Health care law: Court ruled, now state should act

Georgians need health care fixes. Thus, Gov. Deal’s decision to do nothing toward that goal in hopes Obama’s law will be repealed is bad medicine. Read what the AJC Editorial Board, Dr. John P. Maupin, and other leaders have to say. Then comment below.

By the AJC Editorial Board

The longer Georgia waits, the more we could lose.

That’s a very real possible outcome of our leaders’ stubbornly steadfast pattern of delaying implementation of health care reform.

If the state continues to whistle and wait in the hopes that relief from Obamacare will somehow, some way, appear, the risks are real and the downside is significant if the reforms survive future challenges. Standing still may play well politically, but it does nothing to help Georgia’s businesses and consumers pragmatically plan their future health care decisions.

In sticking with inaction as a strategy, Georgia lost a major, first-round decision Thursday when the U.S. Supreme Court largely let stand the landmark health care law.

With that judicial hope dashed to derail Obamacare, state officials should now move to begin implementing two key parts of the controversial law.

One calls for states to set up health insurance “exchanges” that would offer coverage options to uninsured Georgians.

The other major plank of the law that state officials would like to see disappear in its entirety calls for expanding state Medicaid plans, a move expected to add about 650,000 Georgians to the program. The high court did perhaps bolster Georgia’s hopes on Medicaid by ruling that the feds cannot withhold money from states that refuse to enlarge Medicaid programs.

On the day the court’s opinion was announced last week, Gov. Nathan Deal told reporters, “Obviously, the elections in November will determine a lot of these decisions that will have to be made by the state at some point in time.”

“We are probably just going to be in a holding pattern until such time as we see what the events of November bring us,” Deal said.

Any airline executive can attest that keeping jets in a holding pattern doesn’t move them from Point A to B, but it does burn lots of expensive fuel. The contentious issue of health care reform is similar in that respect — solutions won’t get any cheaper or easier even after several more pages are ripped from Georgia’s monthly calendar.

In fact, matters may well deteriorate if our inaction continues. Time spent waiting on the outcome of November’s elections would be better spent engineering the details of what Georgia’s insurance exchange would look like. That would give us the best chance of crafting a brokerage that works best for the state, its budget and consumers. Georgia should take the initiative, within federal guidelines, to design the electronic marketplace offering insurance options, public and private, to state residents.

If we don’t step up soon, then we could face two unpleasant options. The worst one would see the federal government stepping in to establish and run Georgia’s exchange. We strongly doubt a D.C.-designed operation would be an optimal solution for this state. Georgia can do better by setting up its own exchange.

The other suboptimal scenario sees Georgia scrambling at the 11th-hour to set up an exchange if President Barack Obama’s law survives the congressional sausage grinder and the implementation countdown keeps ticking. Hurriedly hammering together a solution would leave us both vulnerable to poor decision-making and unlikely to negotiate the best deals with insurers for coverage and rates.

Even if today’s health care reform is dumped at some point in the future, it’s still prudent to make plans to implement what’s now the law of the land.

Proactive initiative is better than inaction, we believe. That’s especially true, given that both the unpopularity of Obamacare and the growing weight of health care costs make the status quo an endangered species under most any scenario.

The dual challenges of controlling health care expenses and providing reasonable health system access to more Georgians will be with us long after whatever changes may be set in effect by the outcome of the November elections.

It will be the case even if Deal and Attorney General Sam Olens get their wish and the next Congress quickly moves to “repeal and replace” the Patient Protection and Affordable Care Act.

An estimated 30 million Americans lack health insurance. Georgians account for nearly 2 million of that total, numbering 19 percent of the state’s population.

That must change, one way or another. The American way of health care needs a major overhaul. On that much, we nearly all agree regardless of political leanings.

Our challenge in Georgia, and nationally, is to find a better way than the present path of paying more for less when it comes to health care. The faster we set about and complete that work, the healthier our wallets and bodies will be.

Andre Jackson, 
for the Editorial Board

Lessening the burdens of the underserved

By John P. Maupin

On Thursday, the Supreme Court of the United States largely upheld the Affordable Care Act.

After months of debates and harrowing statistics tossed back and forth, the question remains, what does this mean for Georgians?

For the working poor and 1.83 million impoverished Georgians who strive to keep their families healthy, it means access to quality care.

