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Georgia Gov. Nathan Deal.
Gov. Nathan Deal

More than 409,000 Georgians fall into the Medicaid gap—they make too much or don't meet the benefit guidelines for traditional Medicaid, make too little to get a subsidy to buy private insurance—because Republican Gov. Nathan Deal refused Medicaid expansion for the state. But more than just the people lacking coverage, the state's healthcare network is now suffering, with rural hospitals in particular struggling to even stay open. Democrat Jason Carter is highlighting that issue in his campaign challenging Deal, calling for Medicaid expansion.
Montezuma’s squat hospital now offers only psychiatric services and little else. County officials said they’ve had to spend more than $800,000 extra on basic healthcare services, such as ambulance costs, to stabilize patients and transport them to nearby regional hospitals.

One official from the remote town of Ideal told Carter it could take up to three hours from a 911 call to a hospital. Another said he worried that the regional unemployment rate, which hovers around 13 percent, will stay stagnant without a hospital. And a county commissioner said he often worries what would happen if a major tragedy struck town.

“Who says there’s not going to be a natural disaster, a train derailment?” said Bob Melvin, the Macon County commissioner.

Four rural hospitals in Georgia have shut down and a dozen more have had to cut the services they provide. The state has come up with a semi-solution, a new licensing program that would allow these hospitals to operate as free-standing emergency departments, but right now it's unclear where the funding for that would come from.

It's not going to come from Medicaid, if the Republicans in Georgia have anything to say about it. Georgia recently passed legislation, which Deal happily signed, to give the legislature veto power—in perpetuity—over any decision by a future governor to accept the Medicaid expansion under Obamacare. State laws aren't written in stone, and this could be repealed, should be repealed. It's not just the 400,000+ low-income Georgians who are being punished by state Republicans—it's anyone who is losing access to local emergency care because of nothing more than politics.

Originally posted to Joan McCarter on Tue Jun 10, 2014 at 11:24 AM PDT.

Also republished by Obamacare Saves Lives, Kos Georgia, and Daily Kos.

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Comment Preferences

  •  Tip Jar (27+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Tue Jun 10, 2014 at 11:24:20 AM PDT

  •  I hope Scalia is pleased with what he's wrought (0+ / 0-)

    as sections of the country descend back to the pre-Civil War era when there were no hospitals, and life expectancy drops accordingly.

    At least this make it clear what's at stake: Are you willing to shut down the health care system for everyone, just in order to make sure that the poor can't possibly access health care?

  •  If These Republican A88holes (3+ / 0-)
    Recommended by:
    joansd1950, marty marty, buffie

    Can pass a law of "no takebacks" in the future, I don't understand why hospitals and consumers can't sue their asses off for causing deaths and economic destruction NOW.

    •  It's called Sovereign Immunity (0+ / 0-)

      The government can be sued only when it consents to be sued.  It dates from Merry Olde England when the King could do no wrong.

      "Corporations exist not for themselves, but for the people." Ida Tarbell 1908.

      by Navy Vet Terp on Wed Jun 11, 2014 at 06:46:39 PM PDT

      [ Parent ]

  •  It is way m ore than no healthcare in the area. (4+ / 0-)

    What happens to nurses, aids, pt, ot, st, transporters, xray tech, house keeping, food services, medical record clerks, tlelphone operaters etc., who will not have jobs as these facilities close?    I am a nurse and in the last 5 yrs I have received 3  - 2% raises.  I have been a nurse for 38 years and never thought I would have to worry about loosing a job at my age, but it is possible as my hospital in Indiana (upper teabaggistan) refused medicaid expansion

  •  As ridiculous as GA's fast paced Gun Bill! (4+ / 0-)

    Deprive future governors of authority by empowering a legislative veto on a particular subject?

    What a view of government, now and in the future!

    2014 is HERE. Build up the Senate. Win back the House : 17 seats. Plus!

    by TRPChicago on Wed Jun 11, 2014 at 06:42:10 PM PDT

  •  Deal's a gutless wonder (9+ / 0-)

    As long as he's in office, the legs can blow Medicaid expansion out of the water, shrug his shoulders, and say, "Hey, it's got nothing to do with me..."

    This is also the guy who adopted the TP's beyond-hardline attitude on illegal immigrants and nearly nuked the state's agriculture industry. (Surprise, surprise!) Deal must go -- period.

    "If you're going to go down with the ship, make it a submarine." - Wayne Shorter

    by Oliver Tiger on Wed Jun 11, 2014 at 06:44:36 PM PDT

  •  I work in the woods near small towns (12+ / 0-)

    such as Montezuma and Ideal, and many other off-the-beaten-path locations. It's stunning to think that, should I get injured out there, that help might be three hours away.

