Healthcare has been the center of much discussion during the last few weeks. Whether you agree or disagree with the politics and conversations surrounding it, this is a conversation worth having, because healthcare is big and complicated and touches everyone. Here at Voices, we love well-informed advocates almost as much as we like teachable moments, so we thought this was the perfect opportunity to talk about the health insurance programs that cover the largest percent of Georgia’s kids –– PeachCare and Medicaid.
So, what are Medicaid and PeachCare and why should you care about them? For those of you not familiar with the alphabet soup we’ve come to know as health-speak, Medicaid is a jointly funded, federal-state health insurance program for low-income working people. It covers children, pregnant women, the aged, blind, and disabled. In Georgia, Medicaid expenses are shared by the federal and state government in a 70/30 (roughly) split.
The Children’s Health Insurance Program (CHIP), also known as PeachCare in Georgia, is a federal assistance program that helps states provide insurance for low-income children whose families earn too much to allow them to qualify for Medicaid coverage, but too little to obtain insurance on their own. CHIP covers primary, preventive, specialty, dental and vision care for enrolled children, and also covers things like hospitalizations, emergency room visit, prescription medications and mental health care. As of 2015, the federal government pays 100% of Georgia’s CHIP costs. So if Medicaid is a parachute for families, CHIP is the safety net.
Now that you know the basics, you might be saying, these programs don’t affect me, why should I care about them? On its’ face, that may seem accurate, but these programs reach deep into our economic structure because of the sheer number of people they cover and the direct implications they have for our state budget. The fact is, there is hardly a person in Georgia who would not be touched by any changes to CHIP and Medicaid. That may sound like a stretch, but let’s break this down.
Roughly 63 percent of the children in Georgia depend on Medicaid or Peachcare, making them the largest single group of beneficiaries. Chances are you know someone who has children who depend on Medicaid or Peachcare. Any proposed changes to the funding or structure of Medicaid or Peachcare will impact more than half of the children in Georgia.
Overshadowing all of this is how Medicaid and CHIP dollars play into our state budget. These dollars make up 49 percent of Georgia’s federal funding. The state’s Fiscal Year 2018 state budget includes $6.6 billion for Medicaid, so any changes to the amount the federal government pitches in towards Medicaid or CHIP would have to be offset by cutting other areas of Georgia’s state budget. This is all the “big picture” data, so let’s take things to a more granular level.
Tommy, who is eleven and lives in Dekalb county, breaks his leg during a soccer game and needs to go to the ER, a visit normally covered by CHIP. But, let’s say the structure of CHIP changed, and that visit is no longer covered. The thing is, the people at the ER don’t care whether or not the Tommy can pay, because he is guaranteed the right to receive medical care by a generation-old federal mandate that requires hospitals to care for all in need, regardless of ability to pay. So Tommy gets treatment, but who pays? In Fulton and Dekalb counties, Tommy’s visit would be paid for by the local county taxpayers who subsidize Grady Hospital through the hospital authority. While it varies from hospital to hospital, the point is, whether it is taxpayers or the hospital –– someone has to pay, and if Tommy isn’t insured and his parents can’t afford to pay, the hospital will be left to absorb the debt while that bill floats in debt-collector limbo.
When we look beyond hypothetical ER visits, children with Medicaid and CHIP have greater academic achievements and become healthier and more economically successful, all of which help the government recoup its investment in the long term. Healthier adults have fewer hospitalizations and emergency room visits, which translates to fewer public costs. More educated adults typically earn more and can contribute back into the system because they are less reliant on safety net programs. At the end of the day, a healthier citizenry creates a more prosperous society.
> > > Click here to check out our interactive map for a look at how many children in your county are covered by either Medicaid or CHIP.