For 43,500 uninsured young adults in Georgia, it means an opportunity to remain covered.

For the 1 million kids in Georgia suffering from obesity, it means a move toward prevention and wellness programs that prevent this chronic disease.

This landmark decision is a step in the right direction as we aim to close health disparities for all.

Currently, about 19 percent of Georgians are uninsured — one of the highest percentages in the nation.

Georgia ranks fifth highest in the number of residents who died prematurely because they didn’t have health insurance, according to a study by Families USA.

When the Affordable Care Act is fully implemented, this figure drops to 6 percent — a major win for our state and its people.

Our state boasts very diverse communities and needs.

The sweeping changes within the Affordable Care Act grant us the opportunity to provide quality care to those who have been historically underserved.

During the past five years, Morehouse School of Medicine has had the highest percentage of graduates entering primary care.

Often we are at the frontline of care in the communities that are medically underserved and we recognize the shortage that exists, particularly in rural areas.

A reformed health care system allows us to increase the number of primary care physicians and provide them with the experiences and skill set needed to treat diverse populations.

Georgia’s medical schools will be able to continue to implement community-based strategies that address the needs of low-income and minority families.

It is critical to also note that by eliminating health disparities, we will ultimately help save lives.

The estimates range from 20,000 to 45,000 people who die each year in our country because they lack insurance.

Isn’t one life one too many?

For Georgia, the answer is yes.

Dr. John P. Maupin is president of the Morehouse School of Medicine.

ON THE RECORD

Following are responses from conservative leaders issued after the U.S. Supreme Court ruled on the health care reform law.

Gov. Nathan Deal: “My battle with Obamacare didn’t start when I was elected as governor of Georgia. I wear with pride my bruises and scars from the fight against its passage in the U.S. House. Today, the highest court in the country let the American people down.

“While we recognize this is a huge setback for fiscal sanity and personal liberty, we are not giving up. Georgians and the American people deserve high-quality, sustainable health care. Congress must now work steadfastly on repealing this law and replacing it with reforms that help taxpayers instead of hurt them.”

Kelly McCutchen, president of the Georgia Public Policy Foundation: “The Founding Fathers would be mortified to see the body blow to their hard-won concept of America’s limited government. Congress now has the power to do whatever it wants.”

“This flawed decision highlights the urgent need for state action to protect taxpayers and health care consumers from the harmful effects of this law. The solution to this nation’s health care problems certainly are not in Washington, D.C., and this ruling reinforces our commitment to work harder than ever to restore the proper balance of individual rights and government power in Georgia and in Washington.”

Ronald E. Bachman, a senior fellow of The Georgia Public Policy Foundation: “Anyone who believes the Supreme Court’s ruling has ended the debate on the law is sorely mistaken. The economy will be the leading issue in the November 2012 election, but health care is 17 percent of the economy. The costs and mandates associated with the federal health law have impacted and will continue to affect jobs and job growth in the economy.

In the end, as [Chief Justice John] Roberts stated, ‘We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation’s elected leaders.’ In November, voters will decide its fate. There is indeed a court higher than the U.S. Supreme Court: the court of public opinion.”

U.S. Rep. Lynn Westmoreland, R-Coweta County: “In March 2010, President Obama and congressional Democrats had their say. On the last Thursday in June, the Supreme Court had its say. And on November 6th of this year, the American people will have their say. To quote President Lincoln, our nation is one of the people, by the people, and for the people. And a majority of the people … want this law repealed.”

30 comments Add your comment

ByteMe

June 30th, 2012
5:03 pm

Buncha sore losers with government-provided health care complaining because other people want health care and can’t get it. So they label it “socialism” (no, not the part where they receive government-sponsored health care, but the part where other people want to be able to pay to get their healthcare from a private company) or “marxism” or “the end of America”. Losers.

And people who buy into their “socialism” nonsense are useful idiots, because they lack the ability to think beyond the propaganda and sloganeering.

[...] post: Health care law: Court ruled, now state should act – Atlanta Journal Constitution (blog) Tags atlanta-journal, care-law, court, journal, nothing-toward, now-state, obama, [...]

