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By Jack Bernard
Bernard is a retired corporate executive

They need to send that money where it’s really needed, like permanent shelter for homeless people, and providing Medicaid for the uninsured… I wish they would use that surplus on the realities that people are actually struggling with.”-Debra Saunders 

Ms. Saunders is not wealthy; she runs a day care center (https://stateaffairs.com/georgia/people-have-mixed-feelings-about-governors-proposed-tax-refunds/ ). And Saunders is correct- we have many unmet needs in Georgia that our tax money should go toward, such as Medicaid expansion. Rather than sending $3 billion back in order to ingratiate the governor to MAGA conservative voters. 

The ACA (Obamacare) has been a tremendous success throughout the nation. Low-income Americans have gotten healthcare via the marketplace and Medicaid expansion. 

In fact, there are now a record 16.3 million people who have gotten ACA coverage marketplace. That represents a 13% increase, remarkable for a program that is more than a decade old.  

However, this was due in part to the pandemic and legislation related to it, preventing states from making participant deletions during the pandemic. This provision ends in April and roles are expected to decline significantly and the number of uninsured will go up substantially.

The ACA has been a political football for the Georgia GOP for a decade. That is one of the main reasons that Georgia has the third highest number of uninsured, 1.3 million residents or nearly 13% of all Georgians. Only Texas and Florida, which also have refused to expand Medicaid, have a higher percentage uninsured. 

Further, despite what our Governor misleadingly says, the facts show that Georgia is toward the bottom of the states when it comes to healthcare. In large part, that is due to his inexcusable failure to propose full Medicaid expansion to the legislature. 

There are a multitude of organizations that rank state healthcare status/systems according to varying criteria. For example, Georgia ranks: 

• 44th per Commonwealth (https://2020scorecard.commonwealthfund.org/rankings/ ) 
• 44th per Better Benefits Guide  (https://thehill.com/changing-america/respect/equality/3687284-here-are-the-states-with-the-best-and-worst-healthcare-systems/ ) 
• 43rd per US News and World Report (https://www.usnews.com/news/best-states/rankings/health-care ) 
• 43rd per Wallethub (https://wallethub.com/edu/states-with-best-health-care/23457 ) 
• 34th per Moneygeek (https://www.moneygeek.com/insurance/health/analysis/2022-top-states-health-care/ ) 
• 32nd per Sharecare (https://wellbeingindex.sharecare.com/interactive-map/?defaultState=GA ) 

At the same time that our rankings are so low, Georgia has a $6.6 billion (that’s billion, with a B) surplus. And our Governor refuses to fully expand Medicaid, one of only 11 states (all GOP controlled) that have refused to do so, solely for political reasons, as opposed to economic ones. Instead, playing politics as usual, the Governor wants to send back money to voters, a billion plus in property and income tax refunds. 

And please do not be fooled by Kemp’s politically motivated Medicaid “waiver” which requires that Medicaid recipients work. Kemp indicates that it will add 50,000 to Medicaid. But more than 10 times that number would be added if we simply expanded Medicaid as did 39 other states, including many controlled by the GOP. 

And, the waiver is financially inefficient – “The cost per person for fully expanding Medicaid is 5 times lower than Georgia’s Medicaid waiver because the federal government pays 90 percent of the costs for full expansion and only 67 percent of costs for partial expansion.”(https://gbpi.org/expand-medicaid-fully-reject-risky-and-expensive-state-plan/ ). 

Another source states that Georgia would spend $322 million to extend coverage to less than 80,000 people via its two waiver proposals. 

But would spend only $188 to $213 million under full Medicaid expansion that would cover 487,000 to 598,000 more Georgians.

Isn’t it time for Governor Kemp to stop playing politics and wasting our money? And letting our Federal tax money be used to expand Medicaid in NY and California? Governor, just ask the General Assembly to approve full Medicaid expansion and take the 90% Federal contribution to do so.