New Obamacare provisions add nearly $50 million to state budget

Walter Jones writes:

ATLANTA | Two, little-reported provisions of the Affordable Care Act — Obamacare — are expected to add nearly $50 million to the tab for Georgia taxpayers by increasing access to Medicaid and limiting one tool the state has used to catch people who aren’t eligible.

“I’m frustrated as a taxpayer,” said state House Appropriations Chairman Terry England, R-Auburn.

The Georgia Department of Community Health estimates all provisions of the sweeping federal health care law will add almost $250 million to the state budget during the current fiscal year. That includes expanding benefits in the insurance plan for government employees and increased enrollment in Medicaid and PeachCare for Kids by people who were eligible all along but never applied for coverage until the new federal law required them to.

But the biggest jolt to the budget from Obamacare comes from the federal government prohibiting state officials from checking the eligibility every six months.

“It’s one of those things you look at it and say that’s the prudent thing to do,” England said. “It might cost you a little bit more paperwork on one hand, but you are saving more on the other hand on benefits.”

Medicaid eligibility, like PeachCare, is based on citizenship and income, which can change based on a new job or marriage.

“In that six-month interval if you find someone who’s no longer eligible, you take them off the rolls,” said Clyde Reese, Georgia’s commissioner of community health. “Now, waiting the extra six months to 12 months, you may be paying for somebody in that (added period) who was not eligible.”
Checking income yearly instead of semiannually added $42 million to the state budget.

Advocates for the poor say the longer period reduces hassles for people on Medicaid and lowers the risk they are accidentally dropped from coverage because of missing paperwork.

Georgia’s re-verification system has been problem-plagued, dropping thousands of people in error, according to advocate Linda Lowe.

“It means cancelled appointments, interrupted treatment, missed medications, and headaches for the family and medical providers,” she said.

The other new provision adds more than $7 million to the budget by allowing hospitals to bill Medicaid for patients before their eligibility is checked. So-called presumptive eligibility ensures providers get paid for treating someone who shows up in an emergency room, say hospital representatives.

“While this may add costs to the Medicaid program in the short term, we expect significant cost savings in the long term,” said Kevin Bloye, vice president of the Georgia Hospital Association. “Without insurance coverage, hospitals have to cost shift their losses from the uninsured — who only pay, on average, between 5-10 percent of the hospital’s cost to provide care — to other payers to break even.”

Reese said allowing hospitals to rely on the patients’ say-so could be hard to police.
“There is a very limited ability to go back and recoup the money that Medicaid has paid, so there’s going to be a cost associated with that,” he said. “As far as abuse, I think we’re going to see what the experience is when people present.”