Pizzaman

June 30th, 2012
6:32 pm

What else do you expect from a man who voted against the ACA then resigned rather than be impeached( yes tighty righties censure is Congresses impeachment procedure). Another white southerner defying the President because he’s black. All Georgians will suffer in the end because of his ego.

yuzeyurbrane

June 30th, 2012
6:55 pm

Let’s get practical here. Very very wealthy people will always get primo healthcare. But fewer of the rest of us each year are able to get it. So if you think, “I got mine, screw everyone else”, mostly likely you would end up on the short end of the stick unless something changed. Doctors and other health care providers will do just fine especially if they were permitted to just turn people away from ER’s and let them die. But if that doesn’t change then hospitals written off noncollectable bills will keep growing until they grow to such a critical mass that they start closing. It is already beginning to happen so don’t scoff. Prospective doctors who are mainly motivated to become millionaires may indeed instead choose hedge fund managers. Good. So Obamacare at least represents a reasonable shot at these problems which have been increasing. There is no going back to the old forever private practice model–it has failed. Under Obamacare we will at least have a good start at providing quality affordable health care for all Americans. And it includes measures to reduce health care costs for both private citizens and the government. Georgia in particular should not cut off its nose to spite its face. We should seize the moment and shape our own exchange (although a strong argument could be made that Georgians would be better off if the Feds implemented our exchange rather than Deal and his cronies) and we should join the overwhelmingly Federally subsidized expansion of Medicaid to people who cannot afford insurance premiums because it is the right thing to do for hundreds of thousands of poor Georgians, not to mention the billions of Federal dollars which would flow into the Georgia economy and into the pockets of hospitals, doctors and others in the healthcare industry. We are a poor state aren’t we? Now, this is not to say Obamacare is perfect. If I had my druthers, there are a number of things I would have done differently. But it is a reasonable start and we can modify it as experience dictates. The likely alternative would simply be a continued march towards higher premiums with poorer care for less and less people.

Retired Vet

June 30th, 2012
8:34 pm

The right is now crying health care tax! No, a tax/penalty for freeloaders who do not buy health insurance. Single folk can also cry childless tax because poeple without children do not get tax credits that people with children get. Let’s face it. There are winners and losers in every facet of our tax code. Get over it already. Somehow the ones screaming the loudest, tea party types, make it seem as if they are the only ones taxed. Eyeroll.

Retired Vet

June 30th, 2012
10:05 pm

Another thing. Federal taxes for everyone including the very wealthy are the lowest ever yet some people act as if taxes suddenly skyrockted snice 2008. Why is that? Denying facts and believing what one wants to believe despite facts makes for a delusional individual. More scary is when the delusional organize under a banner and become rowdy and are enabled by elected officials who clearly know better.

JayInAtlanta

July 1st, 2012
1:16 am

A decision by governor Deal to not implement two of the best parts of the Affordable Care Act would be ludicrous and disgusting. It mirrors the unconscionable actions by Florida governor Rick Scott and Louisiana governor Bobby Jindal.

These are simple concepts:

- He is rejecting an expansion of a program that already exists, which would now be able to provide healthcare coverage for Georgia citizens who make up to 33% more than the poverty line. (It’s also worth noting that as taxpayers, we are paying MORE for these people today when they use emergency room services. Medicaid is a CHEAPER way to deal with this problem for the state, and it’s humane.)

- He is rejecting perhaps the best part of the Affordable Care Act: state healthcare exchanges. This would be a marketplace where we could buy PRIVATE INSURANCE for minimum coverage at the lowest possible rates. Like an “eBay” for insurance, if you will. This was a great idea when Mitt Romney implemented it in Massachusetts, and it’s a great idea today.

Generations of my family have lived in Atlanta. It would be hard to find a person as proud of our great city and our great state as me. I am a centrist and I have never wanted to leave Georgia. But why is our governor so intent on lying to citizens, and working AGAINST their interests? Georgia, Florida, Louisiana: these states will actively drive away centrists who would prefer to live somewhere where governors actually accept common sense laws, no matter which party proposed them.

bug

July 1st, 2012
4:28 am

“IF YOUR INCOME IS LESS THAN YOUR OUTGO, YOUR UPKEEP WILL BE YOUR DOWNFALL!”

No one or no country can spend themselves out of poverty. America spends more and more on some form of “hand out” each year and the only thing we have accomplised is more non producers wanting more without contributing anything.

