March 17, 2015 Little Rock, AR - Jennifer Hill, MD, performs ultrasound scan at the UAMS Emergency Department in Little Rock, Arkansas on Tuesday, March 17, 2015. When the Supreme Court ruled in 2012 that the federal government couldn't force states to expand Medicaid under Obamacare, Republican leaders across the country reveled in victory - staunchly refusing to grow the health program for poor Americans. But as Georgia and most of its conservative Southern-state brethren doubled down on their rejection of Medicaid expansion, a small group of Republican lawmakers in Arkansas saw opportunity. HYOSUB SHIN / HSHIN@AJC.COM

Red state solution: does Arkansas' Medicaid expansion offer lessons for Georgia?

A Medicaid expansion would have brought $35 billion in federal dollars into Georgia over 10 years. But Gov. Nathan Deal said no: Medicaid is broken, and the last thing we should do is make it even bigger. 

The promise of those federal billions, however, has proven irresistible to many states, even some that are just as conservative as Georgia. Arkansas leaders, for example, took a look at all the poor and unhealthy people in their state, and then they took a look at the boatloads of federal money that would flow in to pay for Medicaid expansion.

But leaders in Little Rock added a free-market twist: send us the money for Medicaid expansion, they told the feds, and we’ll give it to the poor for health care. But they won’t get Medicaid coverage. They’ll get private health insurance on the Obamacare website and have the same coverage as everybody else.

AJC staff writer Misty Williams, who specializes in health care policy and the Affordable Care Act, went to Arkansas to see how – or whether – the so-called private option is working. She also wanted to find out what Georgia could learn from Arkansas’ experience. This is the first of three articles arising from that reporting.

Also: a map showing where every U.S. state stands on Medicaid expansion.

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