Deal’s Decision to Not Expand Medicaid Could Cost GA $33.7 Billion

August 14, 2014 13:37 pm

by Ed · 12 comments

Creative Loafing has news that Governor Deal’s refusal to expand Medicaid could cost us a ton of money. 

Georgia was set to be the fifth-best paid state in the nation from the federal government–if we expanded Medicaid. That’s according to a new report from the non-partisan Urban Institute. A whopping $33.7 billion in funds were set to line our coffers. Georgia would have had to pay $2.5 billion over 10 years to expand Medicaid.

Perhaps underplaying the impact slightly, the report says “Medicaid expansion thus offers significant state-level fiscal and economic benefits, along with increased health coverage.”

If you want to read the nine-page, not-as-dense-as-you-might-expect report, head over to CL‘s website.

Three Jack August 14, 2014 at 1:46 pm

Lost me right here – “non-partisan Urban Institute”. About as bad as a xenophobic GOPer starting a diatribe about immigration with the word ‘amnesty’.

notsplost August 14, 2014 at 3:08 pm

It’s too bad we have to keep hearing this tired old nonsense.

First off, there is no such thing as “free money.” That money has to come from somewhere – either from taxes or borrowing with interest. The idea that Georgia is somehow losing out on some kind of windfall is ridiculous. Every dollar that comes into existence has to come from somewhere, whether it is taxes, treasury borrowing or the Fed hitting the Alt-P key.

Even the latter has consequences, like higher food prices. Which, ironically, hit the audience for Medicare expansion (the truly poor and indigent) the hardest.

To the extent that expanding Medicaid exceeds the funding for the program through payroll taxes, it is just another unfunded long term liability. That liability will come home someday. Along with all the other unfunded mandates and ridiculous can-kicking policies coming from our DC clowns.

Another equally valid way to look at it would be, Deal’s decision not to expand medicaid could save U.S. taxpayers 33.7 billion.

Chris Huttman August 14, 2014 at 6:27 pm

You have mixed up MedicAID and MedicARE not only in your spell check but also in how each program works, who it targets, and how it is funded so badly that it’s really laughable that you even think you have a valid opinion on this.

One place you can start doing your research: Medicare is funded by payroll taxes, Medicaid is not.

notsplost August 14, 2014 at 9:48 pm

Well typos happen, I am sorry for that. Medicaid is not funded by payroll taxes. You got me there if it makes you feel any better.

The money does have to come from somewhere, though. Whether it is payroll taxes or income taxes there isn’t much of a distinction, and the reality in these days of $500 billion deficits is that the money is likely borrowed, either from abroad or from the Federal Reserve.

The false premise here is that we’re somehow losing out to other states. Every state takes in massive amounts of Federal money, much more than payroll, income and other taxes they send from their citizens. That’s how we got to a $17 trillion debt. Think Lockheed, Savannah port dredging, and all the pork Saxby Chambliss and Johnny Isakson ever brought home.

Perhaps we’re not the worst in the nation in terms of leeching off the China/Fed loan machine, but is that a title we really want to aspire to?

If every state were limited to spending only those federal dollars that originated from that state, the massive cuts required would make the sequester look like spare change in your love seat cushions.

FranInAtlanta August 14, 2014 at 5:46 pm

The money is coming from us and going to other states. Not smart on the surface.
However, as difficult as it is for the very poor to find a doc that takes Medicaid, can the money even be spent?
Also, I keep hoping that those in the next step up from current Medicaid can at least choose to take the supplement (if that is available after the courts finish with the current skirmish).

Chris Huttman August 14, 2014 at 6:32 pm

Has anyone considered that part of the reason it is hard to find a doctor that takes Medicaid is because people currently bounce on and off Medicaid. One month they may be able to pay and the next month they could be off. Especially when you consider that in Georgia once you make more than about $3k per year you’re no longer eligible.

Compare that to Medicare – once you’re on it you’re on it. Steady customer base. Easy to predict who will be able to pay (everyone) and what they will be able to pay (same amount). Doesn’t seem to me like it’s that hard to find a doctor that takes Medicare.

Though I don’t claim to be an expert on this matter, I would imagine that Peachcare dental coverage pays less than what private insurance or out of pocket people pay. That doesn’t seem to have prevented an entire industry of providers springing up to serve that market/take the money.

Right now if you’re a GP and you want to take Medicaid patients, your average prospective patient might be able to pay this month, maybe not next month etc. Make it consistent and I guarantee the market will find a way to deliver care to this group of people.

Rich August 14, 2014 at 6:56 pm

Medicaid would have been a win-win for everyone except Obama haters, whose votes Deal depends on. It mirrors the childish dysfunction in Washington with representatives choosing not to play ball at the expense of others. It would be nice if enough are paying attention to set things right in November.

Bobloblaw August 18, 2014 at 9:58 pm

$33.7B gives you an idea of how much taxes will have to be raised once federal funding ends.

Chris Huttman August 18, 2014 at 11:42 pm

Why would federal funding end? Has it ended for the military, social security, medicare, the existing medicaid program, transportation, etc?

I believe the $33.7B is a 10 year number, 3.37B/year, 90% fed, 10% state = $337m, 10m residents = $34 per person per year. Brother can you spare a dime?

Bobloblaw August 19, 2014 at 7:12 am

Federal funding for medicaid expansion is slated to end in 2016 or 2018.

saltycracker August 19, 2014 at 8:47 am

How much is it @ divided by the number of taxpayers paying into it ?

notsplost August 19, 2014 at 9:42 am

Federal funding for Medicaid expansion could disappear in the future, although I hadn’t heard it was slated to end as soon as 2016 or 2018. The story I heard was that it would go from 100% to 90% at that time. If it’s subject to the annual budgeting process there are no guarantees on what a future Congress may do.

However if you look at the CBO estimates for the deficit and how it is predicted to rise again at the end of the decade, combined with the fact that Medicaid outlays have predictably exploded this year, it is easy to envision another recession/fiscal crisis putting the Federal funds on the chopping block.

Which would leave states that took the carrot looking pretty stupid, and make Deal look pretty smart.

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