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ForsythOpinion
Georgia can
learn something
from Louisiana
TOM CRAWFORD
Columnist
This may be the first
time I’ve ever written
these words, but here
goes: Georgia could
learn a lesson from
Louisiana.
On June 1, Louisiana
became the first Deep
South state to launch a
Medicaid expansion
program funded
through the Affordable
Care Act.
That happened
because of the upset
victory last fall of
Democrat John Bel
Edwards in the gover
nor’s race.
Where outgoing gov
ernor Bobby Jindal
denounced Obamacare
and refused to expand
Medicaid coverage,
Edwards pledged to
bring healthcare access
to more low-income
residents of the Pelican
State.
In less than three
weeks since the expan
sion was launched,
more than 200,000
people signed up for
Medicaid coverage;
Edwards’ goal is to
attract at least 375,000
enrollees.
Louisiana’s rollout is
being closely watched
by people in other
states where Medicaid
expansion has been a
non-starter, including
Georgia.
Amanda Ptashkin of
Community Catalyst, a
healthcare advocacy
organization, said
many of the Louisiana
enrollees signed up
through limited expan
sion programs that
were already in effect
in several cities.
Edwards’ administra
tion also devised a way
to work around the leg
islature’s refusal to
appropriate money for
the administrative costs
of expanding Medicaid.
Louisianans apply for
Medicaid coverage at
the same time they
apply for food stamps
under the Supplemental
Nutrition Assistance
Program (SNAP).
“I really do believe it
(coordinating with
SNAP signups) would
work here,” Ptashkin
said. “I think the les
sons learned in
Louisiana certainly
will resonate with the
southern states.”
Whether the
Louisiana model is fol
lowed or not, there is
more talk in Georgia
these days about the
possibility of Medicaid
expansion, even if it
isn’t directly connected
to the Affordable Care
Act. The state could
customize its own ver
sion through the use of
federal waivers, as
other states have done.
Gov. Nathan Deal
and the Republican
leadership of the
General Assembly have
refused to accept the
federal funding that
has been available for
Medicaid expansion
since 2014. That refus
al has cost Georgia
nearly $9 billion and
kept an estimated
650,000 citizens from
potentially getting
healthcare coverage.
State Sen. Renee
Unterman (R-Buford),
who chairs the senate’s
health and human ser
vices committee, has
been talking about the
need for Georgia to
bend a little so it can
get some of that
money.
“You have to reexam
ine where you are
because the times
change, you can’t stay
stagnant,” Unterman
said in a public radio
internview.
“Everything’s on the
table and we need to be
open-minded.”
She suggested that
Georgia could follow
the example of
Arkansas, which imple
mented a version of
Medicaid expansion
that required recipients
to pay small premiums
for their coverage.
*The consumer
would have to have
some skin in the
game,” Unterman said.
“You don’t want to
give these people a
handout, but if they
contribute to what
they’'re trying to pur
chase or get, they have
some skin in the
game.”
Unterman also
acknowledged that the
Affordable Care Act,
which she has opposed
for the last five years,
is not likely to be
repealed.
“I believe some form
of it is here to stay, and
that’s why I am willing
to look at a (federal)
waiver,” she said. “The
infrastructure has
already changed. You
can’t flip back time.”
One good reason for
Georgia officials to
consider accepting
these federal funds is
the precarious financial
condition of many hos
pitals, particularly
those in rural areas that
treat a large number of
indigent patients who
can’t pay their bills.
Since 2013, at least
five rural hospitals
have shut down
because of financial
shortfalls. The latest
one, North Georgia
Medical Center in
Ellijay, was in the dis
trict of House Speaker
David Ralston (R-Blue
Ridge), one of the most
powerful figures in
state government.
If the state had
agreed to Medicaid
expansion three years
ago, that federal money
would have flowed to
the hospitals and might
have helped keep them
in operation.
Ralston declined to
talk about the Medicaid
situation. “We are still
more than six months
before the 2017 ses
sion, and the speaker
will be happy to chat in
the future should
developments warrant,”
his spokesman said.
While Ralston waits,
thousands of Georgians
continue to lack health
care coverage and more
hospitals are in danger
of closing. It’s way
past time that the polit
ical leadership started
talking about this issue.
{Tom Crawford is editor of
The Georgia Report, an
internet news service at
gareport.com that reports
on state government and
politics. He can be reached
at tcrawford@gareport.
com.)
Send a letter to the editor to PO. Box 210 Cumming, GA 30028; fax it to (770) 889-6017; or e-mail it to editor@forsythnews.com.
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Jim Powell for the Forsyth County News
Why we have sluggish job growth
Why has the American economy
had such sluggish job creation and
economic growth? That’s a pretty
fundamental question, and one for
which most conventional econo
mists have had unsatisfying
answers.
