State Sen. Chuck Hufstetler: Many of state’s hospitals ‘in crisis’

by Sarah Carroll and Grace Barker

ROME, Ga. – More than 400,000 Georgia residents have no health insurance because of unanticipated consequences of the Patients Protection and Affordable Care Act (ACA) and the state government’s decision to opt out of the Medicaid expansion the Act allows.

The estimated 16% of Georgia residents who are uninsured, according to the U.S. Census Bureau’s March 2014 Current Population Survey, includes 22% of Floyd County residents who are uninsured, or more than one and five.

State Sen. Chuck Hufstetler, R-Rome

“These people are in ‘no man’s land,’” said State Sen. Chuck Hufstetler, R-Rome, for District 52. “They don’t make enough for a subsidy, but they make too much for Medicaid. There’s just this huge a gap of [uncovered] people.”   

Before a Democratic-led Congress passed ACA in 2010, eligibility for Medicaid meant earning no more than the federal poverty level, according to Medicaid.gov. For individuals, this meant an annual income of less than $11,770. A family of two would have needed to earn less than $15,930, a family of three less than $20,090.

Though with the ACA’s passage, Medicaid eligibility nationally expanded to include individuals and families with household incomes of up to 133% of the federal poverty levels just cited, states aren’t required to opt in to the expanded Medicaid program. Each state gets to decide, and Georgia opted out. (The ACA also provided for a 5-percentage-point adjustment upwards, making the upper income eligibility limit for Medicaid actually 138% of the federal poverty level).

“People between the ages of 19 and 64 in Georgia don’t have many options for Medicaid or Medicare,” said Barbara Earle, executive director of the Free Clinic of Rome. “Just because you are poor or uninsured in Georgia does not mean you automatically get Medicaid coverage.”

Resources in Rome for Expecting Moms Produced by Faith Mantia and Kelsey Merriam

Georgia on Medicaid expansion: ‘No, thanks.’

Though 29 states opted into the Medicaid expansion, most southern states, including Georgia, did not, leaving millions of working poor out in the cold. In 2010, nearly 1.7 million of Georgia’s nearly 10 million people lived below the poverty line, or nearly one in five, according the U.S. Census.

“These are not deadbeats,” Hufstetler said. “These are not people on welfare. These are the working poor. The people who aren’t making anything are (still) covered with Medicaid.

The number of people in Georgia who do not qualify for any assistance because they are ineligible for Medicaid, people with incomes too low to be considered for tax credits, is 409,000, according to The Kaiser Family Foundation, based off of the 2012-2013 Current Population Survey Results.

Hufstetler said Georgia would be better off economically if it implemented the Medicaid expansion. Regardless, something should be done to meet the need created by the ACA and the state’s decision to opt out of the Medicaid expansion.

Statistics gathered from citydata.com

Pay now, or pay more later

“We should be treating these people upstream where the cost is pennies on the dollar, as opposed to much later when quality of life is much worse and it’s more expensive,” he said. “We’re not really saving money; we’re paying either way.”

Hufstetler has himself worked in healthcare for six years, or since September 2008, as an anesthesiologist in Rome.

Data from the Johnson Foundation indicate that in the past year, 19% of Floyd County adults could not afford to see a doctor.

Because the working poor do not have healthcare insurance, many must turn to hospital emergency rooms. A 1986 law called the Emergency Medical Treatment and Labor Act ensures public access to emergency services regardless of a patient’s ability to pay.

 

INTERACTIVE MAP OF HEALTH RESOURCES IN ROME

Contact information and directions for healthcare organizations in Rome, Ga

Hospitals ‘overwhelmed’

Hufstetler said the 1986 law forces hospitals to provide free care, cost to the hospitals that must be made up elsewhere. In short, it drives up the costs of healthcare for everyone.

Four hospitals in Georgia have closed in the past two years because of budget shortfalls spurred by the state’s decision not to expand Medicaid, he said.

The hospitals are “overwhelmed with all the free care they’re giving out, and they have to close as a consequence,” said Hufstetler, who is an anesthesiologist with HCA Redmond Regional Medical Center. “We’ve got a lot more [hospitals] in trouble. Two-thirds of hospitals in Georgia are losing money. We’ve got a crisis on our hands.”

Stepping into the breach are organizations such as Women of W.O.R.T.H. (Women’s Organization for Reproductive and Total Health care), The Free Clinic of Rome and Floyd County Health Department in providing at least some basic health services.

In addition, non-profits such as the AIDS Resource Council and Cancer Navigators seek to serve those battling, respectively, AIDS and cancer.

Kristen Sheely of Women of W.O.R.T.H.

However, these organizations can only provide basic healthcare services and virtually no care specific to mental health or substance abuse. Most of the patients seen at the W.O.R.T.H. clinic cannot afford specialty testing, such as X-Rays or CAT scans, according to Kristen Sheely, office manager and volunteer coordinator for Women of W.O.R.T.H.

A person in need for these services must go to Floyd Medical Center, which has an Indigent Care Program and a Charity Care Program.

The Indigent Care Program helps patients unable to pay for services and is subsidized by the state government. Floyd Medical Center also has a “We Care Program,” which serves patients with chronic conditions.