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Health Reform

Commentary: A scary court case

Georgia has recorded strong enrollment gains in the second year of open enrollment for the health insurance exchange.

Erin C. Fuse Brown

Erin C. Fuse Brown

Yet an upcoming U.S. Supreme Court ruling could unravel that coverage for tens of thousands of Georgians, notes a Georgia State University law professor.

In a new GHN Commentary, Erin C. Fuse Brown writes that if the court strikes down subsidies in states that let the federal government run the exchange, that decision “would have grievous consequences for patients, providers, and the stability and affordability of health insurance.”

And Fuse Brown goes further. “If the court takes this opportunity to gut the ACA, it does so at the cost of the principle of separation of powers and the Supreme Court’s institutional legitimacy and credibility,’’ she writes.

Here’s a link to her 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

Legislator: Medicaid expansion may get a look

A Republican state senator said Thursday that he believes the General Assembly will hold hearings this year on the idea of Medicaid expansion in Georgia.

Sen. Chuck Hufstetler

Sen. Chuck Hufstetler

“I think there’s a number of Republican [legislators] who are looking for a solution,’’ said Sen. Chuck Hufstetler (R-Rome), after speaking on a legislative panel at an event sponsored by the consumer group Georgians for a Healthy Future.

The conventional wisdom has held that Medicaid expansion would not be a topic of discussion in the Republican-dominated Legislature, which convened this week. The issue barely came up in the 2014 elections.

Gov. Nathan Deal, a Republican, has been a vocal opponent of expansion, saying it would cost the state too much money. And last year, the General Assembly added an additional roadblock to such a move in the future. It passed a bill requiring legislative approval, not simply a decision by the governor, for Georgia to expand Medicaid.

About half the states have expanded Medicaid under the Affordable Care Act, including some led by Republican governors. If enacted in Georgia, it would extend coverage to an estimated 500,000 low-income people. full story

Georgia exchange enrollment nears 400,000

Almost 400,000 Georgians are signed up for coverage in the 2015 health insurance exchange, federal officials announced Wednesday.

The Georgia signup total as of Jan. 9 greatly exceeds the state’s 316,543 enrollees during the first open enrollment last year. The enrollment period this year ends Feb. 15.

clipboardU.S. Health and Human Services officials, who released Georgia’s 398,781 enrollment figure, did not include details on plan design, age, or other such characteristics.

Among the 37 states using federally run exchanges, Georgia trailed only Florida, Texas, North Carolina and Pennsylvania.

Since open enrollment began Nov. 15, nearly 6.8 million consumers in those 37 states selected a plan or were automatically re-enrolled in the federally facilitated marketplace, HHS announced. full story

Will Ga. hospital group go to bat for expansion?

Unlike its counterparts in other states, the Georgia Hospital Association has not been seen as actively advocating for Medicaid expansion.

A number of states have expanded their Medicaid programs, making more low-income people eligible for benefits and thus helping hospitals financially by reducing their numbers of uninsured patients.

Hospital Outpatient Entrance SignBut expansion has gone nowhere in Georgia. Gov. Nathan Deal and his fellow Republicans who dominate the General Assembly have made a point of blocking such a move, saying it would cost the state too much money.

Just last week, Georgia House Speaker David Ralston slammed the door on the idea once again. “I haven’t heard any widespread regret in Georgia on our decision not to expand Medicaid,” said Ralston, as reported by Tom Crawford in his Georgia Report.

But in recent days, Georgia’s biggest hospital association has crafted a proposal to the state that would include Medicaid expansion, and the group says the plan would be both beneficial and fiscally wise.

The GHA proposal, obtained by Georgia Health News,  calls for the state to take advantage of the federal government’s commitment to absorb 100 percent of the costs of expanding the program until 2017.

The plan urges the state to use $6.1 billion in federal funds to extend coverage for uninsured Georgians, with services delivered through the existing Medicaid managed care companies for two state fiscal years.   full story

Workers face increased burden on health costs

Health care costs are increasingly squeezing American workers, especially those in Georgia and the South, a new report released Thursday finds.

Healthcare CostNationally, workers’ out-of-pocket costs for premium contributions and deductibles in 2013 accounted for a higher percentage of median family income in all states compared to 2003.

According to the report from the Commonwealth Fund, this higher burden for workers comes despite a slowdown in health insurance premium growth in most states, including Georgia, since 2010.

In Southern states,  where incomes are below the national average, worker costs for premiums and deductibles are especially high compared with median income, the report found.

Combined costs for premiums and deductibles ranged from 6 percent to 7 percent of median household income in the District of Columbia, Hawaii and North Dakota, to 12 percent or more in Texas and Florida. The average was 9.6 percent.

Those worker costs were 10.8 percent in Georgia in 2013, up from 5.5 percent a decade earlier.

“Incomes haven’t grown as much as health care costs, so we’re all feeling it,” said Bill Custer of Georgia State University, when he was asked to comment on the report by GHN.  full story

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