Medicaid expansion has nothing to do with improving health care and everything to do with improving the image of politicians. A recent study published in the New England Journal of Medicine showed that expanding Medicaid will have no major positive effect on the health of state residents. Georgia should look to Oregon to realize that this part of the Affordable Care Act (ACA) is not all it’s cracked up to be.
In 2008, Oregon expanded Medicaid coverage by lottery. That allowed researchers to conduct a gold standard study which revealed that the only significant measurable improvement for the new recipients was in mental health. Meanwhile, health outcomes for blood pressure, cholesterol levels and glycated hemoglobin showed no improvement over those Oregon residents that had not been chosen in the lottery. Georgia Gov. Nathan Deal is right to say the state can’t afford to expand Medicaid.
Despite the scientific evidence against Medicaid expansion, ACA supporters are spinning the study. Proponents of Medicaid expansion point to two meaningless factors — that new recipients used more health care services and that they felt more financially secure.
Bluntly, expanding Medicaid coverage would only make recipients “feel better,” and not necessarily lead to healthier outcomes. Expanding Medicaid lives up to the name of the ACA — it gives “affordable care” — providing you can find a physician that takes Medicaid patients. And the financial protection afforded Medicaid recipients is most effective in protecting against “catastrophic” health expenditures.
If the only goal of Georgia’s leaders is to provide rudimentary insurance coverage for low-income residents, Medicaid is the very expensive solution to that problem. But if the goal is to consider actual health outcomes, there are far better options than expanding Medicaid that could fall in line with Georgia’s ongoing search for expansion alternatives.
Consider the Medicaid Cure program, a successful pilot program that has been working in Florida, Louisiana and Kansas. The Medicaid Cure model lets patients choose among numerous private plans. In Florida, health measures for low-income residents on the program have improved over traditional Medicaid. In just the five Florida counties where Medicaid Cure is being used, the state has saved roughly $118 million and estimates show that when fully implemented, it would save the state almost $1 billion annually.
It’s also a smart fiscal move for Georgia to reject Medicaid expansion. The state already relies on far too much federal funding to operate. State Budget Solutions found that in 2011, 41 percent of all funds in Georgia’s budget came directly from Washington. Relying on a dysfunctional federal government to keep its funding promises is a bad idea. Washington’s giant carrot to states now will become a painful stick when funds dry up.
The decision to expand Medicaid, already one of the country’s largest government programs, is not to be taken lightly. Georgia, like all states considering expansion, must seriously consider the consequences on both their bottom line and on the low-income residents that they are trying to help. It isn’t compassionate to force these residents to take an insurance plan that won’t help them receive better health care.
