Gov. Nathan Deal: Georgia can’t afford feds’ bad medicine

Growing health care costs, whether through employer-provided health plans or the Medicaid and PeachCare programs, increasingly crowd out other state priorities in our budget.

Obamacare has exacerbated the problem. Like all private-sector businesses in Georgia, the state government is seeing its costs grow for employee health plans because Obamacare’s coverage mandates have driven up prices. We’re talking hundreds of millions of dollars.

As expensive as the mandates are, they are chump change compared to the costs of Medicaid expansion. After the Supreme Court ruling, states can choose to accept or reject the Medicaid expansion. I’ve stood strong against expansion because the state can’t afford it as it is currently configured, and there’s little reason to believe that our debt-soaked federal government will continue to pay 90 percent of the cost far into the future. Expansion will exacerbate the problems of an already unsustainable program.

I recently signed into law a second layer of protection for taxpayers. Now, instead of a governor single-handedly deciding to commit the state to billions in new spending, any Medicaid expansion must also pass the General Assembly.

This puts into law what already existed in fact. Governors can’t spend money if legislators don’t appropriate it. A large commitment of public dollars, such as Medicaid expansion, should have the support of both the executive and legislative branches before it moves forward.

Obamacare negatively affects the state budget no matter which way we turn.

If we accept Medicaid expansion, we have a new entitlement that grows no matter how state revenues or the economy are performing. That means less money for our top priorities such as education, which is more than half of the state budget.

Expansion, which would add hundreds of thousands to the Medicaid rolls, wouldn’t be a slam dunk win even for low-income Georgians. Coverage isn’t the same as access. Those kicked off their private health insurance would now have little choice in coverage or doctor and would have to wait to see the limited number of providers willing to accept Medicaid, which reimburses below the cost of care.

That competition for limited spots would spell trouble for the 1.8 million children, pregnant women, seniors and those with disabilities in our current Medicaid program.

If we don’t expand, the federal government makes darn sure we’re punished. The Obama administration refuses to allow a block grant approach, which would spur state-level innovation. Giving flexibility would go a long way toward covering the affected demographics without piling a huge new financial burden on states. Adding insult to injury, the administration will soon cut the payments to safety net hospitals that serve a disproportionate share of Medicaid patients, on whom they lose money.

Leaving those cuts in place when nearly half of the states have decided against expansion exemplifies how the Obama administration has refused to acknowledge that the Supreme Court changed the playing field. Rather than working with us, the federal government has relied on strong-arm tactics to crush dissent.

We’re plotting a sustainable path forward for Georgians, but the “one size fits all” approach that Washington demands is ironically hurting the very cause it claims to champion.