The most prominent opponent of Obamacare in the Georgia General Assembly says he’s not done fighting the law.
Rep. Jason Spencer (R-Woodbine) pushed through the Legislature a Tea Party-supported bill that prohibits the state from running its own insurance exchange.
House Bill 943, passed at the tail end of the General Assembly, also forbids state employees to advocate for Medicaid expansion, and halts the “navigator” insurance counseling program at the University of Georgia. The bill was signed into law this week by Republican Gov. Nathan Deal.
Supporters of the Affordable Care Act, meanwhile, say that House Bill 943 is bad, though not nearly as bad as it could have been.
But Spencer told GHN this week that his legislation “is going to be a huge problem for Obamacare.”
He said it works in tandem with another bill – also signed this week – that requires legislative approval for a Medicaid expansion. (The state’s GOP leadership has already rejected such an expansion, but the new law makes a reversal of that decision more difficult.)
“We are the first state, to my knowledge, that has put such a tough initiative together at the state level to essentially throw sand in the gears of Obamacare,” Spencer said. “Other states are watching what we are doing.”
ACA supporters, meanwhile, expressed relief that one key provision was dropped from the bill. It would have barred the state insurance commissioner from enforcing provisions of the ACA, such as the prohibition on insurers discriminating against people with pre-existing medical conditions.
“That would have been very problematic,’’ said Beth Stephens, health access project director for consumer group Georgia Watch.
Cindy Zeldin of Georgians for a Healthy Future said the insurance commissioner’s office “is the first line of defense’’ in enforcing the law. “The feds don’t have the capacity to do everything that the Department of Insurance does.”
Spencer, though, vowed to work on legislation to restore the insurance department prohibition as well as a provision to allow the state to opt out of paying ACA-related fees and taxes in the state employees’ health plan.
“We will continue to push for more impediments to Obamacare,’’ Spencer said.
UGA navigator program
The Spencer bill started out with a blanket ban on state institutions and employees implementing ACA provisions. Tea Party activists packed a House hearing room to support the bill during an initial committee hearing on it.
But the bill evolved to something much narrower – specifically halting UGA’s navigator program when its grant runs out.
Still, Stephens of Georgia Watch said the provision on navigators is more damaging than the prohibition against a state-based insurance exchange.
Forbidding a state-run exchange, she said, “is unfortunate, but the state doesn’t seem to be heading” toward establishing one in any case.
Spencer told GHN that one big problem with the navigator program is that it is helping sign people up for Medicaid. “Georgia cannot afford for our Medicaid rolls to swell,’’ he said. “Otherwise we start cutting into the education budget, the transportation budget and the public safety budget.”
Though Georgia has not expanded Medicaid, people currently eligible for that program and for PeachCare can still be signed up for it.
House Bill 943 prohibits the state or any unit of it from expending money or assets to advocate or intend to influence citizens to support Medicaid expansion, which is optional for states.
Gov. Deal and legislative leaders oppose expansion, citing the cost to the state.
The Spencer legislation against advocacy has an exception for people who are discussing such issues as part of their regular jobs, or for educational purposes.
Spencer told GHN that the provision allows employees such as in DFCS or public health to point people “in the right direction, but they can’t help them sign up for Obamacare.”
The measure also allows elected officials to advocate for expansion while debating public policy, and university professors can discuss the ACA with students, Spencer said.
Stephens, though, said there are a lot of misconceptions about this language.
“People working for state agencies or state-funded agencies are afraid to talk about the ACA or Medicaid expansion,” she said.
Stephens, an attorney, said she thinks this provision could be challenged in court as a possible violation of the First Amendment.
Many critics say the law will lead to confusion among state employees on what they can and can’t say about the Affordable Care Act or Medicaid expansion.
Spencer said the attorney general’s role will be to clarify the law for state agencies and employees who have questions about it.
Overall, opponents of the Spencer bill consider it a partial victory that the final version of the bill was less sweeping than the original proposal.
Still, Zeldin said, the legislation “sends a bad message on where state policymakers are . . . that the state wants to prevent people from getting health insurance.”