This commentary originally appeared in the Atlanta Journal-Constitution on September 6th, 2012.

By Cindy Zeldin

Nearly 2 million Georgians are uninsured; that number is among the highest in the nation.

Georgia policymakers have long recognized this problem as a tragic reality for the one in five Georgians who struggle to access medical care when they need it, as a strain on our state’s health care delivery system, and as a weight on Georgia’s economy.

Until now, however, they haven’t had the tools and resources to comprehensively address it.

What has changed?

The Affordable Care Act  put in place a basic framework to ensure that all Americans have a pathway to affordable health care coverage. This framework has three key components. First, those of us who get health insurance at work as an employee benefit will continue to do so.Second, new health insurance marketplaces, or “exchanges,” will come on line in just over a year to help consumers who don’t have employee coverage at work find an affordable health plan that meets their needs. Third, a new category of eligibility for Medicaid was created for the lowest-income consumers, many of whom work in low-wage jobs that don’t come with health insurance, yet earn too little money to afford a private health insurance policy.

In June, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act but ruled that states could choose whether or not to implement that third component, the Medicaid expansion.

Covering the lowest-income uninsured through Medicaid will provide access to basic prevention and treatment services that uninsured Georgians lack today. A landmark study published last year by the National Bureau of Economic Research found that people who gained coverage through Medicaid were more likely to access preventive services and have a usual source of care than their uninsured counterparts. A study published in the New England Journal of Medicine found that states that expanded Medicaid saw lower mortality rates, even after taking into account a range of other factors, than their neighboring states who did not.

In other words, if you want to improve health care outcomes, expanding Medicaid is a proven way to accomplish this goal.

The benefits to Georgia of expanding Medicaid go far beyond the 650,000 uninsured Georgians who stand to gain coverage. Because the Medicaid expansion is financed almost entirely with federal dollars, an infusion of resources will be pumped into our state’s health care delivery system.

If Georgia expands Medicaid, we stand to draw down approximately $14.5 billion in federal funds over the six-year period between 2014 and 2019, according to an analysis by the Urban Institute. In fact, Georgia taxpayers are already contributing towards the cost of the Medicaid expansion. It’s just a question of whether some of that money comes back to Georgia or whether we leave it on the table and allow it to be diverted to other states.

Last week, Gov. Nathan Deal announced that he did not intend to move forward with the Medicaid expansion, expressing concerns about the federal government’s long-term fiscal outlook. Just last month, states received word that they have an important element of flexibility: They can implement the Medicaid coverage expansion and, after a few years, if it isn’t working for them, they can withdraw.

There is no reason why Georgia can’t take advantage of the tools and resources before us to invest in our state’s health care economy today  and revisit our participation periodically to ensure that the federal government is meeting its end of the bargain and that the program works.

We have an unprecedented opportunity to improve the health of Georgia patients and consumers, strengthen our state’s health care delivery system, and bolster the state’s economy by moving forward with the Medicaid expansion.

Georgia policymakers should seize the moment and invest in our future.

Guest Blog By Benjamin Nanes

Grady Memorial Hospital’s decision to close its outpatient dialysis clinic has brought protesters to hospital board meetings, sparked a lawsuit, and generated headlines across the country. The clinic’s patients, mostly undocumented immigrants who cannot get regular care elsewhere, will be forced to leave Atlanta or to seek care through emergency rooms.

They will face delayed and inadequate treatment, spend more time in hospitals and die sooner.

It’s a dramatic story, but the closing of Grady’s dialysis clinic is only one symptom of a larger problem. Grady is in trouble, largely because the state and county governments, while claiming to support the services that Grady provides, have failed to support the hospital financially. That needs to change. Without adequate funding, Grady will be forced to cut more services, leaving even more people without the medical care they need.

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