Medicaid expansion would bring huge economic and governmental revenue benefits to Georgia, studies show.
Gov. Nathan Deal in the recent debate in Perry said that Medicaid expansion under the Affordable Care Act would cost the state $2.5 billion over the next 10 years. However, the studies show that the cost would be much less because of federal dollars received and increased revenues spurred by the expansion. The action would bring Georgia thousands of new jobs, improve health care and boost local revenues, the studies found.
“The bottom line is that the benefit of Medicaid expansion outweighs costs,” said Georgia State economist Dr. William Custer, author of a 2013 study that showed the expansion would add billions a year to statewide economic output. “It’s pretty clear that the benefits to the state of Georgia are pretty large and widespread.”
In contrast to Deal’s figures, the Medicaid expansion would cost the state around $350 million over the next 10 years, according to Tim Sweeney, director of health policy for the Georgia Budget and Policy Institute.
Sweeney in a fact sheet said the state would receive more than $33 billion of new federal funding over the next decade under the expansion, generating about $1.8 billion in state revenue from resulting economic growth, according to forecasts from Deal’s office and Custer’s study.
“This new revenue would offset more than 80 percent of expansion-specific state spending over the next 10 years,” the fact sheet said. Local governments and school districts would gain about $1.2 billion in sales tax revenue.
Custer in his report estimated that the state would receive $40.5 billion in additional federal revenue over the decade.
Democratic governor’s candidate Jason Carter supports the expansion. Deal signed legislation that requires the Georgia General Assembly to approve such a move.
While the GOP opposes expansion, 60 percent of Georgians in a new Healthcare Georgia Foundation poll support it, according to Georgia Health News reporter Andy Miller, as cited by the Atlanta Business Chronicle. The Schapiro Group conducted the survey in August, Miller reported.
Custer cautioned that his report for the Healthcare Georgia Foundation was based on 2010 figures, during the recession. The report found that 600,000 uninsured Georgians would be eligible for Medicaid. Today’s improved economy would lessen that number to 450,000 to 550,000, he said. Under the 600,000 figure, the amount of federal funds coming into the state would add 70,343 jobs.
With the improved economy resulting in more Georgians attaining health insurance, fewer would need Medicaid. The resulting lower federal spending would bring a payoff closer to the 56,257 jobs cited in an “alternate estimates” appendix. That would boost the state’s annual economic impact by $6.54 billion, with an annual increase of $117 million in local taxes and $104 million in state revenue.
More than half of the jobs created would be in the health industry, Custer said. The thousands more insured Georgians would seek medical care, resulting in the employment of more doctors, nurses and laboratory specialists, especially in rural areas. The rest of the economic boost would come from the higher number of health professionals buying houses, eating out, shopping for hardware.
The expansion “increases access to care for everybody,” Custer said, because those with insurance would also have more health options.
Under the ACA, Medicaid eligibility was expanded to families with annual incomes less than 138 percent of the poverty line, or $27,300 for a family of three, Sweeney’s fact sheet said.
In a separate publication, Sweeney said that 47 percent of all uninsured Georgians ages 18 to 64 would meet the new criteria.
A Supreme Court decision that found sections of the ACA constitutional gave states the choice of accepting the Medicaid expansion provision.
From 2014 to 2016, the federal government pays 100 percent of the expansion cost. On a sliding scale, the federal share goes from 95 percent in 2017, to 90 percent beginning in 2020.
Without the expansion, uninsured Georgians seeking emergency care remain a burden on community hospitals, Sweeney said. While hospitals haven’t reported how many uninsured they treat and the amount of unpaid bills, anecdotal evidence reveals “they’re serving a lot of people who would otherwise be eligible for Medicare if we expand it.
“Hospitals in Georgia continue to see a large number of patients who don’t have health insurance,” he said. “In states that have expanded Medicare, hospitals are showing significant declines in the number of uninsured patients that they see.”
