Medicaid $300 Million Short For Next Year; 2014 To Be Worse

The AJC is reporting that Georgia’s Medicaid funds are facing a $300 Million shortfall for next year in addition to being $90 Million short this year:

The state Department of Community Health plans to ask the state legislature for roughly $308.2 million to make up the gap for fiscal 2013, Vince Harris, the agency’s chief financial officer, told board members.

The health care program is also looking at a $90 million deficit for the current fiscal year. That accumulated in large part because the state legislature did not allocate funds for the final month of payments to three for-profit companies that manage care for primarily low-income kids and moms in Medicaid.

So, that’s “not good”.  And it gets worse.

The looming deficit comes at a time when the state health agency is also facing the addition of another 600,000-plus Georgians to its Medicaid rolls starting in 2014, as part of the program’s expansion under the health care law.

“The budget numbers that we have are very daunting,” Commissioner David Cook said.

Add this to a growing list of issues facing Georgians that need real leadership.  Instead, we’ll likely get press releases blaming illegal immigrants or gay marriage, followed by a referendum asking for a tax increase to fix the Medicaid funding gap that continues to grow.

 

56 comments

  1. View from Brookhaven says:

    They’ll loudly shriek about Obama and DC Democrats ruining the country…while quietly begging the same people for additional federal funds.

  2. Jackster says:

    I predict a MED-SPLOST. A list of procedures and facial improvement projects which have been hand picked by the healthcare lobby will be presented state wide for a 2% sales tax on all consumption.

  3. John Konop says:

    What I find ironic is social conservatives are pushing stronger laws to create more low income babies from teenage mother that use this program (abortion bill). And they are against end of life directives that would save money on the elderly portion. While at the same breath they want to cut out coverage for the above people. As I said many times, most in the pro-life movement are just pro-birth.

    • SallyForth says:

      Amen, John! And the knuckle-draggers are now pushing a similar abortion bill in Michigan (guess they have a Medicaid surplus to cover all the associated costs?). I loved what the female legislator up there said from the well today, “Why are you so interested in my vagina? No means No!” That made me stop and think – it truly is flat out wrong to pass laws that force any female to let her vagina be used for ANY reason (whether intercourse or childbirth) to which she says “No.” And never mind that pregnancy involves even more, literally a woman’s whole body.

  4. Three Jack says:

    Simple solution, opt out of the non-mandated Medicaid program. Then tell the 1.7m freeloaders taking advantage of the other 6.3m Georgians that either they start earning their way or go find another state to get your handouts. This will have the added benefit of saving money in a slew of other redistribution programs including Peachcare, WIC, and so on. Then re-allocate the savings to transportation needs thus eliminating the need for TSPLOST!

      • I Miss the 90s says:

        Kidding or not, John is simply taking your beliefs to their logical conclusion.

        As much disdain as I have for conservatives I am still willing to chalk most of the policy whacky-ness up to ignorance and the failure to think policy propositions through.

        • Jackster says:

          No, i was replying to three jack – the post just gets added in order. From the get go I have classified this federal “cost saving” measure of obama care as nothing more than a cost shift, with no real improvement to the situation.

          • John Konop says:

            Obamacare in general does not deal with major issues like Medicare Part D, Medicade, Medicare……..The public option concept would help small businesses and individuals save about 20 percent. But neither party is really willing to take on an aging population of voters who will bankrupt the country if we do not take on the above issues. At the end of the day to many voters want the service without dealing with the reality of what we can afford. Also the healthcare lobbyist have overtaken Washington ie Medicare Part D in which we could solve overnight. Intead of tax payers paying for 75 percent of the cost for drugs on an inflated price, why not let seniors buy the drugs at the VA for a 60 percent discount. If you combined irrational policy that favors a pay for policy system with some cuts we could solve the problem.

            • Three Jack says:

              Nope, not kidding. It’s time for some personal responsibility in this country…you have a baby, pay for it. You get sick, pay for it.

              Amazing that my position of self reliance is considered ‘whakyness’ while it is now normal to expect redistributed handouts from earners to freeloaders.

              John, your extreme reply about death has been rebuked multiple times on this site…no need for me to do so again.

