Benjamin Wills’ dream is to open a private Christian school in a downtrodden area of west Atlanta. One hurdle he has faced, though, was...

Benjamin Wills’ dream is to open a private Christian school in a downtrodden area of west Atlanta.

One hurdle he has faced, though, was finding a less expensive source of health insurance for himself, his wife and their daughter.

Benjamin Wills speaks to reporters as (from left) Fulton County Commission Chairman John Eaves, Dr. Michael Brooks and Sylvia Burwell look on.

Benjamin Wills speaks to reporters as (from left) Fulton County Commission Chairman John Eaves, Dr. Michael Brooks and Sylvia Burwell look on.

Wills, 28, found an answer in the Affordable Care Act exchange. He chose a plan with a monthly premium of $370 for family medical and dental coverage — an amount that was less than what they were offered through an employer, he said.

The price and security of the ACA coverage, Wills said, helped give him confidence to establish his school, which he aims to open in August. “We want to serve others,’’ he said.

Wills and his family are among the more than 425,000 Georgians currently signed up for coverage in the health insurance exchange in 2015.

That signup number has exceeded expectations for this point in the open enrollment process. The enrollment period ends Feb. 15.

Wills joined U.S. Health and Human Services Secretary Sylvia Burwell and local officials at an Atlanta news conference Friday discussing enrollment in the health insurance exchange. The event took place at The Family Health Centers of Georgia’s location in the West End of Atlanta.

Burwell indicated that she was pleased with Georgia’s current enrollment number, adding, “We want to keep that number moving.’’ 

Different takes on Medicaid expansion

She also said that HHS is being flexible in discussing possible Medicaid expansion plans presented by states. Each state has different needs and approaches, she said.

The ACA calls for Medicaid expansion, but the U.S. Supreme Court ruled in 2012 that expansion is an option, not a requirement, for individual states. About half the states have chosen to pursue it.

Republican officials nationwide have largely been hostile to expansion, but Burwell pointed to Tennessee, Utah and Alaska as states that appear to be moving forward on Medicaid expansion plans. As she noted, such plans can differ by state.

In Georgia, Gov. Nathan Deal and his fellow Republicans in the legislative leadership have firmly rejected the idea of Medicaid expansion, citing the costs to the state. The issue was barely mentioned in the 2014 elections, and House Speaker David Ralston (R-Blue Ridge) told reporters recently, “I haven’t heard any widespread regret in Georgia on our decision not to expand Medicaid.”

Still, there appears to be a small group of state senators interested in at least discussing the idea. “I think there’s a number of Republican [legislators] who are looking for a solution,’’ Sen. Chuck Hufstetler (R-Rome) said recently.

Sylvia Burwell

Sylvia Burwell

Burwell, who has been in office less than eight months, said she has not had a conversation with Gov. Deal about the issue.

Deal’s spokesman Brian Robinson, in an email to Georgia Health News on Friday, outlined the governor’s position. “In Georgia now,” he wrote, “the governor cannot unilaterally expand Medicaid. It must be approved by the General Assembly.

“Gov. Deal has said that he would support a block grant approach that wouldn’t put Georgia on the hook for billions in new spending. The governor doesn’t believe we can afford expansion as it is currently set up, and he doesn’t believe that the federal government will be able to cover 90 percent of the cost [as it is committed to do] for very long into the future, which would put an even bigger burden on the state.”

Burwell noted that Medicaid expansion has been a financial help to hospitals in states that have pursued it. The move extends coverage to previously uninsured patients and thereby increases hospitals’ reimbursements. She alluded to the financial struggles of hospitals in Georgia, saying the plight of rural hospitals in the state “is extremely important.’’

 

Upbeat on exchange suit

The HHS chief defended the administration’s position in an upcoming U.S. Supreme Court case that could complicate how the ACA is being implemented.

Plaintiffs in the case are challenging the consumer subsidies offered in states, including Georgia, that have allowed the federal government to run their insurance exchanges.

The federal government approves the subsidies for consumers in both state-run and federally operated exchange, but the plaintiffs say the language of the ACA limits such subsidies to state-run exchanges. Currently, most exchanges are federally run.

“We believe we have the right legal position’’ in allowing the subsidies on a broad basis, Burwell said. She said Congress, in passing the ACA, would not have given a federal tax credit to citizens in New York state (which runs its own insurance exchange) without also giving it to people in Georgia.

Burwell listed among the ACA’s accomplishments an improvement in patient safety in hospitals; lower health cost increases for employers; and reduced overall spending on Medicare. The law led to a 10 million decrease in the number of uninsured in the nation, she said.

Dr. Michael Brooks, CEO of the Family Health Centers of Georgia, said Friday that the organization’s percentage of uninsured has dropped significantly since the ACA was implemented.

 


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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