It’s not a trick question. When Georgia says “no” to expanding Medicaid, it figuratively piles up billions of dollars and sets it on fire.
Republicans are floating HB 990 because they’re afraid you’ll figure out what they are doing.
HB 990 may seem straightforward enough; it attempts to require that the General Assembly give approval before the governor can expand income eligibility thresholds for Medicaid. What Republican leadership does not want you to know is that Georgians are already paying the tax for the Medicaid expansion. We have no choice about it. The money that would flow back to Georgia is tax money we have already paid.
All of that tax money – roughly $3 billion in 2015, or about $850 per Georgia household – could stay in the state and benefit Georgians. It could employ doctors and nurses and therapists and pharmacists here. It could make people healthy enough to work harder here. Or it can go somewhere else. That’s a choice.
We could simply lose the money if the governor refuses the expansion. We won’t get $850 per household back. It doesn’t go to some other critical state services. Our money just disappears.
And it’s not like the state proposes as a statement of moral purity to send back the rest of the $5 billion it gets from the federal government to cover Medicaid — any more than we’re ready to send back the $1.26 billion we get for federal transportation money, just because some folks think we are splendidly capable of managing our highways without Washington’s interference.
No, Republican legislators aren’t doing this because they feel a solemn duty to carefully consider a contentious spending question.
A majority of Georgians – 57 percent – favor Medicaid expansion, according to a poll released by the AJC in January. The same poll showed Gov. Nathan Deal with a lead over his likely Democratic challenger, state Sen. Jason Carter, by 22 points, with a third of the electorate undecided, a lead nervous Republicans may not consider insurmountable. In a poll released this week by Public Policy Polling, Deal’s lead has narrowed to a statistical dead heat.
The fallout over ethics charges, teachers irate over their health care benefits plan and the mishandling of winter weather advisories has rendered Deal vulnerable in November. More voters want the Medicaid expansion than not, today. If that figure grows over time, those voters may give Carter a victory.
So, Republicans have introduced a poison pill. They’re afraid Jason Carter might beat Deal in November. And if Carter does beat Deal in November, why not render him powerless. The HB 770 authors have calculated cynically that they can protect Deal by taking away his power to protect their politics in the future.
Alas, HB 770 does more than that. It hampers the governor – Carter, Deal or anyone — from crafting any kind of real-time fix for many of the state’s real-world problems.
Four rural hospitals have closed in the past year, largely because of federal funding changes. Grady Memorial Hospital remains a ticking financial time bomb. The state will still have about 600,000 poor people with a federally mandated right to walk into a hospital for emergency medical care and without the health insurance to pay for it.
It also robs you, the voter, of an honest choice. It’s not like the legislature plans to give voters a referendum on Medicaid expansion, because they’re afraid it might pass.
So, the governor’s race is your referendum, unless this bill passes. I suppose it’s a shame that Republicans don’t trust Georgians enough to make a carefully considered choice of your own.