Health Reform

Fifty-fifty.

Those are the odds given by a prominent Atlanta attorney that the Supreme Court will uphold the 2010 health reform law.

He gives the same odds that the justices will strike down the Affordable Care Act (ACA) in its entirety or part of the law that includes its controversial mandate for most individuals to purchase health insurance.

“The case is truly difficult,’’ said attorney Bruce Brown of McKenna Long & Aldridge, at an Atlanta conference this week held by the Georgia Charitable Care Network, an organization of charity clinics serving the uninsured in the state.

Brown, whose legal experience includes clerking for the late Chief Justice Warren Burger, said he believes the justices ‘‘will really grapple with’’ the complex law.

The court’s decision is likely to come in late June.

The stakes for Georgia and other states are high. The law, if upheld, would extend Medicaid coverage to 650,000 Georgians and private insurance to thousands more. The state’s current rate of uninsured is 20 percent, one of the highest percentages in the nation.

And a new study shows access to health care is a big problem in Georgia.

Adults in nearly every state saw their access to health services worsen during over the past decade, with Tennessee, Florida and Georgia having the greatest increase in people reporting having an unmet medical need, according to a study released Tuesday. full story

Georgia consumers will qualify for an estimated $30 million in health insurance rebates this year due to a newly implemented provision in the federal health reform law, according to an analysis released Thursday.

Nationwide, health insurers will have to pay an estimated $1.3 billion in rebates, said the report by the Kaiser Family Foundation.

Under the 2010 law, officially called the Affordable Care Act, insurers in a state are required to spend at least 80 percent of premium dollars on medical care costs, or pay rebates to consumers.

The U.S. Department of Health and Human Services, though, allowed Georgia health insurers to meet that level gradually for individual health policies, with a 70 percent mark in 2011, 75 percent in 2012 and 80 percent in 2013.

Insurance companies will be required to issue rebates by August if they did not meet those spending levels last year.

The Kaiser report said that 109,776 people in Georgia with individual plans will get rebates totaling $3.9 million, averaging $35.12 per enrollee. Almost one in three Georgians in individual plans will get rebates. full story

It was pitched as a way to provide cheaper health insurance for uninsured Georgians.

House Bill 47 would let health insurers in Georgia sell policies from states that have fewer coverage requirements.

Proponents said these out-of-state policies, stripped of Georgia’s mandates, would have lower premiums – and allow more people to afford individual health insurance coverage.

The high-profile legislation was passed by the Legislature last year and signed into law.

But a year later, nothing has happened. No insurer here has started selling a non-Georgia health plan.

The state Insurance Commissioner’s office says it fielded some inquiries as regulations were being written, but that nothing has yet been offered.

Experts speculate that health insurers, here and elsewhere, have their focus squarely on the pending Supreme Court decision on the 2010 federal health care law – and don’t want to offer a policy that may soon be extinct. full story

The federal government announced Tuesday that 27 health collaboratives –- including two in Georgia — have been picked to participate in a new Medicare program that provides financial incentives for doctors and hospitals to form an “accountable care organization.”

The program is called the Shared Savings Program. If the organizations improve patient care and contain costs, they can share in the savings, getting paid more for keeping their patients healthy and out of the hospital.

Accountable care organizations, or ACOs, are a central feature of the federal health reform law of 2010, also known as the Affordable Care Act. Medical providers will be rewarded based on the quality of care they provide, not the volume of services they deliver, as under the traditional fee-for-service model.

The U.S. Supreme Court is considering a challenge to the health care law and is expected to rule in June whether the law and the programs it has created remain in effect.

A Kaiser Health News article points out that the announcement on ACOs was the government’s first major health law action since the court held arguments on the law two weeks ago.

The 27 new ACOs will serve an estimated 375,000 beneficiaries in 18 states. The Georgia collaborations are in Athens and Savannah. full story

The debate about the health care reform law has continued two years after its passage, and if anything has intensified in the week since the Supreme Court heard arguments about its constitutionality.

GHN on Wednesday posted a Commentary that supports the Affordable Care Act.

Taking the opposite view in today’s Commentary is Ralph Hudgens, the state’s insurance commissioner. He calls the Affordable Care Act a “government takeover’’ of health care. The law, Hudgens argues, ‘’changes health care into a commodity that will be more expensive and less effective, and will render a free people less free.’’

Here’s a link to Hudgens’ Commentary.

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