    The arrogance shown by Nathan Deal and the rest of the Georgia Republicans is stunning. Their actions are driven by hatred of Obama, and they care not what becomes of the citizens who are not wealthy enough to be party donors.

  •  There should be a way to use the refusal to (4+ / 0-)

    expand Medicaid and the all guns all the time to expose the lie that the GOP is the "pro life" party.

    “The future depends entirely on what each of us does every day.” Gloria Steinem

    by ahumbleopinion on Wed Jun 11, 2014 at 06:49:32 PM PDT

  •  PLEASE speak English! (0+ / 0-)

    Progressives are notably deficient in making their message understandable to "two digit" voters.

    Voting in one's own self-interest becomes especially relevant in the rural aras. But Progressives think they are smarter than everyone else and fail to explain "why."
    Why do rural "red necks" vote Republican? Read "Deer Hunting with Jesus" and then comment.

    •  So, teach us how to explain why Deal & Co. ... (1+ / 0-)
      Recommended by:
      marty marty

      ... are so wrong on Medicaid expansion.

      What do we tell those "'two digit' voters" of yours?

      2014 is HERE. Build up the Senate. Win back the House : 17 seats. Plus!

      by TRPChicago on Wed Jun 11, 2014 at 07:21:24 PM PDT

      [ Parent ]

      •  You tell them that (0+ / 0-)

        when an ininsured person ends up in the emergency room we all pay his bill through higher insurance rates and government subsidies. I ask my father-in-law why do you want to pay the bills for someone who is playing Russian roulette with health? He agrees, then.

        •  Good approach, but your dad-in-law is going easy, (0+ / 0-)

          ... easier than any Republican I've talked to, who find it no problem to yield a little emergency room time - after all, it's not long term care! - to "those people", a small price for themselves not to have another big spending plan, etc., etc. Besides, insurance or Medicare takes care of most of their own bills so they don't see the astronomy that "self-insureds" deal with when they check out.

          Look, I'm with you on the principle of using fewer and simpler words and ideas to combat the GOP's dummying down of its base. Its adherents, in my experience, do not start out that stupid. They're being talked into it.

          2014 is HERE. Build up the Senate. Win back the House : 17 seats. Plus!

          by TRPChicago on Thu Jun 12, 2014 at 04:45:58 AM PDT

          [ Parent ]

          •  Being bought into it (1+ / 0-)
            Recommended by:

            Worked hard for a candidate in MI 1 (Stupak's old district) last summer. The DCCC abandoned the district to the teabagger. We were ahead until the last two weeks when a ton of Koch money just swamped the local television stations (all they have up there; not an Internet-savvy area) and the Dem lost by less than 1000 votes.

            Long term care? Very few people know that Bush (with a pen, not legislation) changed the look-back period so if they end up in a nursing home anything they have given away for the previous five years (rather than two) goes to the government. That almost gave father-in-law "the big one."

            We simply don't know how to talk. I want a bumper sticker that says "The Kochs can't buy my vote."

  •  This is criminal. If I were Carter, I'd put it (4+ / 0-)
    Recommended by:
    Oliver Tiger, askew, Stude Dude, buffie

    in those terms.  Seriously, how in the world do so many Georgians stand for this?  I hope Jason Carter (this is President Jimmy's son, right?) takes this election!

    I would rather spend my life searching for truth than live a single day within the comfort of a lie. ~ John Victor Ramses

    by KayCeSF on Wed Jun 11, 2014 at 06:51:34 PM PDT

  •  Ballot initiatives (1+ / 0-)
    Recommended by:
    marty marty

    Why aren't Democrats pushing for ballot initiatives for the Medicaid expansion in every state that refused it? It would drive turnout, and even if the Democrats still lost - hey, at least Medicaid would still be expanded.  The whole mess in Virginia could have been avoided if the last election had Medicaid literally on the ballot, instead of just implied by voting Democratic.

    •  because it doesn't work that way (1+ / 0-)
      Recommended by:

      it's not something people can vote in

      the money has to be accepted by the governor

      Politics is like driving. To go backward put it in R. To go forward put it in D.
      Drop by The Grieving Room on Monday nights to talk about grief.

      by TrueBlueMajority on Wed Jun 11, 2014 at 07:02:47 PM PDT

      [ Parent ]

      •  Ah okay. Thanks. (1+ / 0-)
        Recommended by:

        I was wondering why it hadn't been done anywhere. Is that due to the way the ACA was written or because of state laws on allocating funds? (or both?)

