Health Reform Law Upheld, but Questions Remain about Georgia Medicaid Expansion

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President Obama’s signature health reform law was upheld today, but a big question remains over the accompanying Medicaid expansion.

In all, about half of the people expected to gain coverage under the Affordable Care Act will gain it through an expansion of Medicaid, the healthcare program for children and the poor.

However, the court decision effectively gives Georgia the ability to opt out of the expansion.

Under the original law, the federal government could have withheld existing Medicaid funds if states opted out. But in the ruling, the justices said the federal government was overstepping its authority. 

“They viewed the provision of the law that made the state give up all of their Medicaid funding as being unnecessarily harsh, or coercive, or draconian,” said Bruce Brown, a partner at the law firm McKenna Long and Aldridge.

It now means the federal government can only withhold funds it would have given if the states expanded.

“It’s going to be a political decision for the states and their citizens as to whether they want to take the federal government’s money for the Medicaid expansion,” said Brown.

For Georgia, one of 26 states that sued to overturn the law, the option to not expand will almost certainly be considered.

State officials predict the expansion will bring in about 600,000-700,000 new Georgians.

Given the federal government is completely covering the first three years of the expansion and about  90% thereafter, many health advocates believe state leaders will be compelled to go along with the law. 

“I think there will be tremendous pressure to expand Medicaid because the provider community is going to want as many people covered as possible so that they can get reimbursed for services.” said Cindy Zeldin, executive director of patient advocacy group Georgians for a Healthy Future.  “It would be a terrible gap to do everything else and leave this piece open.”

Since the beginning of the year, Georgia’s Department of Community Health has been developing a plan for a potential Medicaid expansion. Agency officials say they will be releasing the details at the end of the summer.

For the complete text of today’s Supreme Court decision, click here.