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State’s Top Medicaid Official Standing By For Key Decision

July 4th, 2012

The Supreme Court has issued its ruling on the Affordable Care Act, and state leaders are now faced with a pivotal decision over whether to expand Medicaid, the safety net program for the poor.

The state official in charge of Medicaid says he’ll be ready to expand if need-be, but Georgia shouldn’t rush to a decision.

The proposed expansion is expected to add more than 600,000 Georgians to the Medicaid rolls. The federal government would cover the full cost of the new enrollees for the first three years, and about 90 percent thereafter.

Still, Department of Community Health Commissioner David Cook says the expansion would come at a significant cost to the state.

“The federal funding on this is substantial but then you have to take a little bit longer view than two or three years down the road. What are the long term impacts going to be for the state? Those can be quite staggering.”

Cook says the expansion would cost about $4 billion over the first 10 years. In addition to known costs, Cook is worried the federal government could change funding models at any point, leaving the state with an even bigger commitment down the road.

Cook says the governor and other policymakers are correct in taking pause and considering whether the state can afford it.

However, in the event the state decides to expand, Cook says DCH will be ready.

An overhaul of Medicaid has been in the works for more than a year. DCH has regularly met with providers, patient advocates, and health consultants to help with the revamp.

“When we first set out on the redesign initiative, our goals included scalability of the project given the great degree of uncertainty that we have so we could be nimble enough to respond to changing circumstances,” said Cook.

Part of the plan, Cook says, may entail recruiting private health management companies to help care for the state’s costly elderly and disabled populations. The companies would bid on incentive–laden state contracts aimed at streamlining costs and improving patient health.

The redesign, which is due at the end of the summer, comes as the state struggles to contain rising costs for its 1.7 million Medicaid and PeachCare enrollees.

DCH expects to be $300 million short for next year alone.