GB

July 1st, 2012
7:01 am

“For the 1 million kids in Georgia suffering from obesity, it means a move toward prevention and wellness programs that prevent this chronic disease.”

One could not find a better example of the rot that is destroying our country. There seems to be no problem that does not demand a massive government program. Kids are fat: pass a 2700 page bill and spend trillions of dollars.

GB

July 1st, 2012
7:04 am

Yeah, Pizzaman. It is all because he is black. No doubt about it. Were he white all these conservative white southern politicians would be 100% supportive of Obamacare. They just don’t like black people. Or people who are half black.

buzztech

July 1st, 2012
7:36 am

@JayInAtlanta, I can get you the phone number for the moving company to assist you in leaving.

jd

July 1st, 2012
7:39 am

As soon as Georgia gets over the fact that President Obama is a man of color, you may see some normal reaction to a law that will eventually help the nation. Conservatives are sitting around hoping that President Obama will just ‘go away’. It’s not gonna happen. So get off you dusties and work with the New Program. Look at it this way. President Obama is just a PIONEER. In other words, there are more to come, just like him. I agree with ByteMe. Get over your losses and get busy trying to help the nation. As President Kennedy said, ‘Ask not what your country can do for you,…….’. You know the drill. Do your self another favor, look around the world and try to figure out who is RUNNING THINGS! If that does not work, go back underneath your rock!

middle of the road

July 1st, 2012
8:02 am

“And a majority of the people … want this law repealed.”

Do they? Or do they just want the “I now have to buy insurance so I can’t mooch off of others” part repealed? Do they want the part where theie kids can stay on the parents insurance after college until age 26, hopefully when they will have a job that provides insurance? Or do they graduate college, and immediately have to find insurance or take the big risk (or just mooch off of us insured). Anyone can come down with a major disease, just ask Aimee Copeland. Does the American people want the part of the law repealed that says you cannot have your insurance terminated when your insurance company finds out you have cancer? Does the American people want the part of the law repealed that says you can buy private insurance if you get laid off from your job after 20 years, and you have a pre-existting condition (like diabetes)?

No, Americans just want to “eat their cake and have it, too”.

They want the best parts of the law, but they don’t want the part that will tell a few people that they HAVE to buy insurance or pay a very paltry additional tax that nowhere near covers what they cost the rest of us.

If the individual mandate had been struck down, I would have campaigned for the logical solution then: create a law that hospitals could not transfer the costs of providing care from those who do not pay to those who do. Since Congress created the EMTALA law (an unfunded mandate) then hospitals should bill the US government for all unpaid bills the hospital can’t collect (thus funding the mandate). They should also make it legal for hospitals to check financing, and allow them to refuse care to anyone who cannot pay cash or has insurance – put them on the curb to die – now THAT is true FREE ENTERPRISE – the freedom to DIE.

That “other” party that is so unhappy with this law had plenty of chances to work within congress and make it a better law, but they did not.

Eric

July 1st, 2012
8:04 am

I’m all for repealing the law! Keep up the good work, GOP. (And would you believe I’m a Democrat, but not on this issue).

Craig Fluck

July 1st, 2012
1:30 pm

The Gov needs to read the stats, get off the proverbial pot, and crank up the health care exchange and Medicaid expansion, before he leaves office and has to get his own insurance.

Halftrack

July 1st, 2012
4:25 pm

We are in this mess because of the rush to pass a bill. There is only 4 months until Election time. A wait of that small amount will not hurt that much. It is in rushing to do something like chicken little did. The sky won’t fall in 4 months. Too much tax money, our money, is being wasted now.

Horace

July 1st, 2012
5:21 pm

It would be absolutely irresponsible for Georgia’s “leaders” to decline Medicaid expansion under the Affordable Care Act. An article in today’s AJC.com lays out some of the numbers regarding the existing cost for caring for the poor/uninsured – Georgia hospitals lose an estimated $1.5 per year caring for them, those with insurance spend an estimated $1,000 each per year caring for them. How much will that cost over the next 10 years? $20 billion maybe for a fractured, inefficient and insufficient system of care?

The federal government is offering this: lets expand Medicaid to provide a comprehensive way to cover these folks, while at the same time improving care by emphasizing preventative measures. It will be expensive – about $40 billion – but we will cover $35 billion of that. Yes, you will pay about $5 billion over the next 10 years, but look what you are paying now, and look at the benefit you are going to get.

