How do you rescue Georgia’s rural hospitals — the heart and soul of their communities — from the financial challenges that may force them to close their doors forever?
If you’re the state of Georgia, you don’t. You express insincere concern for their health, slap a Band-Aid on their gaping wounds and push them out the door to let nature take its course.
Back in March, when he still had an election to win, Gov. Nathan Deal pretended otherwise. He even went so far as to appoint a special committee to study how the state might be able to help those hospitals. In its report released Monday, the panel acknowledged the seriousness of the situation, noting that “four rural hospitals have closed in recent months with a total of eight having closed or attempted to reconfigure in the last two to three years. Additionally, 15 rural hospitals are considered financially fragile, with six operating on a day-to-day basis.”
Yet the panel did not propose a cure. It offered one proposed policy change of such a small scale that it amounts to a hospice program, slightly easing the pain that will come as hospitals close their doors. That’s because the one proposal that might have made a difference — Medicaid expansion through the Affordable Care Act — was taken off the table by the governor.
The contrast with states such as Kentucky and Arkansas, which did accept Medicaid expansion, is stark. According to Gallup, those two states have cut the percentage of their citizens who don’t have health insurance in half. And with more insured patients, once-struggling rural and urban hospitals in both states have been able to regain their footing.
The scale of the change is dramatic. A new study by business consultants at Deloitte tallied how much “uncompensated care” Kentucky hospitals had been forced to provide in the first nine months of 2013, before Medicaid expansion took effect, and compared that number with the same nine-month period in 2014. The amount of uncompensated care fell from $1.9 billion in 2013 to $766 million in 2014, a decrease of $1.15 billion in just nine months.
Adjust that amount to a full year, and adjust it to the fact that Kentucky has roughly 40 percent of Georgia’s population, and you begin to understand the financial impact of that change.
According to Deloitte, the net economic impact of Kentucky’s Medicaid expansion through 2021 is now projected at $30 billion, double the projection of a year ago. In 2014 alone, it found, Medicaid expansion injected $1.6 billion into Kentucky’s economy. More than than 12,000 jobs, including 5,400 health care sector jobs, were created by Medicaid expansion, and Deloitte now projects that by 2021, 40,000 jobs with an average salary of $41,000 will be created in Kentucky.
And of course, hundreds of thousands of Kentucky citizens now have access to the medical care that will help them live longer, happier, healthier and more productive lives. How much is that worth? What could possibly be more important?
It’s crucial to point out that despite our economic challenges, Georgia (median household income of $47,439) is still considerably more prosperous than either Kentucky ($42,158) or Arkansas ($39,919). So our failure to do our part on Medicaid expansion is not a matter of can’t.
It’s a matter of won’t.
