An open mind, especially when looking at a spreadsheet, stands the greatest chance of creatively solving fiscally thorny problems.
That could be the case on the issue of expanding Medicaid rolls in Georgia. Improving access to health insurance for half a million uninsured Georgians carries sizable costs as measured in either political risk or dollars and cents.
There’s no mistaking that Obamacare remains unpopular among many here. Ditto for other conservative or Southern states as well.
Yet, other states with leanings similar to ours are exploring ways to provide insurance benefits to more of the uninsured while also keeping a fiscally conservative eye on ever-rising health care costs.
Thus, it was encouraging to learn recently that Georgia is keeping a low-profile eye on what other states are up to on expanding Medicaid coverage. We should continue in this quest — keeping watch for good ideas and using pragmatic smarts to seek a workable way to provide even the basics of health insurance coverage to more of those who lack it now. And we shouldn’t be afraid to act on a workable solution that may emerge in coming months.
Gov. Nathan Deal has long contended that the state can’t afford to expand our already strained Medicaid roster. As many as 650,000 additional Georgians could join an expanded Medicaid program here. During an interview late last month in The Atlanta Journal-Constitution, Deal didn’t rule out for all time reconsidering Medicaid expansion. Rather, he said the door remains shut “for now.” That’s an understandable political position for the governor of a deep-red state.
Deal, however, has also been known to show a pragmatic streak. So it’s not surprising that his health policy adviser said last month that state analysts have been crunching numbers on a range of expansion models and looking at what other states in similar situations are doing. “We’re never going to stop looking,” Katie Rogers, Deal’s adviser, said during a Children’s Advocacy Network event. “Just saying ‘no’ is not an option.”
Keeping options open, even on this politically charged subject, is smart thinking. And it is defensible in our view, even during this current season of scorched Earth politics. Genuine doing-more-with-less smart fiscal conservatism requires keeping an eye on current best practices in order to get the optimal results for our hard-earned tax dollars.
Georgia, rather quietly, seems to be moving toward performing such due diligence. Earlier this month, House Speaker David Ralston, R-Blue Ridge, announced his appointments to the General Assembly’s Joint Study Committee on Medicaid Reform. Ralston, Lt. Gov. Casey Cagle and Deal each have six seats to fill on the committee. Last week, Ralston told the AJC Editorial Board that “obviously Medicaid’s going to be a big challenge for us going forward … funding growth in that program.”
The joint study group was created by House Resolution 107, signed into law earlier this year. It begins by noting that “Medicaid serves a vital role in ensuring the health of the needy citizens of this state who would otherwise be without access to necessary health care … .” And it directs the committee to study the issue “for the purposes of determining an appropriate plan for Medicaid reform… .”
The resolution makes clear that the key driver of the effort is an ongoing, “unsustainable” increase in cost at a time “that states are facing unprecedented budget pressures.”
The study committee should look broadly for options. As the rollout of Obamacare continues, even some former staunch opponents of Medicaid expansion are changing course, lured by the prospect of federal subsidies.
Arkansas has gotten a lot of attention recently for its creative plan to use private health insurance plans to cover the uninsured who would otherwise fall under Obamacare’s Medicaid expansion scenario.
Earlier this spring, the pro-free market Georgia Public Policy Foundation’s Kelly McCutchen wrote that public hospitals are required to care for anyone who shows up in their emergency rooms, “regardless of their ability to pay. So even if Medicaid did not exist, taxpayers and citizens would be paying for health care for the poor and uninsured.” McCutchen suggests that a more-efficient alternative is to grant state credits to low-income people that would go toward costs of private health insurance. If people didn’t use the credits, the allocated money would then go to safety-net healthcare providers.
Ideas like these show that states and think tanks are working creatively to increase access to basic health care. As an important, populous state, Georgia should be part of the national thinking in this regard. That will require continuing, and likely even more engagement on our part, but that’s the real price of controlling our destiny and ultimately arriving at the best deal for Georgia taxpayers.
