Medicaid Expansion in Georgia
Current State of Medicaid
Medicaid was implemented in 1967, providing Georgia’s low-income resident’s healthcare, which can include members of the AAPI community. People that are eligible for the program include people over the age of 64; those pregnant or with a child or dependent under 18; those disabled; or those with a dependent who is disabled. With the implementation and edits of the Affordable Care Act of 2010, the national uninsured rate for Asian Americans from 2013 to 2015 was cut in half, from 16% to 8%.
As of 2019, almost 1.9 million Georgians were covered by Medicaid. According to the Kaiser Family Foundation (KFF) 33,900 self-identified Asian American, Native Hawaiian and Pacific Islanders were able to receive coverage in 2018. According to the Georgia Budget and Policy Institute (GBPI), in fiscal year 2019, Georgia spent $7.9 billion dollars of federal funds and $3.1 billion of state funds on Medicaid. Despite this investment, Georgia is one of the 14 states that has not adopted to expand. The expansion would include coverage for non-disabled single individuals whose only current option is to seek coverage through their employer or private insurer. By not expanding Medicaid, Georgia is missing out on the opportunity to reduce uncompensated care, increase job and economic growth, and generally provide greater access to health coverage; thus, Georgia and its citizens lose tremendously from the decision to not expand its program.
Current State with COVID
In 2019 the Commonwealth Fund ranked Georgia 42nd nationally on healthcare system performance based on the number of premature deaths from substance abuse, the slowing of gains from the Medicaid program, and the increasing financial burdens of healthcare seen within the state. U.S. News and Reports gave Georgia a similar ranking in terms of healthcare access and overall quality. Furthermore, in 2018, the uninsured rate in Georgia rose to 13.7%. An additional 36,000 people lost or lived without insurance, indicating a weak healthcare infrastructure and a disservice amid a public health crisis.
According to The New York Times, on March 27th Albany, Georgia had the 4th highest amount of COVID-19 cases worldwide per capita; for every thousandth person, there were 1.35 COVID-19 cases. A city like Albany with a high infection rate despite its population of 153,000 is no surprise considering the structural challenges the state and rural Georgians are facing. Before the outbreak, residents of Albany and Floyd County were interviewed by the GBPI on issues concerning community and economic development, and residents of these counties expressed major concerns about limited access to adequate healthcare. One citizen said “To access care, you have to drive to the next county. You may be in the van for eight hours from medical facility to home.” Rural areas are hospital deserts, and patterns have shown those in rural areas are hit hardest during flu season.
Medicaid Expansion and Next Steps
It’s been estimated by the KFF that 267,000 Georgians fall in the Medicaid coverage gap. Meaning, their household incomes are below the poverty level but due to the current rules of the program, they are ineligible for coverage. This is the primary reason Georgia must expand its Medicaid program, as it is failing the duties of the state in providing the essential service of healthcare to its residents. Economically, the state is voluntarily forgoing billions of dollars in federal funding by opting out of expansion since the federal government is willing to pay up to 90% of expansion costs. Moreover, expansion can stimulate job growth in the health sector, bolstering the economy.
A unique challenge to be addressed for Asian American communities, which includes up to 50 different ethnicities in Georgia, are language barriers. By providing bilingual resources to facilitate health services, many more Georgians would benefit from the healthcare system. Another increasingly relevant public health concern is the conditions in detention centers, especially South Georgia, where immigrants are being detained. Conditions are already deplorable, but especially amid a public health crisis, conditions are rapidly deteriorating because of confined, shared, unsanitary spaces. During the next legislative session, it is worth exploring passing legislation that would allow emergency transfer or release of selected detainees for the safety of incarcerated communities.