Expanding Medicaid: The debate, the cost, the impact on Georgians

11Alive interviewed Director of Policy and Research Chris Denson during their recent series on potential Medicaid expansion in Georgia.

“Rural hospitals in particular are safety net hospitals,” Chris Denson with the fiscally conservative group Georgia Public Policy Foundation said.

The Georgia Hospital Association said they treat a higher percentage of people on Medicaid or uninsured. So, increasing the number of people with insurance will increase the amount these hospitals get paid.

People don’t have to go to a rural area to understand the impact of unreimbursed care on our community. Wellstar announced in September that it would close the Atlanta Medical Center, which houses a level-one trauma emergency room, leaving Atlanta with only one in the city. 

This move came just months after Wellstar closed the emergency room at AMC South in East Point.

Still, Denson argues that since Medicaid reimbursements are lower than the actual cost of care, full Medicaid expansion would only slow the bleed. Not cure the wound. 

As for jobs, the theory is that the more people who have insurance, the more people who will go to the doctor.

“So that’s new jobs in health care, that’s new jobs in construction and retail, in folks working in the financial and insurance industry,” Chan explained. 

But Denson pointed out we’ve expanded Medicaid several times in the past 20 years and, by his analysis, the impact on health care jobs has been mixed. Plus, coverage doesn’t directly correlate to access.

“Only 64% of healthcare providers accept Medicaid patients, and only 60% of those are accepting new Medicaid patients,” Denson said. “We currently have, I believe, 63 counties without a pediatrician and 79 without an OBGYN.”

And in those rural areas, he believes low Medicaid reimbursement rates aren’t likely to attract new providers. That’s why Kemp said he’s focused on trying to move people onto private insurance.

“Commercially insured patients, the reimbursement rate for hospitals is above cost. Most rural hospitals survive on commercially insured patients,” explained Denson.

The cost associated with commercial insurance is still too high for someone working a minimum wage to afford. One way to achieve this, Denson said, is to “increase the number of providers in a lot of our, what are known as health provider shortage areas,” forcing companies “to be more competitive.”

Access the full series at 11Alive here.

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