              • John Konop says:

                If special needs, elderly and children do not have the money if they get sick what do you think would happen under your plan? You realize the county hospitals are exploding with uninsured people already seeking healthcare. Please do not give the charity BS….between no network set up, lack of money, no reasonable locations……….it would lead to a massive…..

                • Three Jack says:

                  Where is the money coming from to pay for all these ‘needy’ folks John? We already face a $300M deficit despite providing 12% of the annual budget for Medicaid. Do you support a massive tax increase to cover freeloaders? The FSPLOST maybe?

                  • John Konop says:

                    I have been very clear what I support to lower the cost ie from dial a doc, buying drugs from the VA, self insured public exchanges, promotion of home healthcare over nursing homes for seniors when appropiate, end of life directives……….I do think if the above was implemented it would fix a large part of the problem.

                    Unlike you letting children, elderly and special needs people die in the streets is not an option.

          • Cassandra says:

            I dedicate the song “Can I Get a Role Model,” by the Dangerous Idiots to YOU, Three Jack:

            http://www.myspace.com/music/player?song=http%3A%2F%2Fwww.myspace.com%2Fdangerousidiots%2Fmusic%2Fsongs%2Fcan-i-get-a-role-model-40-clip-41-82669098

            I hope that you have a chance to actually learn how good Americans, some of them actually Republicans, can get sick – through no fault or choice of their own, exhaust their costly medical insurance, become unable to work, spiral down into medical bankruptcy , be forced to sell all that they worked so hard to achieve by making good choices, at ‘fire-sale’ prices, and finally join all the others luxuriating on the public dole of Medicaid.

            You Sir, are a real pipperoo.

            • Three Jack says:

              Cassandra writes, “get sick through no fault or choice of their own…” before laying out her tale of woe. Yea darlin, obesity, smoking and other unhealthy lifestyle choices surely are not the fault of any individual. Therefore it is society’s responsibility to care for the irresponsible.

              Maybe you and John should form a handout 501c3 organization to take care of all these poor, helpless, ‘no fault of their own’ sick folks currently bilking taxpayers. That would be the American way, at least in the America I remember prior to LBJ and all the do-gooders screwing things up.

              • rrrrr says:

                Dear Three Jack what would your response be to one who experienced that tale of woe you mock BECAUSE our GOVERNMENT allowed ILLEGALS to drive on our roads causing fatal / near fatal accidents?

                Don’t pass this off so lightly, it’s happened to THOUSANDS right here in GA. Some would like VERY much to go after those who allowed this to occur BUT we are unable to, as they are granted GOVERNMENT protection.

                • Three Jack says:

                  rrrrr, It’s a damn shame when anybody has a wreck no matter the nationality of drivers. But that still does not mean society should be forced by government to pay for the victims medical treatment.

                  • Calypso says:

                    TJ, I understand where you’re coming from, but by your definitions of all the things ‘society’ should not do, at what point does ‘society’ fail to exist.

                    • Three Jack says:

                      Society fails to exist when freeloaders fully expect earners to pay for their very existence. Greece, Spain and Italy are finding out what will eventually happen here if we don’t get a grip on redistribution of wealth. Society falls apart, financial meltdown follows.

                    • Calypso says:

                      Perhaps I phrased my query poorly, or I’m not following your answer.

                      I guess I should have asked, “TJ, I understand where you’re coming from, but if ‘society’ never did any of the things you say ‘society’ should not do, at what point does there cease to be a need for ‘society’ and the things which a ‘society’ is normally expected to be/do?”

                      I understand your follow-up about society falling apart when the system melts down, but I’m interested in hearing from you what you think the function of a ‘society’ is.

                    • Three Jack says:

                      Calypso,

                      Society by definition — ‘a voluntary (emphasis added) association of individuals for common ends’.

                      Key word ‘voluntary’ as opposed to forced which is what we have when government in its current form controls who gets what and who pays for it. Society can no longer exist when contribution to it becomes mandatory. Additionally ‘society’ is non-existent when charity is replaced by government redistribution.

