Georgians May Want Medicaid Expansion, But Don’t Expect It Anytime Soon

According to a recent Atlanta Journal Constitution poll, Georgians are in support of Medicaid expansion for the state. That poll suggests that three out of every four respondents favor an expansion of the program to cover even more of Georgia’s struggling families – a dramatic increase from a similar poll in 2014 that found 57% support for such an expansion. Unfortunately, those respondents are likely to be waiting even longer to see their dreams realized, given that the talk in Washington D.C. these days is centered around repeal of the Affordable Care Act that makes that expansion possible.

When Congress passed the law that many now call Obamacare back in 2010, the legislation included language that empowered the states to expand their existing Medicaid programs to cover millions of Americans who had previously failed to meet the program’s income limits. As part of the deal, states that expanded their access to Medicaid would see the federal government pay the lion’s share of the added cost. As a result, the majority of states either adopted the federal plan or obtained approval for modified expansion plans. Georgia has remained one of nineteen states that have refused to expand coverage.

Why Didn’t Georgia Expand Medicaid?

Opposition to expansion in the nineteen states that have resisted the ACA option has largely focused on the cost. While the federal government’s share of those added costs was designed to limit the state’s expense, that initial generosity was also designed to give way to more costs for the states in the years to come. Georgia legislators, like the governments in the other non-expansion states, were reluctant to join an expansion effort that would increase the size of a program that some already believe to be out of control.

Across the country, Medicaid has become an expense that is placing severe strain on state budgets. Even at the federal level, the program requires vast resources that limit lawmakers’ ability to meet other pressing needs. Meanwhile, many critics point to inefficiencies, fraud, and other abuses that contribute to those costs without benefitting the citizens who need help. Those who are concerned about the impact of these types of government programs have legitimate concerns about how they get funded and how that funding impact other priorities in state budgets.

Georgia’s Uninsured and How Expansion Could Help

Despite those concerns, Georgia’s proponents of expansion have solid ground on which to stand. The state’s uninsured rate stands at an embarrassing 13.9 percent. That makes Georgia number three on the list of states with the highest number of uninsured residents, behind Texas and Alaska. These proponents are right to point out that something needs to be done to assist those residents, and they are also correct to point out that the state has missed out on billions of federal dollars that it would have received had expansion been pushed through three years ago.

The fact is that the state’s residents continue to send their tax dollars to the federal government, and Medicaid expansion would have brought some of those dollars back home to provide insurance access to Georgia’s low-income population. Advocates emphasize that expansion would provide immediate relief to at least 600,000 of the state’s 1.4 million uninsured. That’s not a complete solution to the healthcare crisis in the state, but no one can argue that it wouldn’t be a good start.

In recent months, there has been an emerging consensus among Republicans and Democrats in Georgia that some type of Medicaid expansion needs to happen. The recent election, however, has made any serious changes unlikely for the foreseeable future, as legislators are reluctant to adopt an expansion that could be left unfunded if the ACA is repealed and no similar program is passed in its place. That uncertainty is sure to foster a wait-and-see attitude at the state level, since few state governments want to get too far out in front of whatever Congress might ultimately decide.

Georgia’s Current Medicaid Concerns

For now, the Georgia legislature is focused on accomplishing several objectives related to healthcare, Medicaid, and the uninsured. They include:

• Using this new legislative session to examine the feasibility of extending the bed tax hospital fee that could assist the state in addressing its current $600 million Medicaid funding shortfall. That fee has become an important tool for triggering an additional influx of federal Medicaid funding, and provides support to those state hospitals that meet the healthcare needs of Georgia’s uninsured.
• Taking up the issue of opioid abuse. Some legislators want to restore some addiction service funding. There’s also a proposal to enhance tracking of narcotic prescriptions.
• Focusing on concerns about doctors who sexually abuse their patients.
• Addressing concerns about unexpected out-of-network billing, which can leave patients with hefty doctor’s bills that their insurers won’t cover.

Waiting on D.C.

One thing remains certain at this juncture: Georgia’s legislators will not be addressing Medicaid expansion until the state has a better idea about the fate of the ACA. Right now, there are too many competing repeal and replace proposals floating around the nation’s capital for anyone to know which way the political winds are blowing. Several of those have provisions for ending the Medicaid expansion program, without offering a replacement to incentivize states to continue to provide those benefits to previously uninsured residents. If one of those plans ends up being the preferred option, it’s possible that Medicaid expansion could be a moot point anyway. Like the rest of the country, Georgia has little choice but to continue to wait and see.

We’re Here to Help

At the Fouts Law Group, LLC, we’ll continue to pay close attention to these and other Medicaid concerns. Meanwhile, we remain committed to providing our clients in the area with the elder law and estate planning service that they need. Our team can help with your estate, incapacity, and Medicaid planning, to ensure that you have the right strategy in place to address all your end-of-life, long-term care, and legacy needs. To find out more about how we can help you, contact us online or give us a call at (404) 596-7520 today.