Georgia’s hospitals and now its powerful association of doctors say the state should expand Medicaid to cover hundreds of thousands of people who won’t otherwise have health insurance.
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What’s up in Arkansas?
The Affordable Care Act of 2010 called on the states to undertake a massive expansion of Medicaid, the government health program for the poor, to take in millions of people who have no insurance. The law provided that the federal government initially would pay 100 percent of the cost, with support gradually declining to a permanent level of 90 percent.
The U.S. Supreme Court in 2012 upheld the constitutionality of the Affordable Care Act, but the justices also ruled that Congress lacks the authority to compel the states to expand Medicaid.
Given the choice, roughly half the states refused to expand Medicaid, while roughly half the states thought it was a good idea. And then there’s Arkansas. The state this year proposed to take the new Medicaid money from the feds and use it to help uninsured, low-income people buy their own insurance on the private market. The federal government approved this approach a month ago.
So new Medicaid recipients in Arkansas will be able to shop on the federal Health Insurance Marketplace — once it actually starts working — and acquire their own insurance with the money the feds intended for Medicaid. The state says it expects to be able to extend coverage to nearly 200,000 uninsured people. Iowa has applied for a similar waiver.
Now Georgia’s doctors, as members of the Medical Association of Georgia, are on record as advocating the Arkansas approach.
Georgia said no to the Medicaid expansion. Gov. Nathan Deal believes the state cannot afford the expansion, even with the federal government paying most of the cost. A study earlier this year found that a Medicaid expansion would create 70,000 new jobs in the state and bring in more than $30 billion in federal funds over 10 years.