EDITORIAL: Georgia should revisit Medicaid expansion

Numbers in a study by the Urban Institute on the costs and benefits of expanding Medicaid in Georgia and 18 other states that have not done so should give state lawmakers reason to reconsider opposition to the expansion.

According to the study, as reported this week by Georgia Health News, for each dollar that Georgia would spend on Medicaid expansion, the state would gain $8.68 to $9.42 in federal spending.

That’s quite a return.

When the question of Medicaid expansion first came following the passage of the federal Affordable Care Act, it was prudent for Georgia political leaders to determine what the financial effects on the state would be before joining in. The rush to get the ACA, usually referred to as Obamacare, passed by Congress and into law gave rise to concerns about what effect it would have and how it would impact states and individuals.

Now, there is data available, and Georgia leaders should give the idea of Medicaid expansion in the state another look.

According to GHN’s report on the study, researchers found that the 19 states, including Georgia, would see a net increase of as much as $462 billion in the years 2017-26 if they expanded Medicaid coverage this year. The cost of the expansion? According to the study, $56 billion.

The study also found that even with higher spending on parts of the Medicaid program, every state that has expanded its Medicaid program has seen its budget improve, not get worse.

“It appears that Medicaid expansion is a fiscal win for states,” Kathy Hempstead of the Robert Wood Johnson Foundation, which funded the study, told GHN.

While the study didn’t estimate offsetting state revenue gains and state cost savings, the authors said that 14 Medicaid expansion states that conducted a comprehensive analysis saw at least short-term net savings.

Medicaid expansion also would have an impact at the local hospital level, where those who are uninsured are often unable to pay their bills, which ends up costing others. The study found that the 19 non-expansion states would realize a $21 billion-$27 billion reduction in uncompensated care spending 2017-26. Georgia alone would have a $1.9 billion-$2.4 billion decrease over that period, according to the study. The Urban Institute researchers found that 509,000 uninsured Georgians would gain coverage under an expanded Medicaid program, which would be the third-largest increase of coverage among the 19 states.

And it could help relieve the pressure on hospital emergency rooms, which often serve as de facto primary health care for the uninsured. Both Georgia and Kentucky were at 28 percent as far as uninsured ER visits in 2013. Last year, Kentucky, which expanded its Medicaid program, dropped to 7 percent uninsured ER visits, while Georgia was still at 25 percent. This is important because any medical professional will tell you that the most expensive care a hospital provides is in the emergency room.

The ACA is still a political hot button, one that is figuring into this November’s presidential election. And many Republican lawmakers and elected officials still have a bad taste in their mouth about how Obamacare, which has many flaws, came about to begin with. We, however, don’t get to choose our circumstances; we have to deal with them as they are. Reality is this: The health system is now set up in a way that Georgians are being economically penalized by not expanding Medicaid, and our state is missing out on federal dollars that are benefiting 31 other states.

The ACA has changed the playing field, and denying that doesn’t benefit anyone. Georgia’s leadership needs to do just that — lead. The state’s top leaders need to look at these numbers, and then do what’s best for the citizens and businesses in this state.