Budget gurus and health officials in every state are trying to project the costs and benefits of the Affordable Care Act.
Georgia is no exception. As state officials try to decide whether Georgia will agree to expand its Medicaid program, putting a price tag on that decision has been the first order of business. Some experts who have reviewed the numbers say the state's projections may overstate the likely costs.
The Atlanta Journal-Constitution reviewed the details of the state's latest projections, obtained through the Georgia Open Records Act.
Georgia estimates that the Affordable Care Act will add $4.5 billion in costs to the state's budget for Medicaid and PeachCare for Kids between 2014 and 2023. They say about $4 billion of that is tied to the law's Medicaid expansion — which would add about 650,000 Georgians to the federal-state health plan.
The feds would cover about $36 billion of the new Medicaid costs over the decade, according to the state's projections.
"The projection the governor issued is on the high side" of the range, said Bill Custer, a health care expert at Georgia State University. Custer has conducted research on the law's likely impact in Georgia.
Tim Sweeney, director of health policy at the Georgia Budget & Policy Institute, said he also found that the state's estimate is high. He especially questioned estimates for administrative expenses and the costs of providing care to people added to Medicaid.
He said the state's projections include requirements of the law that aren't tied directly to the Medicaid expansion. He estimates the expansion would actually cost the state about $2.4 billion over the decade — an average of about 1 percent of the state budget.
State officials said they stand by the numbers as the best estimate of the law's cost for Georgia. David Cook, Commissioner of the Department of Community Health, said the state expects many of the low-income adults covered by an expanded Medicaid program to come with costly health care needs.
State officials say they will update projections as more information comes in from Washington about how the law will work.
Sweeney said $4.5 billion over 10 years sounds like a lot. But when factoring in all the benefits, he said, there's a strong argument in favor of the expansion. He added that the state could even cover a significant portion of new costs through a tobacco tax.
With some officials already saying Georgia can't afford the expansion, advocates say it's crucial for the state to carefully assess the costs and look at the big picture too — such as the impact on hospitals, doctors and Georgians without insurance.
"It's really important the cost estimate be fair and comprehensive," Sweeney said.
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