Kemp’ budget-wrong healthcare priorities for Coweta's citizens

And, although Coweta is more affluent than most counties in Georgia and the nation, the local need is greater and more diverse than most residents of Coweta realize. In Coweta, it may surprise you to know that most of the poverty is in the white community (https://datausa.io/profile/geo/coweta-county-puma-ga ). Using 2020 census data, this source indicates that 11% of white men and 16% of white women in the county were in poverty. 

Per this same source, 10% of the population of Coweta is on Medicaid. But 10% has no insurance at all, caused to some extent by the political refusal of our Governor and legislature to expand Medicaid under the ACA, even though the Feds pay 90% of the bill. 

Still, the ACA (Obamacare) has been a tremendous success throughout the nation and here in Coweta County. Low-income Americans have gotten healthcare via the marketplace and Medicaid expansion. In fact, there are now a record 16.3 million people nationwide who have gotten ACA coverage marketplace. That represent a 13% increase, remarkable for a program that is more than a decade old. 

However, this was due in part to the pandemic and legislation related to it, preventing states from making participant deletions during the pandemic. This provision ends in April and roles are expected to decline significantly and the number of uninsured will go up substantially (https://aspe.hhs.gov/reports/unwinding-medicaid-continuous-enrollment-provision). 

The ACA has been a political football for the Georgia GOP for a decade. That is one of the main reasons that Georgia has the third highest number of uninsured, 1.3 million residents or nearly 13% of all Georgians (https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Uninsured%22,%22sort%22:%22desc%22%7D). Only Texas and Florida, which also have refused to expand Medicaid, have a higher percentage uninsured. 

Further, despite what our Governor misleadingly says, the facts show that Georgia is towards the bottom of the states when it comes to healthcare. In large part, that is due to his inexcusable failure to propose full Medicaid expansion to the legislature. 

There are a multitude of organizations that rank state healthcare status/systems according to varying criteria. For example, we rank- 

*44^thper Commonwealth (https://2020scorecard.commonwealthfund.org/rankings/) 

*44^thperBetter Benefits Guide(https://thehill.com/changing-america/respect/equality/3687284-here-are-the-states-with-the-best-and-worst-healthcare-systems/) 

*43^rdper US News and World Report (https://www.usnews.com/news/best-states/rankings/health-care) 

*43^rdper Wallethub (https://wallethub.com/edu/states-with-best-health-care/23457) 

*34^thper Moneygeek (https://www.moneygeek.com/insurance/health/analysis/2022-top-states-health-care/) 

*32^ndper Sharecare (https://wellbeingindex.sharecare.com/interactive-map/?defaultState=GA) 

At the same time that our rankings are so low, Georgia has a $6.6 billion (that’s billion, with a B) surplus (https://www.gpb.org/news/2023/01/24/gbpi-says-full-medicaid-expansion-more-fiscally-responsible-georgias-waiver-plan). And our Governor refuses to fully expand Medicaid, one of only 11 states (all GOP controlled) that have refused to do so, solely for political reasons, as opposed to economic ones. Instead, playing politics as usual, the Governor wants to send back money to voters, a billion plus in property and income tax refunds. 

And please do not be fooled by Kemp’s politically motivated Medicaid “waiver” which requires that Medicaid recipients work. Kemp indicates that it will add 50,000 to Medicaid. But more than 10 times that number would be added if we simply expanded Medicaid as did 39 other states, including many controlled by the GOP. 

And, the waiver is financially inefficient –“The cost per person for fully expanding Medicaid is 5 times lower than Georgia’s Medicaid waiver, because the federal government pays 90 percent of the costs for full expansion and only 67 percent of costs for partial expansion.”(https://gbpi.org/expand-medicaid-fully-reject-risky-and-expensive-state-plan/). 

Another source states that Georgia would spend $322 million to extend coverage to less than 80,000 people via its two waiver proposals. But would spend only $188 to $213 million under full Medicaid expansion that would cover 487,000 to 598,000 more Georgians(https://www.cbpp.org/blog/georgia-waivers-at-least-as-costly-to-cover-far-fewer-people-than-medicaid-expansion). 

Isn’t it time for Governor Kemp to stop playing politics and wasting our money? And letting our federal tax money be used to expand Medicaid in NY and California? Governor, just ask the General Assembly to approve full Medicaid expansion and take the 90% Federal contribution to do so. 

Jack Bernard ​was the first Director of Health Planning for the State of Georgia and then served as an executive with several healthcare firms. Jack is a local activist, previously serving on the Jasper County Board of Commissioners and Board of Health. He's now Chair of the Fayette County Board of Health.