            • Three Jack says:

              One more thing Cassandra/John since you guys want to layout sob stories about the unfortunate ‘no fault of their own’ victims of life, what about the families forced to pay for those downtrodden souls. Say a teacher and cop with 3 kids see a big tax increse to cover the $300M+ Medicaid shortfall. This family is already struggling to make ends meet and truly have no fault in their plight. But here comes the do-gooders with Cassandra and John leading the way to extract more $$$$ from their paychecks. The result; this family falls into poverty ‘through no fault of their own’ and end up seeking food stamps to cover basic expenses. Eventually they end up losing their house in foreclosure so move into section 8 apartments with inherent high crime rates.

              In your world, you punish those who take responisibility for themselves so that eventually they end up needing the government to support them. A never ending vicous cycle of doom orchestrated by do-gooders, then administered by government. That to me is the whacky position.

              • Big tax increase to cover $300m shortfall. Dude what are you smoking. $300,000,000 / 10,000,000 Georgians = $30/person/year.

                I love it how on the one hand conservatives lecture everyone about a profit motive (which I 100% subscribe to by the way) but then on the other hand would have you believe that that same profit motive wouldn’t apply and the cop/teacher would foregoe tens of thousands of dollars in additional income so they could avoid paying $150/year in extra taxes and go live in section 8 housing.

                Keep smoking that pipe.

                • Three Jack says:

                  What am I smoking? Apparently not near as good as the green in your bowl Chris.

                  First show me where 10m Georgians pay income tax.

                  Next using your (il)logic, let’s just keep adding additional taxes as long as the amount doesn’t exceed $30 per person, per increase. That’s not real money, just a small pittance to help the downtrodden. Typical liberal reaction.

              • John Konop says:

                Irronically the war on drugs is the top reason for the increase in the underclass. 53 percent of people in person are in for non-violent drug related crimes. This has created the following issues

                Convicted fellons in most cases cannot find a good job via record.
                Convicted fellons cannot contribute enough for child support
                Convicted fellons has difficult time getting higher education via record
                Convicted fellons gets education on crime in prison
                Convivted fellons contributes next to nothing while serving

                The above issue combined with teenage unweeded mothers is the largest factors behind welfare. And one could argue the drug laws contribute to unweeded mothers.

                • Calypso says:

                  “…unweeded mothers…unweeded mothers.”

                  John, I don’t think the unWEEDed mothers are the ones running afoul of drug laws, I believe it’s the WEEDed ones;)

                • seenbetrdayz says:

                  One of the things that surprised me was Deal when he talked about prison reform, over-crowding, etc. I was half-expecting him to go off on a tangent about non-violent crimes, which would have been something most of those people at state convention might have benefited to hear from someone in a position of influence. But, he stopped short. ‘Prisons are just overcrowded, I guess, for no reason.’ Georgia has one of the highest incarceration rates in a country with one of the, if not *the*, highest inmate populations in the world.

                  I’m all for looking at ways to get people to pull themselves up by the bootstraps, rather than locking them up for a few years on mere possession charges, then letting them out so they go right back at it.

  5. seekingtounderstand says:

    Three Jack then the republicans could not pass on the cost of their workers to the tax payer.
    The whole idea is to have cheap labor for friends and passing on the true costs to support those workers on to you and me.

    • I Miss the 90s says:

      Because the GOP cares more about private profits than human lives…we all know this to be true, but we simply do not talk about it.

      The “big government” crap is a facade (literally, the government gets no larger and the costs of the reform are very low), just like the idea it is a jobs-killer (which the GOP is now ceding given the wealth of new data showing costs decreases, job creation, and a lowering of retirement costs all directly attributable to the health-reform law). The GOP is simply worried that their investors’ bottom line will be cut into by shifting focus to coverage and fairness rather than profits (face it, rescinding policies when they are needed is wrong…but it saves a lot of money at the expense of a human life or another bankruptcy).

      • John Konop says:

        Both sides have their hands all over this mess. The left is unrealistic via the cuts. The right is just as bad via the revenue side. And both sides have sold out to the medical lobby. The social conservatives are only adding to the problem with very liberal view of end of life care and promoting teenage unweded mothers. We need some real adults in the room not…..

  6. saltycracker says:

    Is it too difficult to glean the system of fraud, bs litigation, over testing, luxury perks like electric wheelchairs for the obese, able bodied career moochers or set provisions a panel of docs would reject ?

    Medicaid is overused to the detriment of those it should be intended for.
    Turn on your TV and wait for the next ad.

