Most headlines after the June 28, 2012 SCOTUS ruling allowing the individual mandate in the Affordable Care Act to stand as constitutional led every news outlet. What may have been lost in all the hoopla was a critical point—a point that 26 states, including Georgia, sued the federal government in an effort to emphasize its importance. These states challenged the constitutionality of the federal government’s ability to force states to expand Medicaid. If not, grants would be withheld until the states were in compliance.
These states argued that it would create an unfair burden on their fiscal budget. The SCOTUS agreed and stuck down the clause, allowing states to now determine if they can afford to expand Medicaid in their respective states.
ACA would expand Medicaid coverage to anyone, single or family, whose earnings are less than 133% of the federal poverty guidelines. For a single person, this would be approximately $14,050. It would also permit a family of 3 earning $31,000 or less to become eligible for the program. Currently, eligibility would be granted for a family of 3 earning $21,000 or less.
ACA would expand the program to more than 650,000 Georgia citizens and create an estimated $2,4 billion in spending. The Georgia Medicaid eligible would increase from 16.5% to 34% by 2014.
Currently, Georgia is facing a deficit of over $300 million in the Medicaid program, according to state health officials. Unemployment still looms at 8.9%, above the national average. This correlates with the increase of eligible citizens. It also is a factor in Georgia’s decreased revenue as these citizens are not earning taxable income. The Georgia Medicaid program is expanding far more rapidly than the state’s economy. Medicaid is expected to encompass 17.5% of the state’s total budget by 2014.
In a statement from his website, Georgia Governor Nathan Deal states “We will work to ensure that our state, not the federal government, maintains regulatory and oversight control over our healthcare delivery system. Our state’s healthcare delivery system would benefit greatly from greater flexibility and we will continue to pursue additional control.”
Shortly after the ACA ruling, Governor Deal announced he would delay implementation of ACA until after November’s elections. He and other GOP officials remain hopeful that upcoming election results could yield the possibility of legislation that would repeal the law.
In the interim, 15 million Americans (working poor and lower middle class) are in limbo. In states that do not expand Medicaid, the same people would still be required to obtain insurance or face paying the IRS a penalty. Typically, this demographic pays no income taxes.
Tax credits are available to assist in the purchase of private insurance. However, in order to receive a tax credit, one must purchase the insurance up front. If this were in their budget, most would likely have purchased insurance prior to this law.
The people who can least afford taxes at all, let alone a tax increase, will unfortunately be the casualties of this policy as it stands. No insurance coverage and increased fees to the federal government certainly wouldn’t seem like the hope and change any of them expected.