among the many holdouts are states as poorly led as Alabama, Mississippi, South Carolina, Florida, Tennessee, and Texas. However regardless of the politics that these states have in frequent, a stunning variety of states — with management simply as partisan — have determined to stop this “Medicaid Confederacy” and rejoin the Union.
Arkansas adopted Obamacare’s Medicaid enlargement eight years in the past. Arkansas. So did Kentucky and West Virginia. And Ohio. And North Dakota. Indiana (below Governor Mike Pence, no much less) adopted it seven years in the past. What do these states know that Kemp doesn’t?
One factor they know is that their states are already paying for Medicaid enlargement in every single place else — with their federal taxes — so they may as nicely get what they’re paying for.
One other factor they know is that their states stand to realize greater than their fair proportion of the advantages of Medicaid enlargement. That’s as a result of, like Georgia, they’ve the most important Medicaid gaps to shut, they usually’re getting the feds to select up 90 % of the price.
However definitely, crucial factor these states know is that it’s of their state’s financial self-interest that their individuals have fundamental medical health insurance.
These states know {that a} workforce riddled with individuals who don’t have medical health insurance can not compete with states whose staff have good medical health insurance. This is the reason rural Georgia is getting economically sicker the longer her individuals stay uninsured.
In accordance with the Kaiser Household Basis, there are over 450,000 Georgians who’re nonetheless caught within the hole between Georgia’s present Medicaid revenue cap and backed insurance coverage below Obamacare. That’s how many individuals could be lined by Medicaid enlargement — with the feds choosing up the tab — if solely Kemp would do what Mike Pence did.
These individuals sicken and die at a charge all out of proportion to those that have medical health insurance. And the hospitals they frequent additionally sicken and die. All as a result of their leaders are preventing a “misplaced trigger” in opposition to something with the identify “Obama” connected to it.
It’s time Georgia will get what we’re already paying for. If Brian Kemp received’t go for that, then that’s a really large purpose to go for Stacey Abrams.
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