We knew it was a bogus cover-up for a purely political opposition to President Obama's signature program. Gov. Deal finds money to do the things he wants to do, but says we can't afford things he opposes politically -- even though it would be a vital benefit to needy people.
Even that would not have likely happened if the U.S. Supreme Court had not intervened and negated the incentive for states to accept the expansion. The bill, as passed by congress and signed into law by Obama, would have severely penalized states that did not expand, by restricting the federal money the state was already receiving to help cover existing Medicaid costs. That's what SCOTUS said was unconstitutional. So it left it up to each state's free choice whether to expand. And most of the Republican governors opted not to.
This is also an example of how, when you tamper with one part of a complex program, there are unintended consequences. Hospitals had been receiving a partial compensation from the federal government for treating indigent patients who had no insurance. Those funds were also reduced by the ACA because, with the expected expansion of Medicaid coverage, there would be far fewer indigent patients showing up in emergency rooms or needing hospitalization.
The result of the ACA cutting those funds and of governors' refusal to expand Medicaid has hit rural hospitals particularly hard. A growing number of them have closed altogether; others have converted to much reduced services. Now many people live 50 miles or more from the nearest hospital -- often a critical difference in an emergency, or prohibitive for those without transportation.
Jay Bookman wrote his Atlanta Journal-Constitution column on this problem in the Sunday edition. I will be quoting some of his information here:
"With an influx of newly insured Medicaid patients, those hospitals would at least have had a fighting chance of paying their bills and staying open. The contrast with southern states such as Kentucky and Arkansas, which did accept Medicaid expansion, is stark. As Gallup notes, the two states have cut the percentage of their citizens who don’t have health insurance in half. As a result, once-struggling rural and urban hospitals in both states have regained their footing."
In a new study by Deloitte business consultants of the Kentucky experience, the amount of uncompensated hospital charges in 2014, after the Medicaid expansion, declined from $1.9 billion to $766 million, a decrease of $1.15 billion.
Bookman continues: "In the report, Deloitte also documents other economic, medical and social benefits enjoyed by Kentucky as a result of its decision. The net economic impact of Medicaid expansion through 2021 is now projected by Deloitte at $30 billion, double the projection of a year ago. In 2014 alone, Medicaid expansion injected an additional $1.6 billion into Kentucky’s health-care economy. More than than 12,000 jobs, including 5,400 health care sector jobs, were created by Medicaid expansion last year. Deloitte now projects that by the end of 2021, some 40,000 jobs with an average salary of $41,000 will be created in Kentucky as a result of Medicaid expansion. None of that is happening in Georgia.
"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?"
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This is far from the first, or only, thing for which Nathan Deal should hang his head in shame. And he has just been re-elected for four more years. It was not only an act of political cowardice and meanness -- it's not even good business sense. And this from a governor who travels the globe trying to bring business to Georgia. Shame on you, Nathan Deal. You are not a good representative of our home town, Sandersville, GA, where we both grew up. I knew your Momma and Daddy, both school teachers. They would not approve of what you have done.
Ralph
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