It’s nuts. In terms of economic impact, common sense and basic human decency, what we’re doing is just plain nuts.
We have 2 million people in this state who live their lives without health insurance, giving Georgia one of the highest uninsured rates in the country. We have rural and inner-city hospitals struggling to keep their doors open while trying to care for large numbers of people who have no means to pay.
Yet state officials stubbornly refuse to cooperate with federal programs to address that need. To the contrary, they have actively attempted to sabotage those programs and prevent citizens from enrolling. And those efforts are succeeding, if by “succeeding” you mean keeping some 500,000 Georgia citizens from getting Medicaid coverage that federal law offers them.
For the most part, those half-million Georgians are working people. They have low-paying jobs — waiters, retail clerks, laborers, hotel staff — that don’t provide health insurance as a benefit, and they have no other means of acquiring it. Under the Affordable Care Act, the federal government would pay the entire cost of their coverage until 2017. In 2017, the federal government would pay 95 percent of the cost, with the state of Georgia picking up the rest. The state share would then grow gradually until it maxed out at 10 percent.
According to Gov. Nathan Deal, the state simply can’t spend that additional money. And by “can’t”, he means “won’t.” By most independent estimates, for example, the net amount of money involved is roughly equal to the $240 million in special-interest tax breaks that Deal signed into law last week. In other words, a choice is being made.
Nonetheless, Deal has tried to argue that the federal government, not Georgia, ought to be blamed for Georgia’s decision. As he sees it, the problem would be solved if Washington simply converted Medicaid to a block grant and gave the money to Georgia to spend as it sees fit.
Think about that. After the federal government has taken enormous political heat for creating the program and for generating the funds to support it, it is supposed to simply hand billions of dollars to a state government that has been deeply antagonistic to the very idea of government-aided health insurance, that won’t appropriate any of its own money to help its own citizens, and that has barred any unit of state or local government from participating in the program.
This is also a state government that has badly bungled administration of the federal food stamp program, endangering the ability of tens of thousands of its poorest citizens to access benefits needed to feed themselves. Tens of thousands of applications weren’t being processed; panicked phone calls weren’t being answered for hours. And even though state officials knew about such issues, they did little or nothing because, I guess, it was only poor people who were suffering. It took a threat by the federal government to pull millions of dollars in funding to get the state to act.
In recent years, that same state government had also slashed spending on child-protection services, endangering the safety of children in its care. Until recently, Georgia’s mental health system was so scandalously underfunded that the Justice Department had to sue to force the state to meet minimum humanitarian standards. And in 2012, a federal study ranked juvenile detention facilities in Georgia among the nation’s worst in terms of sexual abuse of inmates.
That is hardly a reassuring record of care for the less fortunate. And sadly, it’s perfectly consistent with Georgia’s decision on Medicaid funding.
