April 7, 2014

Letter: Self-inflicted pain

— One of the largest transfers of wealth in U.S. history is going on right now. If we don’t expand Medicaid, $36 billion of Georgia’s federal tax dollars will be spent in other states under the Affordable Care Act (ACA).

Georgia and many other states that have opted out of the Medicaid expansion now are considering mini-bailouts for safety-net hospitals that would have received additional revenue through the ACA provision. In 2010, care for the uninsured cost Georgia hospitals $1.3 billion. Chatsworth’s City Council met recently to approve financial assistance for Murray Medical Center for care of uninsured and underinsured patients (who kept their old policies) fearing its loss would threaten the economic development of Murray County. Four rural hospitals in Georgia have closed in the last two years over the same issue, and that may be the reason Georgia’s hospitals lag behind the nation combating care-associated infections. Georgia’s insured families pay higher premiums to cover uninsured costs.

The first full year of an expansion would run about $48 million, or less than 1 percent of Georgia’s proposed state budget, and is small compared to the $1.3 billion that uninsured patients cost. But the federal government pays 100 percent of the cost for the expansion for the first three years and 90 percent thereafter. The Medicaid expansion would be expected to bring $36 billion in direct federal funds to the state and have a cumulative impact of $72 billion on our economy during the next 10 years. According to Georgia State University, not expanding will kill 70,000 jobs at a cost of $250 million per year. In Kentucky, which took the expansion, the ACA will generate 17,000 new jobs and bring in $15.6 billion between 2014 and 2020.

But the Republicans use scare tactics by saying the federal government might not be able to keep its promises on funding the expansion. They should know — the uncertainty is caused by the Republicans themselves who have voted unsuccessfully more than 50 times to defund the ACA. But 57 percent of Georgians say the state should expand Medicaid under the terms of the ACA.

The ACA has signed up about 7 million people. In states that have exchanges, premiums are 50 percent less than first predicted. Small businesses with less than 50 employees are exempted from the ACA or subsidized. Businesses shouldn’t get to regulate the religious beliefs of their employees. Obamacare (ACA) has survived and you can be assured that that financial pain in those uninsured Georgia feet is self-inflicted.

David Bean


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