Georgia vs. Texas: Medicaid expansion could cost more than it should

Dems push Medicaid expansion for left-behind rural Georgia Share this story The U.S. House of Representatives voted along party lines March 26 to expand Medicaid for the first time under the Affordable Care Act,…

Georgia vs. Texas: Medicaid expansion could cost more than it should

Dems push Medicaid expansion for left-behind rural Georgia

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The U.S. House of Representatives voted along party lines March 26 to expand Medicaid for the first time under the Affordable Care Act, in an effort to take care of the country’s uninsured.

The vote marked a significant turning point for Georgia, which expanded its Medicaid program in 2014 to cover those with incomes up to 138 percent of the federal poverty level—or $16,800 for a family of four. Today, all 13 Georgia counties and most of the state’s 159 municipalities have expanded Medicaid, according to a Kaiser Family Foundation analysis in April.

The vote, along party lines, came only days after the U.S. Supreme Court ruled the ACA’s Medicaid expansion unconstitutional, opening the door to a state’s right to opt out and leave the federal government to pick up the cost.

“This is the most important vote in our state’s history, and I hope it sends an important message that this is a progressive state,” Democratic Gov. Nathan Deal said at the time. “And it also sends a message about what this country is about, that we care about all people regardless of where they live.”

The Georgia debate on Medicaid is of particular interest given that, in the past three years, the states of Texas and Arkansas have expanded Medicaid under federal law to help the Medicaid population get coverage at the cost of new federal tax dollars in exchange for leaving the program entirely.

In this Georgia vs. Texas scenario, Georgia could benefit from spending even more money on its program by expanding its Medicaid population to include people in counties and municipalities that are currently not covered—and therefore more expensive to cover.

Georgia could also find itself spending more money on health care not covered by the ACA—the first state to face a high court ruling that the federal law that was implemented with the ACA is unconstitutional—than it gets to spend on the program that will likely be expanded.

With the ACA already on the books, states are able to opt out of their requirements for health insurance plans to be offered under the program. And Georgia has been among the few states since the

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