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How Medicaid expansion has candidates divided on health care
medicaid
A patient at right is assisted while walking out of the emergency department Jan. 24 at Grady Memorial Hospital, in Atlanta. - photo by David Goldman

The debate over whether to expand Medicaid to more low-income individuals and families in Georgia has gained new life this election year as health care is once again a focal point in races for governor and congress.

And a new study from Georgetown University’s Center for Children and Families and the University of North Carolina’s NC Rural Health Project reports that residents of small towns and rural areas of Georgia have the most to gain if Medicaid coverage is broadened by significantly reducing uninsured rates.

States that expanded Medicaid between 2008-09 and 2015-16 saw more than three times as large a decline in the uninsured rates for low-income citizen adults living in rural areas and small towns than non-expansion states, according to the report.

The uninsured rate for this population in these states fell to 16 percent from 35 percent in rural areas and small towns compared to a decline to 38 percent from 43 percent for the same population in Georgia.

“The results of Medicaid expansion in other states clearly demonstrate that it is the most cost-effective investment that Georgia’s policymakers can make in the health and prosperity of rural Georgians,” Laura Colbert, executive director of Georgians for a Healthy Future, a consumer health advocacy group, said in a statement. “Without action on this issue, rural parts of our state will continue to fall behind.”

An estimated 360,000 low-income adults live in rural Georgia. Georgia’s total rural population is estimated at 1.7 million people.

U.S. Rep. Doug Collins, R-Gainesville, who is running for re-election this November, said he is focused on improving access to care and lowering health care costs.

“Northeast Georgians should have access to affordable, quality health care,” he said in a statement to The Times. “That’s why I supported the Bipartisan Budget Act, which the president signed into law earlier this year. This law prevents the Medicaid disproportionate share cuts that Obamacare imposed on rural hospitals from taking effect, and this is a key step to protecting those hospitals.”

Collins said Medicaid is safety net serving the most vulnerable in our society, such as the elderly, the disabled and children.

“Rather than expand Medicaid to cover able-bodied individuals whom it was never intended to serve, we need to focus on underlying issues — access to and cost of care, and the importance of economic empowerment for individuals in the gap,” Collins said. “Deepening the government’s reach into health care is not the solution rural Georgians need.”

Josh McCall, the Democrat candidate for the U.S. 9th District currently represented by Collins, said in a statement to The Times that the study “shows the tragic consequences of cheap politics.”

“The Republicans that have run Georgia did a grave disservice to their state by refusing to expand Medicaid,” he said. “Now we have rural hospitals like Chestatee Regional closing, and because the GOP puts profit over people, they did not calculate the lives lost because of the extra time it will take for rural Georgians to make it to the nearest emergency room. This is not a luxury or a political football — this is life and death.”

Meanwhile, the differences between the Republican and Democrat approaches to health care are also highlighted in the campaign for Georgia’s next governor.

Stacey Abrams, the Democratic candidate, supports a full expansion of Medicaid and has said it will be her first priority if elected because she believes it is both a “moral and economic imperative,” according to information on her website.

“To create a state where every family has the opportunity to thrive, ensuring access to affordable health care for each and every Georgian is absolutely essential,” Abrams states. “Medicaid expansion will provide access to health care for 500,000 Georgians, create more than 50,000 jobs across the state, expand mental health supports, and protect rural hospitals from closure.”

Republican candidate Brian Kemp, meanwhile, is advocating a more private sector approach to address health care access and costs without expanding Medicaid, which he said will bankrupt the state.

In particular, Kemp is seeking to increase OB-GYN and primary care doctors in rural Georgia and expand the cap on the Rural Hospital Tax Credit Program to $100 million from $60 million, according to information published on his website Oct. 3.

Kemp would also seek federal waivers to help stabilize insurance premiums through a $200 million reinsurance program jointly funded by the state and the federal government, and also protect patients with pre-existing conditions.

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