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Troup County, Southern states and Medicaid

By Jack Bernard

Bernard is a retired corporate executive.

“Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.” – Proverbs 19:17

“But if anyone has the world’s goods and sees his brother in need, yet closes his heart against him, how does God’s love abide in him?” – 1 John 3:17.

Georgia currently has a 15.7% uninsured rate for those under 65. Troup County’s rate is almost as high, 14.3%. (https://www.census.gov/quickfacts/fact/table/muscogeecountygeorgia,GA/HEA775218).The national rate is only 8.5% (https://www.census.gov/library/publications/2019/demo/p60-267.html). 

 A recent column on Southern States and Medicaid expansion in Modern Healthcare magazine, an industry standard bearer, was highly informative regarding coverage: 

https://www.modernhealthcare.com/medicaid/after-victories-other-states-medicaid-expansion-revisited-mississippi

As it pointed out, 8 of the 12 states which have yet to expand Medicaid to cover more of the poor are in the South. They are Georgia, Alabama, Mississippi, Tennessee, South Carolina, North Carolina, Texas, and Florida (note: Only Florida and Mississippi provide for a referendum on the issue, which will almost certainly pass with a majority in every one of these states). 

I find it incredibly hypocritical that the Legislatures and Governors in each of these states have not already expanded Medicaid. After all, the South and Southwest are the most religious areas of the nation (https://news.gallup.com/poll/232223/religious-regions.aspx).  

Of the 50 states, here’s how the above states rank in religiosity: Georgia-8; Alabama-1, Mississippi-2; Tennessee-3; South Carolina-6; North Carolina-10; Texas-11; and Florida-22. (https://worldpopulationreview.com/state-rankings/most-religious-states). So, 7 of the 8 states choosing not to expand Medicaid to cover needy low-income people are among the 11 most religious states. 

So, what are the numbers of insured here and where does Georgia stand versus other states? Let’s start with some history. Georgia’s rate of uninsured was at 19% prior to the Affordable Care Act (ACA, Obamacare) over a decade ago (https://www.kff.org/other/state-indicator/total-population). It did fall substantially, as did the uninsured rate in every state. However, the 38 states which chose to expand Medicaid coverage dropped much more than those that did not, including Georgia.  

Currently, almost 16% of Georgians remain without insurance, whereas the rate for the nation is less than 9%. Of the 50 states, only Texas has a higher proportion of uninsured residents. Georgia is the 8th most religious state and Texas the 11th

These 1.4 million white, black and brown Georgians reside all over our state, in rural, suburban and urban areas. Many are the working poor, either self-employed or working in small businesses which do not provide coverage. 

Instead of simply expanding Medicaid (with 90% paid for by the Federal government) to cover the maximum number allowed under Federal law, Governor Kemp has unwisely chosen to submit a very limited “Medicaid Waiver” to CMS/DHHS (for more, see https://healthyfuturega.org/ghf_resource/outnumbered/). This waiver, currently being considered by CMS, would permit the state to expand the Medicaid program on a highly fragmented basis, covering much less of the uninsured than under a simple expansion.  

During the state comment period (11-4-19 to 12-3-20), 88% of the comments received were negative whereas during the federal comment period (1-8-20 to 2-7-20), 92% of the comments were negative. Commenters wondered why our Governor ignored the will of his constituents and chose not to cover Georgians to the maximum degree possible under the ACA. 

Although I’m not a religious person myself, I believe in following many of the more compassionate teachings contained in the bible. Obviously, our Governor and Legislature… and the Legislatures and Governors in all of these 8 states… must not.