Jay Bookman

Opinion columnist and blogger with The Atlanta Journal-Constitution, specializing in foreign relations, environmental and technology-related issues

Ga. can afford Medicaid expansion; it just won't

“Not only is it the right thing to do, it’s the smart thing to do because it’s good for rural hospitals, it’s good for doctors and nurses, and it will lead to lower costs and healthier Georgians,” Clinton said in a statement.

I’m sure that you will be shocked to learn that Gov. Nathan Deal and the state Legislature showed no signs of listening to the Democratic presidential candidate.

In his annual State of the State speech last week, Deal had already reiterated his continued opposition to expansion. “Had we elected to expand Medicaid, it would have required us to include approximately $209 million in this upcoming year’s budget alone to cover the added cost,” Deal explained to state legislators.

Now, $200 million is a good sum of money, but it’s useful to put it into context:

That $200 million needed to expand Medicaid to Georgia’s working poor, leverage billions of new federal dollars into the state, keep rural hospitals open, create thousands of jobs and improve the lifespan and quality of life for many Georgians would amount to 0.88 percent of the projected $23.7 billion state budget for 2017.

It amounts to less than a third of the $669 million in additional personal and corporate income-tax revenue projected to be collected in the next fiscal year.

It amounts to roughly $670 in state money to provide health insurance to a Georgian for a year.

In short, this is not a case of “can’t”; it is a case of “won’t.” It is a case of Georgia’s leadership feeling trapped into a bad decision by their own rhetoric. It’s bad politics getting in the way of good governance.

And of course, let’s not be naive: Clinton’s demonstration of concern is itself motivated by politics. I doubt that she’s trying to curry favor with Georgians in hopes of making the state competitive in the general election come November — if Georgia is in play by then, Clinton and her fellow Democrats don’t have anything to worry about nationally. Her interest is more immediate: The state presidential primary is March 1, and she’s trying to appeal to Democratic voters and officeholders in Georgia who could prove very important to Clinton in holding off a challenge from Sen. Bernie Sanders of Vermont.

But Clinton is also right. Take the situation in Ellijay, where there are indications that the North Georgia Medical Center is in danger of becoming the latest in a string of rural hospitals to close their doors. The facility provides some 300 jobs in that community, but may not have enough paying patients to keep afloat. (See update below)

The numbers explain why:

According to the Centers for Disease Control; the uninsured rate in Gilmer County is 28.1 percent, compared to 17.7 percent nationwide. And according to data compiled by the Urban Institute, some 48 percent of uninsured adults in that part of Georgia could get covered if Medicaid was expanded. Expansion may not solve all of the problems of the North Georgia Medical Center, but it would help.

And who represents that area in the Georgia Legislature? House Speaker David Ralston.


UPDATE: According to Hannah Towns, marketing and public relations director for North Georgia Medical Center, the facility's 50-bed inpatient hospital is expected to close but may provide rehabilitation services. Its 100-bed nursing-home operation will stay open, and a separate hospital company has applied with the state to take over operation of its free-standing emergency room.

Reader Comments ...

About the Author

Jay Bookman writes about government and politics, with an occasional foray into other aspects of life as time, space and opportunity allow.