Jay Bookman

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

Opinion: The proof about Medicaid


Brian Kemp, the Republican nominee for governor, strongly opposes Medicaid expansion in Georgia, calling Medicaid “a failed government program” that “costs too much and fails to deliver for hard-working Georgians.”

That’s a pretty harsh assessment. Without Medicaid, some 1.8 million Georgians, including tens of thousands of children and senior citizens in nursing homes, would lose their access to needed health care. For most of those people, Medicaid delivers quite well, especially in contrast to the alternatives offered by Kemp and others, which is, well, nothing.

But what about Medicaid expansion? Georgia has the fourth highest uninsured rate in the country, according to the U.S. Census Bureau. Hundreds of thousands of our fellow Georgians are going without health care, with many probably dying unnecessarily. For many thousands of others with untreated chronic illnesses or perhaps an addiction to opiates, their quality of life and ability to work have been seriously hampered. And in rural areas, hospitals are closing their doors because they can no longer continue to treat people who have no insurance or other means of paying their bills.

According to advocates such as Stacey Abrams, the Democrats’ nominee for governor, accepting federal Medicaid expansion would alter that picture dramatically. They claim it would provide health insurance for roughly 500,000 of our fellow citizens and inject an additional $3 billion a year in federal money into the state economy, creating tens of thousands of new jobs.

So who’s right?

Well, to borrow the words of Supreme Court Justice Louis Brandeis, state governments serve as “laboratories of democracy,” and for several years now, states all around us have been running an experiment with Medicaid expansion. Let’s see what they can teach us.

Medicaid expansion certainly hasn’t failed in conservative Arkansas, which has slashed its uninsured rate by more than half. Since Medicaid expanded in that state in 2013, 275,000 people have become insured through the program and the number of hospitals closed in the last five years has been zero. 

It also works in conservative Kentucky, which has cut its uninsured rate from 14.3 percent in 2013 to 5.4 percent in 2017. Some 440,000 Kentucky citizens have gained insurance through expansion, with roughly half of those coming from rural areas where problems such as the opiate epidemic have hit hardest. In fact, Kentucky has more rural enrollees in its Medicaid expansion program than any other state in the country.

It also works in conservative and poverty-stricken Louisiana, which in 2015 elected a Democratic governor on a platform of Medicaid expansion. Since Gov. John Bel Edwards initiated the program on July 1, 2016, almost 500,000 Louisiana residents have gained insurance coverage, rural hospitals have begun to recover and according to a study by LSU’s Ourso College of Business, the infusion of $1.85 billion a year in federal funding has created 19,000 new jobs.

So yes, Medicaid expansion works. But can we afford it? Kemp claims that if Georgia adopts Abrams’ “radical plan” -- basically the same plan already implemented in more than 30 states -- it “will literally bankrupt our state.” Is that true?

Again, look around us: States such as Louisiana, Arkansas and Kentucky are all much poorer than Georgia, yet somehow they manage to afford it. What do they have that we don't?

Well, they have political leadership that values helping their own people over blind loyalty to a cruel ideology.

 


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.