Snapshot: Georgia's Medicaid Enrollment and Spending
Medicaid is a highly utilized joint state and federal program that provides health care to millions of Georgians. Currently, eligibility for Medicaid is determined by need, and federal funds are tied to reimbursement rates for health care costs associated with eligible individuals.
There are several policy proposals to cap federal Medicaid spending either through a block grant program or by providing states a fixed per enrollee reimbursement. Such federal proposals would likely limit the state’s receipt of federal Medicaid funds, and areas of the state with more dependence on the program are more likely to feel the impact of any such efforts.
The following interactive maps, created by Selma Dogic, take a closer look at the Medicaid program in Georgia. They expand on a previous piece written by Peter Bluestone.
Researchers
-
Peter BluestoneBluestone is a senior research associate with the Center for State and Local Finance and the Fiscal Research Center.
-
Selma DogicDogic is a senior business analyst at NCR. She previously worked at the Center for State and Local Finance and Fiscal Research Center.
Medicaid Enrollees per County
This map shows the average monthly Medicaid enrollment by county for fiscal year (FY) 2015. Not surprisingly, the state’s most populous region, metro Atlanta, accounted for a large number of these enrollees. Five counties in the metro-Atlanta area accounted for 33 percent of all statewide Medicaid average monthly enrollees in FY 2015. These five counties were Fulton, DeKalb, Gwinnett, Cobb, and Clayton. Most rural areas had considerably fewer enrollees, with 66 counties having 4,000 or fewer. The other counties with higher enrollments tended to be the hub cities around the state: Rome, Macon, Albany, Valdosta, Savanah, Athens, Augusta, and Gainesville.
Medicaid Enrollee Share of Population
Another way to examine the impact of Medicaid is the share of the population enrolled. The map below shows the average monthly enrollment in FY 2015 as a share of county population in 2015. Here, the rural counties of the state tended to have higher shares of their population on Medicaid. Metro-Atlanta counties generally had lower percentages of their population on Medicaid, generally falling within the 10-20 percent range. The north Georgia mountain area, as well as coastal Georgia, also were in the 10-20 percent range.
Counties with higher shares of their populations on Medicaid can be found in southwest Georgia, south and west of Bibb County and Macon along I-75. Many of these counties had 20-30 percent of their populations on Medicaid. Another large swath of counties south of Richmond County (Augusta) and south of I-20 and north of I-16 also had higher shares of their populations on Medicaid, falling into the 20-30 percent group. Of the 10 counties with shares of their population on Medicaid at more than 30 percent, nine were south of Macon. Only 11 counties entirely north of I-20 had Medicaid enrollees between 20-30 percent of their population.
Medicaid Spending per Enrollee
The amount of spending per enrollee can further illustrate county Medicaid impacts, as shown in this map. This spending was more evenly distributed between urban and rural counties but it tracked with the share of population Medicaid map. Spending was tightly bunched, with 98 counties spending $5,230 and less per enrolee. High-spending counties tended to be in southwest Georgia and a swath of counties south of Richmond County (Augusta) and I-20 and north of I-16.
Aged, Blind and Disabled Share of Medicaid Population
A potential factor that could influence the Medicaid spending per enrollee is the share of the Medicaid population that is aged, blind or disabled (ABD). A significant share of Medicaid spending goes to long-term care for the elderly and disabled. This map shows county ABD Medicaid enrollees as a proportion of all Medicaid enrollees for calendar year 2013. Note that the metro-Atlanta area tended to have counties with the lowest share of ABD recipients, roughly 25 percent and below. Counties with higher shares of ABD Medicaid enrollees tended to be in rural areas of the state and similar to regions where counties had a higher percentages of their population on Medicaid.
Share of County Population Age 65 and Older
The following map shows the share of a county’s population age 65 and older in 2015. This age cohort is likely to need long-term nursing home care, the most expensive component of ABD Medicaid car, beginning in the next 5-10 years. A 2009 Centers for Disease Control and Prevention report, The National Nursing Home Survey: 2004 Overview, found that roughly 80 percent of the residents in nursing homes were 75 and older. Also, some 65 percent of nursing home residents are supported primarily by Medicaid.