    • saltycracker says:

      P.S. A month ago I asked the head of a hospital group what was her view to reduce their costs:
      #1 Tort reform

      She did have some stories on extremely costly illegals but I’ll leave those out so Charlie won’t get upset.

      • I Miss the 90s says:

        We did the tort reform thing here is GA and it has done nothing but make the cost of bringing lawsuits against bad doctors too high. That hospital group’s lobbyists convinced them tort reform would save them money…it hasn’t. Or they are lying to you. As it stands, in GA, hospitals do not get sued successfully. Why? Joint and Several Liability. Not to mention the near impossibility of filing suit in federal court.

        It is a non-issue designed to distract your attention and would save fewer than $10billion in the healthcare industry (a multi-trillion dollar a year industry) annually. The frivolous lawsiut non-sense has not been an issue for thirty years.

        Just ask the 12 children whose circumcisions were botched by a drunk doctor at Northside Hospital four years ago. The doctor was fired and declared bankruptcy…preventing those boys from ever receiving justice of any kind. Why did this happen? Malpractice insurance is usually a benefit that doctor’s receive from our employers. The company (or hospital if you work in a hospital) holds the policy…and if you need to make a claim because of serious malpractice they can simply fire you (in which case you are no longer covered and must pay-out damages from your own savings). This is further exacerbated in right-to-fire states like GA. These states privilege the super-wealthy’s profits over justice for anyone else. Take the right-to-fire, GA’s version of Joint and Several Liability, and a cap on awards…and it is suddenly too costly for plaintiffs attorneys to even bother filing malpractice suits in GA.

        Over-testing is simply a way doctors can charge for more services, it means nothing in the courts in GA or other tort-cap states. They have nothing to worry about so it is not as if they are covering their @$$es.

        The tort-reform non-sense is amongst the least honest claim ever made by the GOP…and it is easily to most unjust.

        • saltycracker says:

          I passed on her comment as I was expecting a different ranking.
          I have no idea of her party of choice.
          I thought Ga overturned the tort reform law. If so there might be something to the employees position that there might be a better way to punish for the screwups.

          All I can find on Northside hospital circumcisions is multi-million dollar payouts.
          The docs ordering excessive tests at her hospital were self serving only from the aspect of fear of hovering attorneys, not personal profit.

          • Well you have to understand that doctors are extremely biased – tort reform is about the only reform out there that benefits their bottom line 100%. They have an instinctive aversion to many other reforms that have to deal with cost control, bending the cost curve, giving other people access to healthcare at reduced costs etc because it might mean $300k a year instead of $400k a year. Do I blame them? Nah, but still you have to keep that in mind.

            In fact, if you look at the history of when “tort reform” started becoming a “problem” it was in the late 90’s when the Patients Bill of Rights and other pro-consumer/doctor reforms started gaining traction. The insurance companies realized that doctors and healthcare consumers were starting to team up against the insurance companies and so they collectively started raising premiums and “awareness” about tort reform as a way to drive a wedge between consumers and doctors, putting the doctors back on the side of the insurance industry instead of the patients.

            So take it all with a huge grain of salt. Ironically this country has too many lawyers and not enough doctors – the doctors have done a better job of reducing access to medical schools, teaching hospitals etc. A lot of recent law school grads are making much less than they thought because of a glut of supply – meanwhile most specialists are still in line to make half a million dollars a year while there aren’t enough primary care doctors making mid $100s (about 3x the average starting salary of a new lawyer, btw). It’s pretty easy to fix this problem and btw Obamacare does start to address this with community healthcare initiatives and whatnot.

            • saltycracker says:

              The liberal world of no reform would cripple private practice and drive Docs to work for govt entities or at least big hospitals and large corporate groups. In turn making a bigger business of the litigation world.

  7. Harry says:

    If DHR employees and others were given the proper tools and support, the amount of welfare fraud could be greatly diminished.

  8. I Miss the 90s says:

    You know, we can get around all these SPLOST measures by simply raising and reforming taxation in GA.

    It will require the admission that conservative tax policy is fundamentally incorrect. Tax cuts do not attract business like the GOP pretends it does. Tax cuts do not generate revenue.

