Last week, the Georgia Chamber of Commerce released their policy alternatives to expanding Medicaid, but unfortunately, their proposed solutions all show a lack of understanding of what living in poverty means.
The Chamber’s policy proposals, not surprisingly, include an emphasis on “personal responsibility,” in calling for the folks who are in the Medicaid coverage gap — mostly very low-income, childless adults — to be required to share costs of co-pays and deductibles.
Their proposals also represent ongoing efforts to snub Obama and the federal government, and insist on a conservative “solution,” because it’s more important that your side is right than making sure that Georgians have access to healthcare.
It’s unfortunate that this needs to be said, but I would like to point out that living below 138 percent of the federal poverty line — or about $16,000 for a single adult — means that your are poor. Poor as in: do not have “extra” money. It means you pay rent, pay your utilities, pay your cell phone bill and then don’t have any other money. More accurately, it means you pay rent, pay a single utility bill, and hope your job stops cutting your hours so you can make enough next paycheck to get “caught up” on the essentials you couldn’t cover with this paycheck.
Just making sure that’s clear because any Medicaid expansion alternative that requires poor people to magically come up with “extra” money for co-pays, deductibles or health savings accounts seems to fail to grasp what living in poverty means.
The Chamber’s proposals even make sure to include a statewide expansion of the work requirement to qualify for SNAP (colloquially referred to as food stamps). Already this requirement will impact about 15,000 Georgians across more than two dozen counties by January 2017. You know how people get healthier? It’s certainly not by cutting people’s ability to buy fresh fruits and vegetables or obtain a modicum of food security.
The Georgia Chamber of Commerce commissioned a task force to study the Georgia landscape for nine months and come up with their Medicaid expansion policy alternatives. During this time, the Chamber seems to have reached the same conclusions that Medicaid expansion proponents have been advocating for for a long time.
For instance, they establish that it makes the most sense to “take advantage of all federal dollars available,” (we missed the window to have 100 percent of the cost of Medicaid expansion borne by the feds, they now will only cover 95 percent), reiterate that Georgia has one of highest uninsured rates at 16 percent of the population and emphasize the need to stabilize rural hospitals and other rural healthcare infrastructure.
One of the proposals, bound to be the most contentious, doesn’t even cover everyone in the Medicaid coverage gap. It would only cover folks making up to 100 percent of the federal poverty line. To be clear, any alternative plan to actually just expanding Medicaid would require approval from the federal government — that’s how the 1115 waivers work.
All three of the Chamber’s proposed alternatives rest on the idea of providing the “skinniest” possible benefits package. Because actually having access to health care — and thus actually being able to manage chronic health conditions and see doctors before medical conditions become medical emergencies — would be the pits. Really the worst.
Medicaid expansion advocates (and Sen. Renee Unterman) have called the proposals “encouraging,” and a sign that business leaders and policy makers might start to take seriously the problems lack of access to health care is causing for low-income people and our crumbling, but vital, health care infrastructure.
However, Medicaid expansion is already a sensible policy to address all the problems the Chamber’s alternative plans do — all without having unrealistic expectations of what living in poverty actually means.