Georgia’s Top Public Health Official Is Against Medicaid Expansion

In a recent interview, WABE asked Georgia Public Health Commissioner Brenda Fitzgerald if she’s for the proposed expansion of the state Medicaid system. 

“I personally am not,” said Fitzgerald. ”I think that it will be a dire financial problem for Georgia.” 

Since last month’s Supreme Court ruling on the Affordable Care Act, there’s been much speculation about whether Georgia will opt out of the law’s Medicaid expansion. If state leaders decide to expand, more than 600,000 Georgians will be newly eligible. The federal government would pay the full cost of the expansion for the first three years and 90 percent thereafter.

Despite the promise of billions in federal funds, Fitzgerald says the state would still need to come up with money it doesn’t have, not to mention additional doctors and nurses.

“There’ll be a lot more demand for services and quite frankly, I don’t think that we have the physician workforce to meet that demand. I think that may put pressure on [the Department of] Public Health to provide some of those services.”

Nationwide, Georgia consistently ranks in the bottom five states in physicians per capita. A recent study predicts Georgia will be dead last by 2020. 

Shortages of healthcare professionals are nothing new to Fitzgerald. She says her agency has struggled to fill key positions since it broke off from the Department of Community Health last year. More than a quarter of the department’s epidemiology jobs are currently vacant and nearly 20 percent of nursing positions remain unfilled. She says none of the expansion funds would directly address those issues. 

Health advocates across the state acknowledge the problem, but many are still convinced the Medicaid expansion would be a good idea. 

“This is an opportunity like the state has never had before to look comprehensively at what our needs are and to figure out a way to comprehensively address these problems,” said Cindy Zeldin, executive director of patient advocacy group Georgians for a Health Future.

Zeldin says the flood of federal expansion money could help train and recruit more primary care providers and pave the way for new medical home models and greater use of telemedicine.  

“People who are sporadically getting care when they can – either at clinics or at the public health department or at the emergency room – could get more coordinated primary care so they could have the full range of prevention and treatment services and that might take some of the strain off of the safety net,” said Zeldin.

Governor Deal, still banking on a repeal of the health reform law, says he won’t be making a decision until after the November presidential election. Fitzgerald says she’ll support Deal’s decision.