Georgia’s rural hospitals continue to be in crisis as Gov. Nathan Deal has refused to bring home federal dollars to close the Medicaid gap. House Minority Leader Stacey Abrams (D-Atlanta) spoke at length with WABE reporter Denis O’Hayer about the rural hospital crisis and options available this session.
WABE Reporter Denis O’Hayer: Let’s take another issue where the Governor has certainly outlined a position and there’s a lot of pushback on it from particularly the health care community: Medicaid expansion under the Affordable Care Act. The Governor has resisted doing that, you and Democrats have pushed for it. The Chamber of Commerce and other business interests, and particularly the hospitals have pushed for, a third way if you will; negotiate something with the government that would not be Medicaid expansion necessarily or might not be called that, but would be something else that some other states have managed to do. Are you confident that can be worked out and do you think the Governor would support it?
House Minority Leader Stacey Abrams (D-Atlanta): I recognize that there have been partisan debates about Medicaid expansion from it’s inception, but I think the reality is, we are facing a critical state for our rural hospitals, for our families, for our military families who are being denied access to healthcare, and for economic development in this state. This is a jobs bill, expanding Medicaid, we can call it the ‘Arthur Laffer Healthcare Access Program,’ I don’t care.
WABE: Arthur Laffer, one of the brains behind supply-side economics.
Abrams: Exactly. And if you take his theory, if we supply to our communities, access to healthcare, if we give opportunities to our families, many of whom are working families, they go to work every day, they simply make too little to qualify for regular insurance, and make too much to qualify for the $7,000 threshold for Medicaid in Georgia, and they are left behind. We’re talking about 15.8% of our population, 300,000 to 470,000 people, who with access to healthcare insurance would be able to go to work every day and not worry about losing their jobs.
WABE: You’re not afraid though, of a cost explosion at the backend when federal contributions to this expansion would be less.
Abrams: So, the way it works is that, for the first four years, and unfortunately we’re about to miss the window, it was a 100%. The next phase it’s 95% Federal, 5% State. When that evaporates, we drop down to the terrible number of 90% Federal, 10% Georgia, so by 2023 Georgia would have to put in roughly $2.1 billion, but the return on invest is more than $6 billion a year to the State of Georgia, more than 56,000 jobs. Kia generated 3,000 jobs, and we celebrated that and spent 20-some odd million dollars to bring it here. For an actual cash return, we would get jobs, we would get healthcare, we would get hospitals that are stabilized. We’ve rural communities where if they lose those hospitals, they lose 33% of their economic development. This is no longer a partisan conversation, this is a people conversation, this is a monetary conversation, but more than that, I think that both Governor Deal and the Chamber of Commerce recognize that healthcare access has to be a priority if we want to continue to attract jobs.
WABE: Have you had conversations with leaders on the other side of the aisle about a third way, a compromise?
Abrams: We have had conversations about the importance of funding healthcare access in Georgia, Medicaid, whether we call it that or not, is the pot of money that we have to draw from, and so I want us to be very clear that there are very limited ways to fund this program. I have no problem funding it by calling it Medicaid expansion, and fully reaching the 138%. There is certainly a conversation to be had about looking at waivers. I think waivers are a difficult navigation point, but states across the country have found ways to do this. No one accused John Kasich of being a liberal, no one would say that Arizona is a liberal bastion, and they both have figured out how to do this; Indiana, Arkansas, Alabama is talking about doing this, and so I think we have to recognize that how ever we do it… And we should have a Georgia approach, we should recognize that Georgia’s differently situated, but I think what we cannot do is continue to pretend that there aren’t real consequences for people, for families, specifically we have 25,000 military families, 25,000 who are not able to access healthcare because we have refused to except the funds necessary to give them services.