For each dollar that Georgia would have to spend on Medicaid expansion, it would gain $8.68 to $9.42 in federal spending, a new study said Monday.
The report from the Urban Institute analyzes the potential costs and benefits for the 19 states (including Georgia) that have not expanded Medicaid under the Affordable Care Act.
If all those states expanded Medicaid this year, they could see a collective net increase in federal funding from 2017 to 2026 of up to $462 billion, versus a cost of $56 billion, the study said.
The authors said that, according to every expansion state that has analyzed the issue, expansion has improved state budgets, despite higher spending in parts of the Medicaid program.
“It appears that Medicaid expansion is a fiscal win for states,” said Kathy Hempstead of the Robert Wood Johnson Foundation, which funded the study.
The study’s conclusions could help bolster the budding movement for expansion in Georgia.
Georgia’s government — led by Republicans in both the executive and legislative branches — has opposed expansion, saying it would be too costly for the state.
Support for expansion has shown a bit more traction lately in the General Assembly, but it still faces strong opposition.
A task force formed by the Georgia Chamber of Commerce, meanwhile, is finalizing recommendations for the state to increase access to medical services for the uninsured. The recommendations are expected to focus on a more conservative approach to potential Medicaid expansion than other states have chosen.
The extra money from Medicaid expansion is largely derived from states getting an enhanced federal match — at least 90 percent — for the population under 138 percent of the federal poverty limit, Matthew Buettgens, an author of the Urban Institute study, said.
Bill Custer, a health insurance expert at Georgia State University, said the federal spending boost “is simple math — it’s how the expansion is set up.”
“The study demonstrates what individual states have already said: State budgets benefit from expansion,” he said.
It doesn’t count the economic impact of the extra spending, which will generate economic opportunity and jobs, largely in health care, Custer said.
The Urban Institute report generally did not estimate offsetting state revenue gains and state cost savings, such as increased tax revenues and a higher federal matching rate for some current Medicaid enrollees.
But Buettgens noted that 14 states that have expanded Medicaid have done an analysis of the fiscal impact, and they saw net savings, at least in the short term.