The Pulse

How court rules on ACA will affect many Georgians

Georgia would have the fourth-highest number of people affected if the U.S. Supreme Court rules against the current implementation of the Affordable Care Act, a study has found.

The case, King v. Burwell, involves a legal challenge to the tax credits in states with federally run exchanges.

iStock_000023217379LargeUnder the ACA, every state has an insurance exchange, with some being operated by the individual states but most by the federal government. Currently, eligible consumers with coverage purchased on an exchange can get federal tax credits, or subsidies, regardless of how their particular exchange is run.

The plaintiffs in the case say the language of the ACA allows the tax subsidies only where there is a state-run exchange. The Obama administration challenges that interpretation.

If the plaintiffs win, the subsidies would end in most states. And these tax credits make ACA health plans more affordable for low- and moderate-income Americans, so the impact would be great.

A Kaiser Family Foundation study notes that 37 states have federally operated exchanges, and finds that of these states, only Florida, Texas and North Carolina would have more people losing subsidies than the Georgia estimate of 784,000. full story

Hospitals cutting payrolls to cope with hard times

A recent series of job cuts shows that tough financial times remain for the state’s hospitals – and may get worse next year, experts say.

The biggest cuts have come in two hospital systems in Columbus.

Columbus Regional Health eliminated 219 positions in a cost-reduction move in November. The cuts came after a $17 million operating loss in fiscal 2013 and a similar loss in fiscal 2014, the Columbus Ledger-Enquirer reported. The job cuts included 99 terminations.

Later in the month, St. Francis Hospital, also in Columbus, eliminated 65 filled positions and 15 vacant positions while grappling with a $30 million accounting inaccuracy it discovered in October.

Newton Medical Center

Newton Medical Center

And last Friday, 23 employees of Newton Medical Center in Covington were affected by staff cuts, the Rockdale Citizen reported.

The layoffs are not at the level that Georgia hospitals pursued during the depths of the recession. And they may be partly a sign of necessary belt-tightening during difficult times.

Still, hospital industry officials see that the current revenue trends aren’t positive. full story

Even in SW Georgia, momentum for ACA signups

Alice Jaye has not had health insurance for years.

Though the Colquitt resident has a restaurant job, it does not pay that much and does not offer coverage.

Colquitt is in Miller County

Colquitt is in Miller County

Jaye has high blood pressure, and recently went to a hospital emergency room to get care. Now she’s stuck with a big ER bill that she’s paying off at the rate of $10 a month.

What about the insurance offered on the Affordable Care Act exchange?

“I didn’t know anything about it,” said Jaye, explaining why she didn’t sign up to get coverage this year.

But with the help of a navigator, or insurance counselor, Jaye, 52, has signed up for coverage in the ACA exchange’s second year, with a Jan. 1 start date.

“I’m glad there’s something for people of low income,’’ said Jaye.  “I really needed health insurance.”

Jaye lives in the southwest corner of the state – a region that had extremely high premiums for exchange coverage in the first year of enrollment. full story

Grady says figures prove Blue Cross is unfair

Grady Health System has released financial data that it says buttresses its argument that it has been paid unfairly by Blue Cross and Blue Shield of Georgia.

It’s the latest salvo in the contract battle between the major Atlanta safety-net provider and the state’s biggest health insurer.

Grady Memorial Hospital

Grady Memorial Hospital

Since late November, Grady Memorial Hospital has been “out of network’’ for Blue Cross’s health plan members after contract renewal negotiations between the two organizations broke down.

Because those talks failed to produce a deal, patients with Blue Cross insurance face higher out-of-pocket costs at the Atlanta hospital.

Grady has mounted a vigorous media campaign asserting that it has been underpaid by Blue Cross for years. Blue Cross has issued arguments against Grady’s stance in a less publicized way.

The newly presented financial figures, Grady says, were based on a 2012 study facilitated by a national hospital association and compiled by an independent consulting group.

“Because we are still negotiating with Blue Cross, we didn’t want to share details – but the insurer is misinforming the public so it is important we share the facts,’’ Grady says in announcing the study results. full story

Georgia, South still low in health rankings

Georgia retained its ranking of 38th in a newly released 2014 state-by-state health report card.

healthyfoodimageSouthern states generally ranked at the bottom in the annual report by America’s Health Rankings.

The report says Georgia has strengths that include a low prevalence of binge drinking; a low rate of drug deaths; and a low occupational fatality rate.

Since 1990, Georgia’s infant mortality has decreased by 48 percent from 12.6 to 6.6 deaths per 1,000 live births, the report said. And in the past year, premature deaths in Georgia decreased by 8 percent.

The report said Georgia’s weaknesses include a low rate of high school graduation, a high prevalence of low-birthweight babies, and a limited availability of dentists.

In the past two years, obesity increased from 28 percent of Georgia adults to 30.3 percent. And in the past year, diabetes increased from 9.9 percent to 10.8 percent of adults.

Georgia also has a high level of uninsured residents, where it’s ranked 46th. full story

Consumer Corner

FDA warning on caffeine powder

The FDA urged consumers to avoid pure caffeine powder, a substance linked to two deaths.

Around the State

DFCS spending problems

An internal audit found mismanagement and misspending at the Georgia Division of Family and Children Services.

Read the full article:
wsbtv.com

Atlanta: Ebola prevention

So when Ebola started to spread across the Ivory Coast’s western border, CARE started to incorporate government orders into their work with cocoa farmers.

Read the full article:
WABE

Gwinnett: Absences on rise

Gwinnett school officials have distributed information about flu season after six schools have reported at least 10 percent of their students absent.

Read the full article:
Gwinnett Daily Post

Macon: Miraculous recovery

After a car accident, a 5-year-old boy had at least 10 potentially fatal conditions, but he beat the odds and will be released from a hospital this week.

Read the full article:
Macon Telegraph

Marietta: Hospital attack

A Canton man is arrested after police say he attacked three people in the emergency room waiting area at WellStar Kennestone Hospital.

Read the full article:
Marietta Daily Journal

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