State won’t act on health insurance exchange

The Georgia General Assembly will not take up legislation to create a health insurance exchange during this year’s session, a key committee chairman said Thursday.

Sen. Renee Unterman (R-Buford), chairman of the Senate Health and Human Services Committee, said the Republican legislative leadership and Gov. Nathan Deal have agreed not to push an insurance exchange bill. She spoke during a panel discussion sponsored by the consumer advocacy group Georgians for a Healthy Future.

That decision comes despite the recommendation of an advisory committee, appointed by Deal, that the state move forward on creating an exchange for small businesses.

An exchange is envisioned as an insurance-buying marketplace that allows individuals or groups to find the best deals on coverage. The advisory committee had stopped short of backing one for individuals in the state.

A spokesman for Deal told Georgia Health News that uncertainty over the 2010 federal health reform law drove the decision to hold off on any exchange.

“With the Supreme Court set to issue a landmark decision on Obamacare this spring, the governor does not want to move forward until the court has ruled,” said Brian Robinson in a statement. “Plus, the governor was concerned about mandates concerning exchanges from the Obama administration’s Department of Health and Human Services.”

Democratic lawmakers on the panel expressed immediate disappointment with the decision not to move forward.

Several advocates of a go-slow approach agree with the governor that there is too much uncertainty about the future of the health reform law. The high court, when it rules later this year, could uphold the entire law, declare parts of it unconstitutional or declare all of it unconstitutional.

“There are too many variables,’’ said Rep. Richard Smith (R-Columbus), who chairs the House Insurance Committee and was part of the Thursday panel.

Georgia is one of 26 states fighting in the courts to overturn the reform law.

If the reform law is upheld and fully implemented, the federal government will step in and run exchanges in those states that don’t establish and operate their own.

Is this the last chance?

It’s generally believed that the 2012 General Assembly session is the last opportunity to create legislation for Georgia to set up its own exchange before 2014, unless a special session is called at some point.

Len Nichols, a health policy expert at George Mason University, told the gathering that 12 states already had set up exchanges. “It will be extremely difficult to be compliant [with the health reform law] if you don’t start now. This is the time to do it.’’

Sen. Nan Orrock (D-Atlanta), a member of the Thursday panel, said both opponents and supporters of health reform can agree on the need for an exchange, an online shopping mall that would boost the insurance-buying power of individual consumers and small businesses.

“Smart leaders can come together,’’ Orrock said. “The business community has said, ‘We want this, we need this.’ We’re missing the boat.’’

Rep. Pat Gardner (D-Atlanta) pointed out that the number of Georgians without health insurance has steadily increased. Roughly 2 million residents have no coverage currently.

“We need to be prepared for the contingency”  that the health reform law is held constitutional, said Gardner.

Smith suggested there is no urgent need for such preparation. He said that if the Supreme Court upholds the law, Georgia could let the federal government set up the exchange, and the state could take over its operation later.

Dim prospects for tobacco tax?

Still, state Insurance Commissioner Ralph Hudgens, a Republican, said he favors setting up a health insurance exchange, noting that it’s an idea originally hatched by the conservative Heritage Foundation.

An exchange could act as a ‘‘superagent’’ for individuals seeking coverage, Hudgens told the gathering. “I would like to see the Legislature move forward on an exchange.’’

Last year, legislation to set up the mechanism for an exchange, though it was backed by the Republican leadership, died in the General Assembly after unexpected opposition from Tea Party members.

On another health-related matter, Unterman predicted that a proposed $1 tax increase for cigarettes will not pass. She noted that many legislators have signed a pledge not to raise taxes of any kind.

Unterman also said the state is making major changes in the Public Health infrastructure, and that the state funding formula for public health districts is being reshaped.

And she applauded the governor’s recommendation for 400 new residency slots for physician training in Georgia.