        •  it's the Supreme Court's fault (2+ / 0-)
          Recommended by:
          RabbleON, Stude Dude

          when the Roberts Court affirmed the ACA that was good for the Blue Team

          but in the same decision they also weakened the provision about the Medicare expansion, saying that the states could not be forced to do it

          that's how we end up with this situation where governors are allowed to opt out, which was not originally written into the ACA

          Politics is like driving. To go backward put it in R. To go forward put it in D.
          Drop by The Grieving Room on Monday nights to talk about grief.

          by TrueBlueMajority on Wed Jun 11, 2014 at 08:40:00 PM PDT

          [ Parent ]

      •  So what TrueBlueMajority? The GOP always put (0+ / 0-)

        items on the ballot that are almost research questions just to get their base to the polls.  Why won't the Dems?  The questions do not make law but GOP will show up just to answer them.

      •  Then is Carter gets in he immediately should sign (0+ / 0-)

        for the Medicaid money.  Let the GOP file a court case.  Then we can see if it is constitutional that the Ga legislature took the reigns from the Gov on the issue of who can accept the money.  If the law from the Supremes says that the money has to be accepted by the governor.....then what the Ga legislature did could be against the law or unconstitutional.

  •  I think Carter is handling it well so far (4+ / 0-)

    The best thing he can do is really, really run with it. The GOP is bound to respond to his early volleys by shouting "OBAMACARE!!&#!" at every turn (and the RGA already has), but if Carter just hammers away at the true cost (including jobs) to rural Georgians and those 409k, and doesn't let the campaign turn into him playing defense against charges of being Obama's BFF or something, he might just pull it off, between this issue and Deal's string of blatant ethics violations, which seems to only be getting longer and costing taxpayers more and more.

    I like Carter's first TV ad. He comes across as youthful, energetic, and positive, while still getting in a dig at Deal. He's definitely playing to the middle ("fiscal conservative"), but the healthcare issue can and should be something all Georgians can get behind. I hope he is successful in getting that message out.

    •  They're going to say he's Obama's BFF anyway... (2+ / 0-)
      Recommended by:
      glitterlust, Aquarius40 he may as well run with it. It won't play with the Teabag voters (who won't vote for him anyway), but it could get the minority vote behind him. Carter gets Atlanta and the college towns, the rural areas can go fuck themselves... which they're doing their own selves by voting for any "Repeal" candidates.

      "If you're going to go down with the ship, make it a submarine." - Wayne Shorter

      by Oliver Tiger on Wed Jun 11, 2014 at 07:11:56 PM PDT

      [ Parent ]

      •  It's definitely an uphill battle (0+ / 0-)

        Best case scenario, Carter is able to get above the noise and make this about Deal's serious ethical failings and abysmal record on education and healthcare. My fear is he tacks so far to the middle that his campaign becomes essentially about nothing. Dems don't come out, and Deal sails through by 8% of the vote or so.

        I hope he (and Michelle Nunn) are working on GOTV efforts. Short a total meltdown by Deal and the eventual GOP Senate nominee, they are going to have to get some serious enthusiasm going to get Dem turnout up and pull this off.

    •  Be nice to get rural support. (1+ / 0-)
      Recommended by:

      I'm guessing Carter gets the urban vote, and Deal gets everybody else.

      If Carter gets some of the rural vote, it has to help.

      (I imagine Deal will get the suburban vote no matter what.)

      •  If he plays it right, the hospital issue could (0+ / 0-)

        help in rural areas. There's not much he could do to win over a huge swath of rural voters, but as you suggest, winning over slightly more than the usual Dem candidate could be a game changer if urban turnout is up (big if). He may do better than average with the suburban vote, but yeah...places like Cobb County are pretty damn red.

      •  Carter must go to the rurals and play the closing (1+ / 0-)
        Recommended by:
        Stude Dude

        of hospitals by not taking the Medicaid money.  It can be done.  Make sure the rurals know that he intends to ask for the Medicaid money as soon as he is elected and sworn in. Make sure the rurals know he cares for them.

  •  Deal is mired in the Confederacy (0+ / 0-)

    Another Death Panel Republican governor

  •  Carter can keep doing what he has been doing. (0+ / 0-)

    He will finish a respectable 2nd with a bright future ahead of him, or he can be a bold, unapologetic liberal and throw some more left hooks at a vulnerable opponent and inspire the electorate to show up for all the right reasons on election day.

    Montezuma's Squat? Did anyone think the name of the hospital might be part of the problem? Not nice of me to pile on when those nice folks might be losing their hospital and I wish them well, but just a thought.

    Patriotism is the last refuge to which a scoundrel clings. Steal a little and they throw you in jail. Steal a lot and they make you king.... Dylan

    by bywaterbob on Wed Jun 11, 2014 at 09:10:18 PM PDT

  •  They should nail Reps on this. (0+ / 0-)

    Any progressive in any state which has refused Medicaid expansion should nail the villains, governor, ste reps, whatever, with that action.

    Find a hospital which has closed or is threatened. Write LTEs about the fault that the governor has in this.

    Remember that the hospital not only provides services; it provides wages.

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