For years, Georgia has been among a small number of states that has resisted fully expanding Medicaid to cover the uninsured. State leaders have chosen time and again to deny coverage to nearly half a million Georgians — but they can still change course.
Full Medicaid expansion has always been the affordable, responsible choice, but the terms now are better than ever. Earlier this year, Congress passed the American Rescue Plan to help states recover from the economic crisis caused by the pandemic. As an incentive to states that have not yet expanded Medicaid, the federal government is willing to pay 90 percent of the costs associated with fully expanding Medicaid, and these states are also eligible for additional funding for other Medicaid programs. With this injection of federal support, Georgia could receive up to $1.9 billion dollars over the next two years.
These funds would cover more than the state’s share of the cost of Medicaid expansion and, most importantly, would extend health care to nearly 500,000 Georgians.
Georgians who would gain coverage earn about $17,600 a year for an individual, $23,790 for a family of two and $29,970 for a family of three. And it’s no coincidence that populations disproportionately affected by COVID-19 are the same populations most likely to be uninsured, 47 percent of Georgians in the coverage gap are Black, and 9 percent are Latinx. This is a pattern that reflects racial inequities in access to health care that we know all too well in Georgia. Full expansion of Medicaid could help address longstanding racial disparities in both health care access and outcomes.
Closing the Medicaid coverage gap will also increase access to health care and strengthen health infrastructure in rural communities. Many Georgians who live in rural areas are less likely to have health insurance through their jobs. Over the next five years, the uninsured rate in rural Georgia is expected to climb to 25 percent. And, with a slate of rural hospital closings over the last decade — two during the pandemic alone — many living in rural places have to travel longer distances to get health care. Expanding Medicaid strengthens both rural families and our rural health infrastructure.
As a state, we will also benefit economically from higher rates of health insurance coverage.
The infusion of funding from the American Rescue Plan is a direct investment in a health care system that has for too long been under-resourced. Medicaid expansion could also lead to significant job creation — for every job added to the health care system, two more would be created in the surrounding community. In fact, 64,000 jobs would be added across the state if Georgia fully expanded Medicaid.
Georgia currently has a pending Medicaid waiver plan that partially expands Medicaid to cover adults with incomes below the poverty line if they meet work reporting requirements and pay out-of-pocket monthly premiums — conditions that will severely limit access and affordability. Additionally, this plan would cover far fewer Georgians than full expansion of Medicaid and cost the state more. This is a bad deal for Georgia and Georgians.
Let’s make the right choice and fiscally responsible choice for Georgia by fully expanding Medicaid. The American Rescue Plan clearly covers the cost of this overdue and much-needed-investment in Georgians that will lead to healthier and stronger communities.
In this time of rebuilding and recovery, it would be indefensible not to make an investment in the people and families across our state.
David Schaefer is research director at the Georgia Budget and Policy Institute.