Medicaid Expansion

Credit: Stacey Abrams' campaign Facebook page Editor’s Note: This story is part of our Running Women project following 15 compelling women candidates in 2018. Ady Barkan was diagnosed with ALS just 4 months after his son was born in the spring of 2016, in the thick of fierce political fights that threatened many Americans’ access to healthcare coverage under the Affordable Care Act (ACA) and the Medicare and Medicaid programs. Alarmed for middle-class families like his own, he decided to dedicate what time he had left to fighting for affordable access to healthcare and founded the Be a Hero Fund, which raises money for candidates who will preserve Medicare and Medicaid. One of those candidates is Stacey Abrams, a Democratic candidate for governor of Georgia who has put healthcare at the forefront of her campaign against Republican nominee Brian Kemp. On September 20, Abrams introduced a detailed, seven-part plan to address the state’s many healthcare challenges -- and launched a major effort to turnout voters like Barkan who are worried about access to the care they need. “The kind of ambitious and common sense agenda that laid out could make a huge difference in hundreds of thousands of lives in Georgia and millions of lives around the country,” Barkan said in a Facebook live video. Georgia is facing a growing health insurance crisis. It had the fourth highest rate of uninsured adults in the United States in 2017 -- 16.8 percent lack health insurance, up 1.2 percent from 2016 -- according to a Gallup poll. It is one of only nine states with an uninsured rate above 14 percent. None of those states expanded Medicaid, the government program for low-income people, under the Affordable Care Act. Reversing course and expanding Medicaid in Georgia is a key pillar of Abrams’ healthcare plan, which she has been promoting in events across the state over the last month. It is also part of her plan to provide better access to healthcare to veterans, seniors, women and 330,000 uninsured people with disabilities. “No one in our Georgia should have to choose between paying medical bills or putting food on the table,” said Abrams on her campaign Facebook page. “I am committed to fighting for all Georgians, no matter where they live or the struggles they face.” Abrams has an intense focus on Medicaid expansion because she believes it could strengthen many areas of Georgia’s healthcare system. For example, it would increase the amount of money going to rural hospitals, resulting in better access to healthcare for low-income people living in underserved rural counties. It would provide more seniors and individuals with disabilities with access to the healthcare they need. And Georgians with mental health issues and addictions could also get more help. Key Groups of Voters Care Deeply About Healthcare Healthcare could be a winning issue for several important groups of voters that Abrams needs to turnout on Election Day, if she is to win in this traditionally red state. In August, Abrams said on Facebook that “we have to reach out to every voter, visit places that are too often overlooked, and stay focused on the issues that resonate for all communities.” And healthcare looks like one of those issues. According to a poll by the Atlanta Journal-Constitution (AJC) and ABC affiliate Channel 2, 16.4 percent of Georgia’s voters consider healthcare the most important issue in the election. Only one issue -- the economy -- was cited more often, with 24.7 percent of voters calling it the most important issue. Among black voters in Georgia, who are overwhelmingly Democrats, a lack of access to quality healthcare is cited most often as the No. 1 issue. Abrams, who would be the state’s first black and first female governor, is trouncing Republican opponent Kemp among black voters, 85.6 percent to 3.8 percent, according to the AJC poll. A core piece of her strategy is to turnout black voters who haven’t always gone to the polls, and she may be calculating that healthcare is an issue with the power to drive them there in November. Credit: Stacey Abrams' campaign Facebook page Military veterans are another group that Abrams has honed in on. She believes the expansion of Medicaid can help veterans get easier access to quality mental health care and substance abuse treatment. Another major group of voters who see healthcare as a top issue is senior citizens. Some 14 percent of voters aged 65 and older consider healthcare the most important issue in the election. Abrams’ plan to help this population includes improving non-emergency transportation, increasing funding for Alzheimer’s research, expanding insurance options for younger seniors and increasing access to senior-living facilities. And finally, Georgian women are even more concerned than seniors about access to healthcare -- 18.9 percent told AJC pollsters that it’s the most important issue in this race. Abrams has promised to protect women’s health and to lower the state’s maternal mortality rate by providing better access to obstetricians and gynecologists, especially in rural areas where they are more scarce. “I will fight tooth and nail to ensure every woman in Georgia, regardless of race or region, has access to reproductive health services,” Abrams said on Facebook in September. Expanding Medicaid to Close the ‘Coverage Gap’ The national uninsured rate has fluctuated over the past 10 years. It reached its peak of 18 percent in 2013 right before the ACA took effect during the administration of President Barack Obama. Once enacted, the rate of uninsured Americans dropped dramatically, reaching a low of 10.9 percent in 2016, according to a 2018 Gallup survey. After President Donald Trump cut funding to promote ACA signups and shortened sign-up period, the rate started to rise again, Gallup said. Georgia’s uninsured rate likewise peaked in 2013 and had dropped by 2016. Yet Georgia, at 15.6 percent, had the fourth-highest uninsured rate in the U.S. in 2016, according to Gallup. Its poor ranking was in part due to its decision not to participate in Medicaid expansion, while 31 other states and the District of Columbia did so. According to a survey by the Commonwealth Fund, 54 percent of uninsured Americans live in states like Georgia that have not expanded Medicaid. Abrams wants to expand Medicaid and lower the number of uninsured Georgians who fall into what is known as the coverage gap -- this is the 19 percent of its uninsured who earn too little money to afford health insurance but make too much to qualify for Medicaid. Abrams has said this can spur growth in Georgia’s economy because it would both extend coverage to the working poor and help keep rural hospitals open. “We have the power to reduce poverty, create economic opportunity, and build a healthier Georgia. Let's get it done,” she said during a visit to Grady Memorial Hospital in Atlanta in September. Rural Healthcare as a Priority With six rural hospitals having shut their doors since 2010, another key pillar of Abrams’ plan is to improve access to health services in rural areas. Abrams argues that expanding Medicaid would combat an especially high 19 percent uninsured rate and strengthen rural hospitals. Not only would access to healthcare improve as a result, more jobs for rural Georgians would open up, she says. Abrams said she would also look into introducing a “telehealth” program, which would use technology to connect citizens with specialists outside rural communities. Abrams is looking to encourage more medical professionals to move to rural hospitals with scholarship programs, and wants to introduce apprenticeships in the healthcare field that would give rural Georgians the chance to give back to their communities and receive job training. Georgia has a serious lack of mental health professionals. It is ranked a dismal 46th in the U.S. for the number of providers, with only 122.5 per 100,000 population, according to a 2017 report by United Health Foundation (UHF). The U.S. average is 218 per 100,000 population. To help turn this around, Abrams plans to open up the conversation around mental health and decrease stigmas. And she aims to increase access to mental health support -- in rural areas and beyond -- with the help of Medicaid expansion.

Medicaid Expansion

Stacey Abrams’ Plan to Turn Out Key Voters: Address Georgia’s Healthcare Crisis

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Medicaid Expansion

Stacey Abrams’ Plan to Turn Out Key Voters: Address Georgia’s Healthcare Crisis

The Story Exchange

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