December 12, 2013

The right call

The Daily Citizen

— Many want to blame Obamacare’s poor rollout and enrollment numbers on states like Georgia that have not created their own health care exchanges or expanded their Medicaid coverage.

We should be very happy our leadership in Georgia chose not to join the other states who did such things. The cost for those mistakes because of Medicaid enrollment numbers could have destroyed the already fragile budgets we are running.

According to the most recent numbers, roughly 1.6 million Americans have enrolled in Obamacare. Enrolled, however, is not the same as actually paid for insurance. That is still an unknown number. Of those 1.6 million enrollees, 1.46 million, or  91 percent, have signed up for Medicaid. If these numbers continue, it could bankrupt both federal and state governments.

Medicaid is our country’s third largest government program, behind only Medicare and Social Security. The Congressional Budget Office projects that, in part because of Obamacare, Medicaid spending could more than double over the next 10 years and that is only the federal portion.

It gets much worse for states. For most states, Medicaid is the single largest cost of government, ahead of education, public safety and transportation. Had our state leadership taken the bait and expanded Medicaid on only a promise that the federal government would pay the bulk of new expenses, the results could be irreparable. After all, the federal government isn’t known for keeping its promises. States that expand Medicaid could be left holding a very large bag.

And most importantly at the most local level, Medicaid pays our community doctors very little. On average, Medicaid only reimburses doctors 72 cents out of each dollar of their cost. Because of the low reimbursement, and the bureaucratic system that accompanies any government program, many doctors accept very few Medicaid patients, or do not take Medicaid patients at all. One study found that among clinics that accepted both privately insured children and those enrolled in Medicaid, the average wait time for an appointment was 42 days for those with Medicaid compared to just 20 days for the privately insured.

Could this be the reason why so many Medicaid patients show up at the emergency room for treatment? They can’t find a doctor to treat them. This not only increases the numbers in an already crowded emergency room, but more importantly hurts those who come with real emergencies.

The decisions by Georgia’s leaders to leave Medicaid as it is and to not set up a statewide exchange look smarter each day.