Next DCH chief will have huge health care role

$7 billion is a lot of taxpayer dollars.

That’s the cost of the government Medicaid and PeachCare programs in Georgia, and it alone would make Gov.-elect Nathan Deal’s choice for Department of Community Health commissioner vitally important for the state. But it’s only part of the picture.

On Friday, Deal announced that Clyde Reese, the current DCH commissioner, would move over to take the top post at the Georgia Department of Human Services, if approved by that department’s board. Reese, an attorney, is highly respected by medical providers and consumer advocacy groups in the state. He has headed Community Health since April, when then-Commissioner Rhonda Medows resigned and took a position with UnitedHealthcare.

The person whom Deal will nominate to succeed Reese as Community Health chief will preside over much more than Medicaid and PeachCare, the insurance program for uninsured children. There’s the State Health Benefit Plan for teachers, state employees, retirees and their dependents. With more than 600,000 members, it’s the biggest health plan in the state.

The agency also now oversees the Public Health division (though that may be broken off to become an agency of its own) and supervises the licensing and regulation of health care facilities in the state.

And whoever becomes commissioner will have a big say in how health care reform is implemented in Georgia, if the new federal law isn’t derailed by the courts or Congress. Under reform, Medicaid would be greatly expanded in 2014 to cover lower-income adults who are now uninsured.

The DCH commissioner will oversee Medicaid at a time when budget-cutters will scrutinize the program for savings. What can happen when services are trimmed? Take the case of Arizona, where people awaiting transplants have hit financial roadblocks because of Medicaid cuts. Here’s the New York Times article on the Arizona debate, which has prompted a back-and-forth about “BrewerCare” (as in Arizona Gov. Jan Brewer) and “ObamaCare.”

The coming year will bring new contracting for health plans that oversee the care of more than 1 million Georgians on Medicaid and PeachCare. The three care management organizations (CMOs) now handling those plans have drawn criticism over the course of the current Georgia contracts.

The choice of Community Health commissioner may send an early message about the Deal administration and how it will tackle health care problems in the state.