Working full time and yet not being able to afford health insurance coverage literally sticks in Kathryn Playford’s throat.
The office manager for a self-storage facility and office park in North Augusta says she has put off surgery for an enlarged thyroid for years because she lacks health care coverage.
“Eventually, it may enlarge to the point where I can’t breathe,” Playford said.
The governors of Georgia and South Carolina have decided not to expand Medicaid coverage to more uninsured despite high rates of working families with no coverage.
In South Carolina, nearly half of the 766,304 uninsured, or 359,107, are working and 19.3 percent of people employed in the state lack insurance, according to the U.S. Census Bureau’s American Community Survey 2011.
In Georgia, 22.7 percent of the employed lack health insurance, and working families make up 48.3 percent of the uninsured.
The states turned down the expansion under the Affordable Care Act despite the fact that it would be fully funded for the first three years and would not dip below 90 percent federally funded in subsequent years.
In Georgia, the expansion would offer Medicaid coverage for individuals making nearly $16,000 a year and for families of four making around $32,000 a year. Within that adult population, 50.6 percent are uninsured, according to Census data.
“I would argue that those are the people that are really getting the burden of the state not investing more of its state dollars” in Medicaid, said Tim Sweeney, the director of health policy for the Georgia Budget and Policy Institute.
Advocates in a coalition called Cover Georgia will gather Tuesday at the state Capitol to rally for the state to reconsider Medicaid expansion.
Georgia Gov. Nathan Deal has said the state cannot afford it and that the federal government might not be able to continue funding it in the future.
As Georgia Medicaid’s budget has grown since 2009, the state has used other means to cover it.
The Medicaid budget has grown 18.5 percent from fiscal year 2009 to the proposed budget for fiscal year 2014 of $2.76 billion. In that time, the amount of taxpayer dollars coming from the general funds has increased less than 4 percent while fees from hospitals, nursing homes and a sizable chunk from the state’s share of the tobacco settlement has more than doubled to cover the difference, according to Cover Georgia.
Even the amount budgeted for next year in Georgia is likely to be about $150 million short of what is needed, particularly when the health care mandate kicks in Jan. 1, the analysis shows. That could lead to 120,000 Georgians joining the Medicaid rolls at an additional cost of $70.9 million, which is not accounted for in the budget, the analysis found.
South Carolina is no better at covering working adults, Playford said. At one point, she saved $5,000 to help cover her surgery only to find out that even with a steep discount it would cost $20,000. Meanwhile, she has been receiving care through Christ Community Health Services in Augusta.
“The people at Christ Community have made it easy for us,” she said. At one point she looked into whether she could qualify for Medicaid, but her income was too much.
“I would have to make pretty much nothing” to qualify, Playford said, even with a family of six.
Jeffery Young knows how she feels. In his first couple of years in Augusta, he was without health insurance and relied on Christ Community. Now, he is able to get coverage as a firefighter with Martinez-Columbia Fire Rescue.
Having that insurance is “a huge comfort,” he said, after putting off dealing with health issues that could have been serious, including a blood clot.
“You hope and you pray that nothing is going to happen to you because if it does, how am I going to pay for that?” he said.
To Sweeney, the states’ rejection of Medicaid money could have a double impact.
“That is going to be money that goes right into the economy, right into the provider community,” he said. “And that also is going to benefit the individuals a great deal as they are going to be healthier.”
Staff Writer Sandy Hodson contributed to this report.