    More importantly: GA in 2012 is not GA in 1950. We have a far more diversified economy and a much larger population.

    I know you people tend to hate government, and in the US hating government literally means that you hate yourselves, but government can work if you allow it. Adequate funding is always step one. Our transportation system is failing because the state can not afford to maintain it, let alone upgrade it…and it needs upgraded (we have a transportation infrastructure that can hardly support half of the population). Cobb and Cherokee County residents need to get over their racism and begin welcoming a MARTA expansion (e.g. light-rail).

    Schools are underfunded, which is another way of saying that GA’s teachers are, on average, scraped from the bottom of the barrel (good teachers cost more money than bad teachers).

    Really, if we fix those three things GA will be in good shape and Medicaid short-falls would not be much of a concern.

    You all know me as a liberal…and I am. Unfortunately, or not, welfare programs are mostly federal and education policy is primarily a state matter. Our legislators and party activists need to stop thinking in terms of the next quarter and start focusing on the next quarter century. Smart people do not need welfare and medicaid. The idea that education begins in the home is important, but the fact remains that a substantial number of children in this state have stupid parents (and stupid parents tend to raise stupid children)…and this is not confined to the inner city like most PP commenters pretend.

    The idea that education begins at home discriminates against all of those children whose parents do not value education and/or are not educated enough to help with their children’s homework.

    I am sure research has been done on this, but I am willing to bet that a high-school education decreases the likelihood of ending up on welfare several-fold. Take care of the education system now and welfare will not be as much of a concern in the future. Raise teacher starting pay to attract good teachers, start laying off the rent-seeking older teachers that merely occupy the classroom, upgrade technology in rural school districts, and most controversially start stripping local school boards of some of their authority. We do not have teacher’s unions in GA, so a lot of this will be easy. The second biggest inefficiency in GA education, however, is the amount of power local school boards have and this will be political difficult to deal with. Sure, there are some good school boards…but not all school boards are created equally. I am willing to bet that for everyone effective local school board in GA there are dozen that make their students worse-off.

  9. seenbetrdayz says:

    I guess we’re going to do everything we can to save Medicaid, before it inevitably collapses.

    • saltycracker says:

      Yes since the Feds pushed major corps out of primary coverage for retirees they won’t be taking it back.

      No problem with individual mandate if the gates of competition were open and the Feds got out of the way.

      • seenbetrdayz says:

        I just meant that having politicians manage a program where they can simply expand coverage to ‘buy’ votes is doomed to fail from the get-go.

        I’m surprised Medicare/Medicaid actually made so far without crashing.

  10. Three Jack says:

    Here is a report about Florida’s Medicaid Reform Pilot program — http://www.heritage.org/research/reports/2011/11/floridas-medicaid-reform-shows-the-way-to-improve-health-increase-satisfaction-and-control-costs

    It still functions as a redistribution system whereby earners support freeloaders, but at least it involves the private sector and saves hundreds of millions over their previous system. Not the best solution (end Medicaid), but it is a solution that Georgia should explore.

    • John Konop says:

      You do understand that is very similar to what I have been advocating for years? Also that a public exchange could achieve much of what is in the plan with even more options, and be used for all of us. The estimates show that we would all save about 20% on healthcare. In a public exchange you can design your own plans and even create a self insure pool. Basically it is a carrot and sticks approach with cafeteria style benefits, that allows small businesses and private individuals to team up for buying power.

      • Three Jack says:

        John,

        Private exchanges maybe, public exchanges no way. Note I only posted that link as an alternative to Georgia’s current methodolgy…I do not support this as a long term solution. America did OK without Medicaid for almost 200 years and will eventually be forced to end the bankrupt program. It is not sustainable.

        • John Konop says:

          HUH, a public exchange uses private companies? A public exchange allows individual to set up in groups as a large buying group like a large corporation. The reason small business and individuals cannot do it now is the pools are too small. But they would still buy re-insurance, medicine……….from the open market, just have better leverage and more options.

          • Three Jack says:

            John, We’ve had this discussion multiple times where I have provided examples of successful private health insurance exchanges. I look to reduce the scope of government if a viable private alternative is available. It would seem you prefer government becoming even more involved in our lives through control of the healthcare system. You and I will continue to disagree on this topic.

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