Oh, and by the way Georgia “leaders”, even if for some strange reason you decide not to participate, the good people of Georgia are still going to be funding this Medicaid expansion with their federal tax dollars — you just won’t be giving them the benefit of it.

Horace

July 1st, 2012
5:22 pm

correction: Georgia hospitals lose an estimated $1.5 billion per year

BobV

July 1st, 2012
5:31 pm

Our owners, the GOPs, do not want people other than themselves to have health care, or for that matter, to vote or have jobs.

middleground

July 1st, 2012
7:11 pm

The President has the best care in the world and so does congress and government workers.
Obamacare will make the lawyers rich so they will have great care and all the rich CEO’s etc.
Who is not going to get great care but rationing by government? You

Anita Cunningham

July 2nd, 2012
7:51 am

YES!!! Deal is just like McConnell…does not care about the people..just wants to dispute anything with President Obama’s name on it.

Road Scholar

July 2nd, 2012
8:56 am

Did anyone watch CNN last night? They had a show on healthcare which was really revealing. In short, they PROVED the right and the whiners are wrong with facts! They compared different healthcare systems around the world. Did you know they all aren’t socialist threats? Taiwan and Switzerland have systems that actually work…and make doctors work for their money. Switzerland’s system is very capitalist but is a third less in respect to the % of GDP.

Dr Sumpta Gupta (sp) hosted it. Watch it, esp the conserves before you spout all that garbage you take for facts!

Road Scholar

July 2nd, 2012
9:13 am

Oh, and why not do the health care exchanges? Are they too capitalistic for the repubs?

MrLiberty

July 2nd, 2012
11:52 am

Yes, they should act. They should Nullify the Act on behalf of all hard-working Georgians. Then they should disband all of the regulatory apparatus in the state that destroys medical freedom. They should end all restrictions on interstate sales of health insurance, they should end all mandates on insurance coverage in the state so people can purchase exactly what THEY want, not what lobbyists have conned the legislature into forcing us to buy. The legislature should look at every single government intervention into medicine and get rid of everything that is not strictly about preventing force or fraud. The government is the reason why medicine is so expensive. They could help us all out by restoring freedom and getting the heck out of the industry.

MrLiberty

July 2nd, 2012
11:56 am

Ah yes, CNN presents an “unbiased” look at medicine, arrives at a non-free market conclusion and we are supposed to just blindly believe their conclusions. Road Scholar, you need to wake up and get an economics education. CNN is just a mouthpiece for the status quo. If any other medical system is actually working in another country it is likely because behind the scenes there is way more medical freedom than we have in this country. Don’t expect CNN to make that clear as they hate freedom, and certainly don’t expect our government to ever support freedom as they do not sustain themselves by giving us freedom. They sustain themselves by putting restrictions on OUR freedom that benefit their friends in bigPharma, big AMA medicine, big insurance, etc. We could have a great working system too if everyone had freedom again.

carlosgvv

July 2nd, 2012
1:18 pm

Enter your comments here

williebkind

July 2nd, 2012
1:52 pm

I knew something was amiss with CNN/AJC extensively reporting and writing about homosexuals. Now Anderson Cooper has announced his vile disgusting behavior. Yes, that should make about half of CNN homosexuals now. There goes unbiased reporting. I cant wait for Obama to come out and say he is bisexual. Oh wait, Jay are you coming out too?

just sme

July 2nd, 2012
2:03 pm

I have worked for my employer for 8 yrs now. Over the last 4 yrs I have not had a raise due to economic conditions, however the cost of our health insurance has risen each year while the coverage I have has declined each year? Really?? Some people think that’s perfectly alright?

Native Atlantan

July 2nd, 2012
4:22 pm

@williebkind: ur the poster child for the GOP….diversion, deflection and hate for certain groups….

Bigboy

July 2nd, 2012
4:25 pm

Repeal?The more southern Republican Gov open their mouths the more Independents move to the left.The red party will be lucky to keep the house let alone win the white house.It is about time to find someone other than Karl Rove to consult with on strategy.The base is not enough and wont ever be given the changing demographics so time to come up with some fresh ideas.Taxes,Socialism,We don’t want Obama..it will appeal to some but not enough.