Last week marked the one-year anniversary of the passage of the national health reform law, the Affordable Care Act. Several provisions have gone into effect such as eliminating pre-existing condition exclusions for kids, allowing young adults to stay on their parents’ coverage until they are 26, the creation of a new pre-existing conditions insurance pool, and a program to help employers (including the state of Georgia) offset retiree health care costs. The bulk of the real reforms, however, will happen between now and 2014.
Although health care debates in the last year have not been as prominent as it was prior to the passage of the law, the propensity for which its critics continue to mislead the public about the law’s specifics and associated costs remain the same.
According to the Kasier Health Tracking poll, which tracks the public’s opinion of health care reform, among other things, more than 50 percent of Americans remain “confused” about the health care law. In fact, another national survey found that 22 percent of Americans thought the law had already been repealed. The critics’ strategy of intentional misrepresentation of the health care law is effective, but is it what’s best for Georgians?
Here in Georgia leaders tout that “Obamacare” will bankrupt the state, yet never offer alternative solutions to address the serious issues facing our health care system. For example, the most recent Census data shows that more than a quarter of all non-elderly adults in Georgia lack health coverage — the uninsured rate rises above 50 percent when considering adults below twice the poverty line. In total, nearly 2 million Georgians lacked health coverage in 2009.
Sadly, one of the most caricaturized aspects of the Affordable Care Act in Georgia is the expansion of the Medicaid program to cover low-income adults up to 133 percent of the poverty level (about $24,400 for a family of three or $14,400 for a single adult).
This expansion is expected to cover more than 600,000 Georgians who may otherwise remain uninsured.
It’s obvious that the current employment-based health insurance system does not work for all Georgians. Prior to the partisan wrangling over the Affordable Care Act, the idea to use Medicaid to expand coverage to low-income adults without employer-sponsored coverage was widely accepted.
Building on this past agreement, the Affordable Care Act’s Medicaid expansion will bring in $15 billion or more in federal funding to Georgia, from 2014 through 2019, to expand coverage to more Georgians. Over these six years, federal funds will cover more than 95 percent of the costs of the program expansion. Beginning in 2020, federal funds will cover 90 percent of the new costs.
The Medicaid coverage expansion will require some level of new state investment; however, this state investment is relatively modest compared to the new federal funds. Under the governor’s estimates, which are considerably higher than state-by-state estimates from the Urban Institute, the new state investment would likely amount to a 10 percent increase in overall state Medicaid costs, based on the long-term 90 percent match rate that begins in 2020. In terms of the overall state budget, the projected costs amount to an approximate 2 to 3 percent increase.
The coverage figures that drive these estimates will mean more Georgians have health insurance. Subsequently, it also will translate to greater funding for the health care system throughout the state and to fewer costs being shifted onto the rest of us as uninsured residents rely on the emergency room and doctors go unpaid.
As we move forward in addressing the challenges of our health care system, we should do so by focusing on the reasons why reform is needed in the first place: too many Georgians are already without coverage and many more face growing uncertainty about the affordability of coverage in the future. The political wrangling can be left by the wayside.
Tim Sweeney, MPA, is the senior health care analyst for the Georgia Budget and Policy Institute.