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neigh­bors would share the same abil­ity to go to the doc­tor and ben­e­fit from fi­nan­cial pro­tec­tion from large med­i­cal bills as you and I.

Stud­ies have shown that peo­ple cov­ered by the Med­i­caid ex­pan­sion seek more pre­ven­tive care, visit emer­gency rooms less, and are more likely to re­ceive reg­u­lar care for chronic con­di­tions. They also have fewer un­paid med­i­cal bills, and see their credit scores im­prove.

Even peo­ple with pri­vate health in­sur­ance ben­e­fit from Med­i­caid ex­pan­sion. A 2016 anal­y­sis found that ex­change pre­mi­ums were 7 per­cent lower on av­er­age in states with ex­panded Med­i­caid pro­grams, re­sult­ing in sig­nif­i­cant sav­ings for con­sumers pur­chas­ing their own cov­er­age.

Com­mu­ni­ties across the state, and es­pe­cially those in ru­ral ar­eas, would feel the pos­i­tive im­pacts of Med­i­caid ex­pan­sion as well. An anal­y­sis from the Ge­or­gia State Univer­sity Cen­ter on State and Lo­cal Fi­nance pre­dicts that the in­flux of Med­i­caid dol­lars as a re­sult of cover­ing more Ge­or­gians would bring $1.4 bil­lion an­nu­ally and an in­crease of 19,000 jobs to the parts of the state out­side metro At­lanta.

As hos­pi­tals in other states have seen, both ru­ral and ur­ban fa­cil­i­ties could ex­pect

re­duced de­mand for free care to unin­sured pa­tients, and ru­ral hos­pi­tals would be more likely to turn a profit, an im­por­tant con­sid­er­a­tion for the many Ge­or­gia towns where the lo­cal hos­pi­tal is the largest em­ployer and the only source of health care.

All this would hap­pen with­out harm­ing the chil­dren, peo­ple with dis­abil­i­ties and se­niors who make up the large ma­jor­ity of Med­i­caid en­rollees.

In states that have ex­panded Med­i­caid, the avail­abil­ity of doc­tors’ ap­point­ments for those with Med­i­caid cov­er­age in­creased to ac­com­mo­date the in­flux of new pa­tients, dis­prov­ing wor­ries that the ex­ist­ing health care work­force would be in­suf­fi­cient. In two-thirds of the same states, the num­ber of peo­ple on wait­ing lists for Med­i­caid sup­port ser­vices de­creased, or the state had no wait­ing list at all, again negat­ing con­cerns that cur­rent Med­i­caid ben­e­fi­cia­ries would be pushed to the back of the line by those newly el­i­gi­ble.

To bring th­ese wholly pos­i­tive ben­e­fits to Ge­or­gia, our state would pay only 10 per­cent of the costs of the Med­i­caid ex­pan­sion; and the fed­eral govern­ment would pick up the re­main­ing 90 per­cent. A small levy on the in­sur­ers and hos­pi­tals that profit from an in­creas­ingly in­sured pop­u­la­tion or a rise in Ge­or­gia’s ex­cep­tion­ally low to­bacco tax would be suf­fi­cient to cover the

state’s share of the costs and bring our fed­eral tax dol­lars back to the state for all our ben­e­fits.

The op­por­tu­nity we face now is clear. We must set aside some Ge­or­gians’ strate­gies that will pro­duce neg­li­gi­ble gains and in­stead move for­ward to­gether to strengthen the health sys­tem for ev­ery­one, by en­sur­ing that all Ge­or­gians have the health care cov­er­age they need.

Med­i­caid ex­pan­sion must be the first step in our col­lec­tive ef­forts.

Laura Col­bert is ex­ec­u­tive di­rec­tor of Ge­or­gians for a Healthy Fu­ture

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