Clues can be found, I think, in
the new book by the unconvention
al economist and blogger Arnold
Kling. “Specialization and Trade:
A Re-Introduction to Economics”
is, among other things, a polemic
against macroeconomists who treat
the economy as what Kling calls a
“GDP factory” and who think poli
cymakers can get it producing
more by just stepping a little hard
er on the gas pedal, with federal
stimulus spending or low interest
rates.
As you may have noticed, that
hasn’t been working very well.
Kling sees the economy as the
constantly changing sum total of
firms, entrepreneurs and individu
als specializing in certain work and
trading with each other. In the pro
cess of that, in a typical month it
destroys and creates about 4 mil
lion jobs.
If the number destroyed persis
tently exceeds the number created,
you have a recession. If the num
ber created only narrowly exceeds
the number destroyed, you have
what we’ve been living with for
the last nine years.
Huge numbers of jobs were
destroyed from 2008 to 2009, and
since then there has been disap
pointingly slow job creation. In
Forbes, Michael Malone points to
Economic Innovation Group fig
ures showing that net new busi
nesses fell from 421,000 (1992-
1996) and 405,000 (2002-2006) to
166,500 (2010-2014). That indi
cates a shocking decline in what
John Maynard Keynes called *ani
mal spirits.”
Reasons are not hard to see.
Higher federal tax rates have hurt,
and high-tax states have seen busi
nesses flee to low-tax places like
Texas. Taking money away from
existing enterprises and potential
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Jimmy Margulies The (New Jersey) Record
This is a page of opinion — ours, yours and
others. Signed columns and cartoons are the
opinions of the writers and artists, and they
may not reflect our views.
| n
MICHAEL BARONE
Columnist
entrepreneurs to pay for skyrocket
ing pensions for retired public
employee union members is not a
recipe for job growth.
The Obama administration’s
record-setting pile-on of regulation
after regulation surely hurts as
well. Obamacare regulations deter
many a business from creating job
No. 50. Higher minimum wages
destroy jobs in which entry work
ers can develop skills and good
work habits. Mandates for
increased benefits and leave time
crowd out job creation.
The aging of the population
plays some role, but doesn’t
explain slow job creation, which
apparently motivates many baby
boomers to cling to jobs they have
after age 65.
Another factor, less often
stressed, is reduced mobility:
Fewer Americans are up and mov
ing. American Enterprise Institute
President Arthur Brooks points out
that 50 years ago about 20 percent
of Americans moved every year
and 25 years ago about 15 percent
did. Now it’s down to about 10
percent.
In an economy in which patterns
of specialization and trade are
always changing, Kling argues, it’s
impossible to maintain stable local
employment patterns. Some places
shed jobs; in others jobs are creat
ed. Many people need to move to
maximize opportunity. These days
fewer do.
Why? One reason is the explo
sion of the number of people
receiving Social Security
Disability Insurance: It’s tripled
since 1980, doubled since 1995.
West Virginia, despite low job cre
ation, has seen little domestic out
migration. Not coincidentally, it
has the highest rate of disability
payments. People once left the
mountains — for Michigan in the
19405, Texas in the 19905. Now
they stay put and wait for $13,000
in annual SSDI.
Another reason is that young
people increasingly are living with
their parents — 32 percent age
18-34, according to the Pew
Research Center, the highest since
the 1930 s and the Great
Depression. Attending local colleg
es and junior colleges with cheap
in-state tuition also tends to reduce
mobility, but it often doesn’t pro
vide job-worthy skills.
Or an urge to entrepreneurship.
Federal Reserve data indicate that
the percentage of under-30s own
ing all or part of a business is one
third the rate it was in 1989. And a
plethora of state occupational
licensing laws, as the Obama
White House has argued, close off
opportunities to protect incum
bents.
Unfortunately, the likely policies
of the presumptive Democratic
presidential nominee would make
things worse.
Hillary Clinton would increase
regulatory burdens and increase
the cost of employing people. Her
goal, like that of Bernie Sanders, is
to make us more like Continental
Europe, which has had virtually
zero job growth for years.
Donald Trump’s promise to
“make America great again” prom
ises restoration of a rosily remem
bered but largely mythical past.
Abrogating trade agreements
won't create half a million auto
and steel jobs. Trump’s penchant
for deal-making and crony capital
ism means propping up insiders
and preventing job creation.
Kling says he’s voting for Gary
Johnson. You can see why.
Michael Barone is senior political
analyst for the Washington Examiner,
resident fellow at American
Enterprise Institute and longtime co
author of The Almanac of American
Politics.