Deal supports alternative to ACA . . . if it’s fair to Georgia

Gov. Nathan Deal said Tuesday that he supports congressional Republicans’ effort to repeal the Affordable Care Act, but also said he wants more details on the GOP plan to replace the law – and its potential effects on Georgia.

“We’re still looking at the implications’’ of the American Health Care Act, the proposal that’s moving through the U.S. House, Deal told GHN in an interview.

Gov. Deal
Gov. Deal

Deal, a Republican, summed up Georgia’s perspective on the proposed new health plan in a few words. “Our message to Congress is: We want to be treated fairly.”

The GOP bill would eliminate the ACA’s requirement for individuals to have health coverage, instead implementing tax credits to induce people to have insurance. The proposal also would fundamentally change the Medicaid program, which currently covers about 2 million Georgians.

Medicaid would be switched to a block grant program, whereby states would get greater decision-making power over the program, and the feds would provide a set amount of funding. Deal has supported the concept of a block grant program in the past.

The legislation also would phase out Medicaid expansion beginning in 2020. Georgia is one of the 19 states that have opted not to expand their Medicaid rolls as called for under the ACA. The Republican bill would give those non-expansion states $10 billion over five years for safety-net funding.

The bill would base the per-enrollee block-grant funding on what each state spent in 2016.

Georgia is a traditionally low-spending state on Medicaid, with one of the lowest per-enrollee expenditure rates in the U.S.


“We just don’t want to be punished’’ as a state under the proposed Medicaid changes, Deal told GHN.

The replacement part is “very difficult to do,” Deal said. He added, “There are going to be parts of it that some people don’t like.”

He reiterated his longtime opposition to the ACA. It passed Congress in 2010 without a single Republican vote, Deal noted, and he said that showed its flaws.

The Congressional Budget Office reported Monday that 24 million Americans would lose coverage over the next decade under the GOP proposal. (Some of that would be voluntary as consumers choose to be uninsured.) Georgia already has a high uninsured rate, at about 14 percent.

The governor said he welcomed another CBO’s estimate — that if the bill passed, the federal deficit would decline by more than $330 billion over 10 years. “Anytime you see the deficit going down is a good thing for everybody,” he said.


State Sen. Chuck Hufstetler, a Rome Republican who is a member of Lt. Gov. Casey Cagle’s Health Care Reform Task Force,  said Tuesday that Georgia “would be significantly punished’’ in Medicaid funding under the American Health Care Act.

Hufstetler cited Georgia’s conservative per-enrollee spending, plus the fact that the state has not expanded Medicaid. Under the current GOP bill, he said, “Republicans would be rewarding the states that spent the most money on Medicaid.”

Many health care provider groups, meanwhile,  have voiced their opposition to the GOP legislation.

Earl Rogers, president of the Georgia Hospital Association, said in a statement that his organization “has significant objections to sweeping reforms to our health care system that would lock the state into arbitrary payment caps, effectively eliminating certain payments for hospital services and reducing resources for caregivers to treat what will surely be an increase in the number of uninsured patients.”