A group of health care experts, consumer advocates, lawmakers and state officials voted Tuesday to pursue legislative options for creating a Georgia health insurance exchange.
Gov. Nathan Deal, while opposing the federal health care overhaul, appointed the committee in June to study whether the state should design its own insurance marketplace -- a key part of the overhaul. The federal government will set up exchanges for states that opt out of running their own.
“This is really the pivotal first question that needed to be answered,” said Blake Fulenwider, the governor’s health policy adviser.
Using the health insurance exchange, consumers who don’t have coverage through their employers will shop for options offered by private companies. It will also determine if someone qualifies for Medicaid, the government program that provides coverage for low-income Americans. A separate exchange would allow small business owners to shop for plans to cover workers.
Even in opposition, Deal said earlier this year that it made sense to study Georgia-based solutions while the courts decided whether the law is unconstitutional. The group chose Tuesday to create a subcommittee that will focus on alternative plans if a portion or all of the law is thrown out by the courts.
Last week, a three-judge panel of the 11th Circuit Court of Appeals in Atlanta ruled the federal law’s individual mandate -- requiring most people to buy health insurance in 2014 or face a fine -- was unconstitutional. The decision moved the argument closer to the U.S. Supreme Court.
“Any good business in doing strategy planning needs to have contingency plans,” said Ron Bachman, CEO of Healthcare Visions, which promotes free market-based health care solutions.
The potential for dramatic changes remains, Bachman said, because a Republican Congress might decide not to fund billions of dollars in federal tax credits to help consumers pay insurance premiums.
Regardless of the health care law’s fate, Georgia needs to solve the health care problems of cost, access and quality and make the market functional, Bachman said.
The committee has been focused on the industry side of things, but it shouldn’t lose sight of consumers, said Cindy Zeldin, executive director for the nonprofit Georgians for a Healthy Future. Roughly 1.9 million Georgians are uninsured and will have access to a health plan or Medicaid through the exchange.
In the coming months, the committee will examine a host of issues -- including who should run the exchange, how to make the system financially self-sustaining and its impact on the overall insurance market. It must issue a final list of recommendations to the governor by December.
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