Why we need Medicaid expansion in Georgia

Published 10:17 am Wednesday, May 15, 2019

My entire 20-year career I have worked in the business side of healthcare in 6 different states. I’ve seen many emergency rooms and inpatient units and worked with a lot of different Medicaid programs. Before I left Minnesota to move to Georgia, Medicaid was expanded through the Affordable Care Act (ACA or Obamacare) and it had a very positive impact on the people of my community, the hospital where I worked, and it lowered the state’s rate of healthcare spending. In 2013, as one of the first states to expand Medicaid, Minnesota’s annual spending growth was 3% lower than the national average (Minnesota Department of Health News Release, 2016.)
The most positive impact I personally saw was how it provided dignity to those seeking preventive care, a large number of whom worked two to three jobs just to survive and still didn’t have health insurance before the expansion. They were finally able to schedule an appointment to see a primary care doctor and get a regular check-up, a colonoscopy, prostate exam or mammogram to make sure they didn’t have an unknown cancer that would prematurely end their life. They didn’t have to wait until they were so ill they had to visit an emergency room where they were guaranteed care by the Emergency Medical Treatment and Labor Act (EMTALA) without being asked first how they would pay.

Unfortunately, there are many members of our Southwest Georgia communities who still lack this basic care and it negatively impacts us all every day. Our hospital cares for people who are negatively impacted and die in their 30’s and 40’s from untreated diabetes, hypertension, and delayed cancer diagnoses. They deserve better. We are a not-for-profit healthcare provider who gladly accepts patients without an ability to pay; that’s our mission and we’re proud of it. But that cannot overcome the guilt and shame the uninsured people in our community feel because they cannot afford what many of us take for granted. They do not have the “privilege” of health insurance so they avoid care. Expanding Medicaid will level the playing field and make having healthcare insurance a right instead of a privilege.
The cost of healthcare is the biggest concern of most businesses and individuals in our region and we are not alone. It’s the same across the country. There are people saying expanding Medicaid will have a negative financial impact to our state and raise our current healthcare costs. I could not disagree more with that statement. Higher rates of uninsured patients in a state guarantee higher costs.
At our local hospital, we provided $16M dollars of charity care to those without the ability to pay last fiscal year.
That is close to what we spent for supplies and drugs for all of the patients we cared for that year.
To offset that loss, prices are raised for those who have insurance to cover for those that don’t. Those patients tend to use more expensive care once they are very sick instead of more affordable preventive care. That affects your out of pocket costs as an individual and your employers’ costs to provide health insurance. This repeating cycle continues to push up the cost of care.
The state legislature will be turning down $45.4B in federal dollars over the next 10 years that will be collected nationally from tax payers, including us, if we do not expand Medicaid (https://www.healthinsurance.org/georgia-medicaid/). That’s in addition to the $7B we have already given up. An Urban Institute analysis found that providing Medicaid coverage to nearly half a million low-income Georgia residents would only increase state spending by 6.3 percent, and that expense “would be offset largely by savings in other areas, including uncompensated medical care for people who are currently uninsured.” (HealthInsurance.org). That would easily be true in our communities and our state if we have the will.

Medicaid Expansion WILL help stabilize the costs of healthcare in Georgia as it has elsewhere. One in five people in our communities does not have health insurance today.

Brandi Lunneborg
CEO, Phoebe Sumter Medical Center