By Kelly McCutchen
With the failure of the federal government to address this nation’s health care crisis, the job now falls to the states. Fortunately for the states, the Affordable Care Act (ACA) provides them broad authority to restructure federal funding and regulations through the underutilized State Innovation Waiver.
Georgia is well-positioned to seize this opportunity and serve as a model to show the rest of the nation the way forward on health care reform.
“Crisis” is an overused word, but it describes the situation for many Georgia families. Premiums for policies on the Georgia ACA exchange have more than doubled over the past four years, and they could increase by up to 40 percent next year. In exchange for these high prices, Georgians get a massive deductible and a limited network where it is difficult for the truly sick to find the specialists they need.
Health care in rural communities is teetering on the brink of collapse. Sixty percent of Georgia’s counties are down to one insurance provider, Blue Cross Blue Shield of Georgia. Many communities have lost their local hospital to bankruptcy, and almost half the remaining rural hospitals are operating in the red.
Some argue in favor of Medicaid expansion. That is an expensive option that doesn’t solve our problems. The federal government projects Medicaid expansion costs will rise to $7,436 per person, more than 50 percent higher than originally projected.
Patients struggle to find doctors who will accept Medicaid, hospitals and doctors continue to lose money on Medicaid patients, and studies show having Medicaid doesn’t improve physical health compared to being uninsured.
Most troubling of all, Medicaid expansion prioritizes able-bodied, working age citizens over our more vulnerable population of pregnant women, children, the elderly and disabled.
There is a better option, one the Georgia Public Policy Foundation has promoted for four years: a patient-centered alternative to Medicaid expansion that reinvests in primary care, fully funds safety net providers, and improves the quality of care for Georgia’s low-income citizens.
This proposal recognizes Georgia is a diverse state and would provide each community the flexibility to design a program that best fits its unique situation. And it costs less to implement.
Georgia is well-positioned to lead on reform, with a governor who understands health care far better than most and a fellow Georgian, Tom Price, heading up the federal agency that will grant our waiver. The state also has much to gain; far too many Georgians battle chronic disease and poor health.
The debate in Washington has produced positive signals. It showed conservatives willing to allocate funding to help low-income citizens afford access to health care. Conservatives also support directly funding those with serious illnesses with tax dollars instead of asking a small fraction of working-class families to subsidize those costs through higher premiums. Finally, conservatives do not support the unfunded federal mandates and price controls bankrupting our rural hospitals.
The will to begin the process is evident in Georgia. Resolutions encouraging the governor to pursue a federal waiver were introduced this year in both legislative chambers.
Heath care is an issue that concerns Democrats and Republicans, urban and rural, rich and poor. Any one of us could be bankrupted by a serious illness. Any one of us could have a loved one involved in an automobile accident in a rural community.
The solution is not in the easy answer glibly offered by some, that is, to throw more money into an already-flawed Medicaid system. The solution lies in uniting to create an innovative, sustainable approach that addresses Georgians’ fundamental challenges of affordable, quality access to care.
This commentary by Kelly McCutchen, president and CEO of the Georgia Public Policy Foundation, appeared first in the August 6, 2017, edition of The Atlanta Journal-Constitution. The Foundation is an independent, nonprofit, state-focused think tank that proposes market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the views of the Georgia Public Policy Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.
© Georgia Public Policy Foundation (August 11, 2017). Permission to reprint in whole or in part is hereby granted, provided the author and his affiliations are cited.
The Foundation’s Criminal Justice Initiative pushed the problems to the forefront, proposed practical solutions, brought in leaders from other states to share examples, and created this nonpartisan opportunity. (At the signing of the 2012 Criminal Justice Reform bill.)