Funding the federal health care law without a tax hike will "require the state to cut nearly a quarter of its annual budget."
The recent U.S. Supreme Court ruling on the federal health care law had many Georgians attempting to figure out what it meant for the state. Brian Robinson, the communications director for Gov. Nathan Deal, a Republican, offered some insight in a front-page article in The Atlanta Journal-Constitution that had a few readers and organizations questioning its accuracy. A couple of them contacted PolitiFact Georgia to get some answers. State officials have said the law will result in at least 620,000 additional Georgians being eligible for its Medicaid program, which they estimate will cost about $4.5 billion over 10 years. Georgia was one of about two dozen states to join the lawsuit against the health care law that was reviewed by the Supreme Court. "To pay for the expansion without tax increases would require the state to cut nearly a quarter of its annual budget," Robinson said. "And that’s after we’ve shaved off billions in state spending since the beginning of the Great Recession." Cutting a quarter of the state budget? That could be catastrophic. The Georgia Budget & Policy Institute, which has concluded the health care law will save Georgia money, quickly disputed Robinson’s math in a news release. The institute, which frequently takes moderate to liberal positions on many Georgia fiscal issues, also pressed the state to provide information detailing how it calculated the $4.5 billion estimate on state finances. "It makes the issue sound bigger than it is," Tim Sweeney, the institute’s director of health policy, said of Robinson’s claim in a telephone interview. "We want to make sure it’s out there that it’s not true." The Georgia General Assembly adopted a $19.3 billion budget for the fiscal year that began July 1. The health care law expands Medicaid eligibility in 2014 to nearly all Americans under 65 with incomes up to 133 percent of the federal poverty level. An additional 5 percent is disregarded when determining income eligibility, which effectively raises the threshold to 138 percent of the federal poverty level. The 2012 federal poverty level for a family of four in Georgia is $23,050. The number of Georgia enrollees is projected to rise from 1.6 million to nearly 2.3 million as a result of the the law. The law provides that the federal government will pay 100 percent of the costs of covering these individuals through 2016. In the following years, the federal payment level gradually decreases, to a minimum of 90 percent. The impact on state government in Fiscal Year 2015 is expected to be about $225 million, according to the state Department of Community Health. The annual impact of the health care law on Georgia’s Medicaid program rises by about $100 million a year between fiscal years 2016 and 2022, the state estimates. Georgia’s fiscal year begins July 1 and ends June 30. As we noted, the state budget is $19.3 billion. If the state had to cut a quarter of its current budget, that figure would be about $4.825 billion. But the health care law’s impact on Medicaid spending in Georgia is projected to stretch over 10 years, not one year. The Fiscal Year 2014 impact on Medicaid spending is estimated to be about $80 million, which would be about 2 percent of the state budget if the budget remains at its current levels. Robinson, after an initial refusal to discuss the matter, admitted he erred. "What I said isn’t accurate," he told us. "I messed up. I was correctly quoted by the reporter." Robinson said his underlying point was that the health care law would result in potentially a major financial commitment from the state for Medicaid payments. "The way I said it made it sound like we’re spending $4.5 billion more per year. That’s not true," Robinson wrote us via email. "I SHOULD have said ‘Over 10 years, the new mandated spending will total a quarter of what the state spends on ALL services in its annual budget." Indeed. If he had said the potential impact of the health care law on Medicaid is equivalent to a quarter of the state’s budget, Robinson would have earned a True rating. But our rating of his actual statement as it appeared in the newspaper: False.
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