If someone asked you to buy something that indebted you indefinitely but offered to pay for the first three years with money from your other pocket, would you take it? If a government program made you 13 percent more likely to die, would you sign up? Would you expand the program? Amazingly, some organizations think Georgia should do just that by expanding Medicaid.
President Barack Obama’s health care law required states to expand Medicaid to cover individuals below 138percent of the federal poverty line or lose all federal funds for the program. The Supreme Court ruled last summer that he had unconstitutionally offered the states an offer they couldn’t refuse. Since Medicaid spending typically accounts for a quarter of a state’s budget – 24 percent in Georgia — the Supreme Court ruled the government effectively left states no option but expansion. States now have the choice of expanding Medicaid without losing federal Medicaid funding. Still, Georgia should reject expansion.
Georgia would get those “free” federal dollars to fund the expansion for three years, but the funding levels off at 90 percent in 2022. The federal budget is a disaster. Any economist will note the problem is entitlement spending. Pretending that federal money doesn’t cost Georgia taxpayers is absurd. We pay federal taxes. Georgia’s budget is already hamstrung between education spending and current Medicaid liability, which are made more costly by federal rules and mandates. Medicaid expansion would cost Georgia taxpayers $45 billion from 2013 to 2022, according to the Kaiser Family Foundation.
Medicaid patients are 13 percent more likely to die when undergoing surgery than uninsured individuals, according to the University of Virginia, and 97 percent more likely to die than privately insured patients. Medicaid cancer patients are two to three times more likely to pass away than other patients, according to the journal Cancer. In a recentstudy of Oregon’s expansion program, newly eligible Medicaid patients had no significant health improvement.
The primary sources of Medicaid’s dysfunction are its mountains of red tape and low reimbursement rates. Georgia doctors receive 69 cents for every dollar they spend on a Medicaid patient’s care. According to a poll conducted by Sandra L. Decker of the National Center for Health Statistics, 33 percent of Georgia doctors reject new Medicaid patients.
Some states have wised up to Medicaid’s nightmare and started scheming to receive federal funds without actually enrolling citizens. As Timothy Sweeney of the Georgia Budget & Policy Institute explained recently in The Atlanta Journal-Constitution, “states are finding ways to customize Medicaid coverage under the expansion … like the model developing in Arkansas that will allow the state to use Medicaid dollars to buy private insurance plans for 250,000 people.”
Expansion alternatives like Arkansas’s still don’t address Medicaid’s underlying reimbursement crisis. New Medicaid patients would still have poor options for health insurance and care. Georgia’s most susceptible residents deserve better. For the health of Georgia’s budget and its citizens, Medicaid expansion is not a reasonable solution.
Virginia Galloway is state director of Americans for Prosperity — Georgia.
