Many states taking this “opportunity and toolbox” approach are now building on the foundation of high coverage rates to invest in prevention, improve access to care and enhance value for consumers, often in collaboration with local health care stakeholders.
Kentucky, for example, has reduced its uninsured rate from over 20 percent to 9 percent since 2013. Combined with an intentional focus on prevention, this has translated to a more-than doubling of the number of screenings for breast, cervical and colon cancer and of dental and physical exams. Other states like Oregon are developing initiatives to contain costs, improve quality and achieve better price transparency for consumers.
Of course, not every promising initiative will be a smashing success, but the pace of innovation and advancement is historic for American health policy. Here in Georgia, approximately 500,000 people enrolled in coverage through the Health Insurance Marketplace, an exciting development that has helped bring our state’s uninsured rate down to just above 15 percent. In normal times, with all else being equal, this would be extraordinary.
And while this achievement is transformative for the people and communities impacted, these are not normal times for the health system. Georgia’s uninsured rate remains among the nation’s highest, and our health outcomes, among the nation’s poorest. Without a more deliberate focus on coverage, access, value and outcomes, Georgia risks falling further behind other parts of the country. We cannot continue to do less with less.
The demise of the Grady experiment, while a disappointment, should be a conversation starter about moving Georgia towards an “opportunity and toolbox” mindset. To date, our state has stayed on the sidelines while others have moved forward, but we don’t have to remain there.
The evidence is beginning to pour in from around the country, and we can take the most promising initiatives out there and use them to inform a uniquely Georgia approach. The clearest evidence we have shows us the decision by the majority of states (30 and counting) to expand Medicaid is foundational in transforming the health system. The Grady initiative, while not Medicaid expansion, was at its heart a delivery system reform that was predicated on moving its target population into coverage as a first and necessary step.
We cannot make progress as a state if 15 percent of our population is uninsured. Too many Georgians fall into a coverage gap our leaders can fix. Medicaid expansion should be on the table, not as a perfect solution, but as a necessary first step.
Cindy Zeldin is executive director of Georgians for a Healthy Future.