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Health Reform

Latest snapshot of Georgia exchange enrollees

First-time enrollees, Medicaid-eligible individuals, and an influx of young people.

Healthcare CostThat’s part of the picture that emerges from the data that federal officials released Tuesday about the more than 425,000 Georgians who have signed up for coverage in the health insurance exchange.

The Department of Health and Human Services reported that 90 percent of enrollees in Georgia received financial assistance, or subsidies, to help them afford an exchange health plan.

The report also said 36 percent were under 35 years of age. The high number of young people is important for insurers. Younger adults, who as a group are generally healthy, balance out the companies’ financial risks of covering older people, who are more likely to become ill. full story

Commentary: Don’t save unauthorized subsidies

The upcoming U.S. Supreme Court ruling on the Affordable Care Act exchanges has already unleashed a torrent of speculation and opinion.

Rep. Jason Spencer

Rep. Jason Spencer

A week ago, Georgia State University law professor Erin C. Fuse Brown argued in a Commentary that the court should preserve the insurance subsidies for consumers in states such as Georgia that let the federal government run their exchanges.

Now, in a rebuttal Commentary, state Rep. Jason Spencer (R-Woodbine) says the subsidies for federally run exchanges violate the ACA and should be thrown out by the court.

Spencer, while a staunch opponent of the health law, says its language on subsidies is clear and binding. “Congress stipulated in the ACA that federal tax subsidies would be limited to individuals who purchased health insurance through an ‘[e]xchange established by the State,’ ’’ he writes. “There is no more ambiguity in the word ‘State’ than there is in the meaning of the word ‘is.’ ”

Here’s a link to Spencer’s Commentary.

Georgia Health News welcomes Commentary submissions. If you would like to propose a Commentary piece for Georgia Health News, please email Andy Miller, editor of GHN, at amiller@georgiahealthnews.com

HHS chief hails exchange success in Georgia

Benjamin Wills’ dream is to open a private Christian school in a downtrodden area of west Atlanta.

One hurdle he has faced, though, was finding a less expensive source of health insurance for himself, his wife and their daughter.

Benjamin Wills speaks to reporters as (from left) Fulton County Commission Chairman John Eaves, Dr. Michael Brooks and Sylvia Burwell look on.

Benjamin Wills speaks to reporters as (from left) Fulton County Commission Chairman John Eaves, Dr. Michael Brooks and Sylvia Burwell look on.

Wills, 28, found an answer in the Affordable Care Act exchange. He chose a plan with a monthly premium of $370 for family medical and dental coverage — an amount that was less than what they were offered through an employer, he said.

The price and security of the ACA coverage, Wills said, helped give him confidence to establish his school, which he aims to open in August. “We want to serve others,’’ he said.

Wills and his family are among the more than 425,000 Georgians currently signed up for coverage in the health insurance exchange in 2015.

That signup number has exceeded expectations for this point in the open enrollment process. The enrollment period ends Feb. 15.

Wills joined U.S. Health and Human Services Secretary Sylvia Burwell and local officials at an Atlanta news conference Friday discussing enrollment in the health insurance exchange. The event took place at The Family Health Centers of Georgia’s location in the West End of Atlanta.

Burwell indicated that she was pleased with Georgia’s current enrollment number, adding, “We want to keep that number moving.’’  full story

Hospitals get financial rewards . . . or do they?

A majority of Georgia hospitals will get performance bonuses from Medicare for their quality of care, federal data show.

The 59 percent of Georgia hospitals getting the financial reward exceeds the national average of 55 percent, according to a Kaiser Health News article. The bonuses come from measurements that include patient satisfaction, lower death rates and how much patients cost Medicare.

Healthcare CostMeanwhile, 40 percent of the Georgia hospitals subject to the measurements are being penalized for quality-of-care problems, while 1 percent broke even in the Medicare quality category.

An official with the Georgia Hospital Association, when asked by GHN to comment on the bonuses Thursday, said, “We are proud of the fact that of the 10 states with the most hospitals assessed in the study, Georgia leads them all with 59 percent of its 99 hospitals receiving the quality bonus.”

“The Georgia hospital community still has a lot of work to do make great care even safer, but these numbers demonstrate that we are moving in the right direction,’’ said Kevin Bloye, a Georgia Hospital Association vice president.

Kaiser Health News reported that many of the bonuses nationally will be offset by hospital penalties that the government has also established as a part of the Affordable Care Act.

Fewer than 800 of the 1,700 hospitals that earned these bonuses nationally will actually receive extra money, according to a Kaiser Health News analysis. full story

Disturbing news for a group of school workers

The state agency that oversees the health care of almost 2.5 million Georgians has drawn sharp questioning over a budget proposal involving a small fraction of them.

Clyde Reese

Clyde Reese

The Department of Community Health’s $13 billion budget for fiscal year 2016 would eliminate health insurance coverage for 11,500 “non-certificated’’ school personnel, such as bus drivers and cafeteria workers.

DCH Commissioner Clyde Reese, speaking Tuesday to the joint House and Senate Appropriations Committee, cited a “fairly large deficit’’ that the state incurs for covering these school workers. He put the figure at $135 million in fiscal 2014.

“We think a lot of these people will get insurance in other ways,’’ Reese told Democratic Rep. Mary Margaret Oliver (D-Decatur), who questioned the coverage move. He added that some may qualify for subsidies in the health insurance exchange.

Reese projected an eventual fiscal 2017 deficit for the State Health Benefit Plan, which covers more than 630,000 state employees, teachers, other school personnel, retirees and dependents.

Other items of interest in the proposed Community Health budget include a total of $42.5 million in the midyear and fiscal 2016 Medicaid budgets to cover expensive new drugs for hepatitis C. full story

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