Social Welfare Policy Memorandum

Policy Memorandum Brief

To:

From:

Date:

Re: Georgia denied Medicaid expansion: Policy brief on the adverse effects low income Georgians face.

Imagine you are a 57 year old adult who suddenly experiences Sudden Cardiac Death. Due to an unexplained heart arrhythmia you are now in the hospital. Just taken off of life support, you receive the news that you died for four minutes on your living room floor. Because of the daunting facts of having no insurance and low income, it is hard to focus on the main priority which should be your health. Imagine how hopeless you would feel and the overwhelming stress a health crisis like this would bring.

This is the reality that over 650,000 Georgians face every single day. If an adult is not pregnant, disabled, over the age of 65 or makes less than $12,000 a year, they will not qualify for Medicare or Medicaid. When the state of Georgia decided to not expand Medicaid to low income adults, this opted them out of being able to receive affordable insurance through the Marketplace provided by the ACA (Affordable Care Act). The Marketplace will only be able to offer low income adults a full priced policy which can cost on average $500 per month for a 50 year old. That cost of health insurance would be difficult to pay for someone who is a middle class citizen, not to mention unemployed. This is an enormous gap in the ACA that indirectly denies millions of Americans health coverage due to the high monthly costs.

Governor Nathan Deal denied the Medicaid expansion called for by the ACA because of claims that the state cannot afford the Medicaid expansion. Expanding Medicaid in Georgia will bring more than 70,000 jobs, and the state of Georgia would receive over 30 billion dollars in federal money over the next ten years. Why not expand Medicaid?

The gap of coverage in the ACA does not apply to the Strengths Perspective. The Strengths Perspective focuses on the strengths of a community, individual or group. The ACA has a lot of aspects in its policy where it values many individuals’ strengths such as accepting anyone with a preexisting condition. However, when Georgia did not expand Medicaid, it caused some adults to focus on the negative effects of having low income.

Director of Case Management at (PFH) Piedmont Fayette Hospital reported that hospitals are greatly affected negatively when low income adults do not have insurance (J. Grebeck, personal communication, December 1, 2015). Readmission rates increase due to limited resources/access to primary care physicians and medications. Mrs. Wilson, MSW mentioned that the length of stay at a hospital for an uninsured patient also increases (M. Wilson, personal communication, December 1, 2015). If a patient needs rehabilitation, the length of stay will often increase due to not being able to discharge the patient until a facility will take in the indigent patient. Lastly, budgets are stretched. The hospital often pays for indigent patient medications and personal care facilities to take care of them when it is needed.

With the Afrocentric Perspective as a frame of reference, the following recommendations were drawn in order to bridge the gaps in the Affordable Care Act:

· Accept federal funds and expand Medicaid in Georgia

· Accept monetary funds from the federal government and use those funds to help low income adults purchase policies in the private sector (Arkansas proposed solution)

An important value in the Afrocentric Perspective is unity in communities. The state of Georgia denied Georgians that sense of unity in our communities when the Medicaid expansion was denied. The state of Georgia is not helping the community by deliberately taking away access to affordable healthcare. All uninsured low income adults should have the privilege of receiving Medicaid or affordable healthcare through the Marketplace. As a result, there will be an increase in funds available to the state, unemployment will decrease due to the 70,000 job increase, and Georgia will see a positive increase in the health of low income adults. All Georgians deserve to have peace of mind knowing that if a health crisis occurred, they will be able to sustain themselves financially.

Ashley R. Smith

MSW Candidate, Class of 2016

References

Steven, C. H., Abdus, S., Julie, L. H., & Thomas, M. S. (2014). Adults in the income range for

the affordable care act's medicaid expansion are healthier than pre-ACA enrollees. Health

Affairs, 33(4), 691-9.

The Institute of Law Psychiatry & Public Policy. (2012). Supreme court upholds affordable care

act; Makes medicaid expansion optional. Developments in Mental Health Law, 31(5), 1-12.

Williams, M. (2013). Medicaid expansion critical, hospitals and MDs say. Georgia Budget and

Policy Institute. Retrieved from http://gbpi.org/medicaid-expansion-critical-hospitals-

and-mds-say