Obama’s offer on health care gets chilly state reception

Georgia leaders push forward with effort  to defeat federal law

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By Carrie Teegardin

The Atlanta Journal-Constitution

Georgia leaders say they intend to continue to fight the federal health care law in federal court despite President Barack Obama’s pledge this week to give states more flexibility.

Curtis Compton ccompton@ajc.com A press secretary says Gov. Nathan Deal “is committed to fighting the unconstitutional mandate that we as a state cannot afford,” referring to healthcare reform.

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Obama said he would support giving states a chance to opt out of major requirements of the law in 2014, instead of waiting until 2017 as the law requires. But states that opt out would still have to insure most of their residents without costing the federal government more than current law envisions. Congress would have to approve such a change.

Georgia’s leadership is still focused on trying to defeat the law in court. A series of federal judges have both supported the law and rejected it. The U.S. Supreme Court may ultimately have to decide if the law stands or not.

Gov. Nathan Deal “is committed to fighting the unconstitutional mandate that we as a state cannot afford,” Stephanie Mayfield, Deal’s press secretary, said in a statement Tuesday. “He will fight it all the way to the Supreme Court and, along with many other governors, has already asked the president to expedite the litigation.”

The state is eager for as much flexibility as it can get if the law stands. But Georgia is just beginning to craft a plan to implement the law, which requires most people to obtain health coverage by 2014.

Georgia Insurance Commissioner Ralph Hudgens said Tuesday he is “reserving judgment” on whether Obama’s offer will make sense for Georgia. He said the requirement that states insure as many people without adding to the federal government’s financial tab seemed problematic.

“I question along with a whole lot of other people if their cost projections were anywhere near accurate,” Hudgens said.

If Georgia has to meet the federal government’s cost projections in order to opt out, Hudgens said “there is no way we can do it.”

Hudgens said Georgia will consider the option, though, as it works on a plan to create a state-based insurance marketplace, which is a major provision of the law. Hudgens said the state plans to appoint a committee of experts to come up with a slate of recommendations for a Georgia “insurance exchange.”

Legislation that would set up a framework for Georgia to begin implementing the new law is expected to be introduced during the ongoing session of the Georgia General Assembly.

“I think it’s positive,” said Ken Thorpe, an Emory University professor and health policy expert. By at least offering the chance to pursue an alternative, the Obama administration is showing it’s not rigid, he said.

Some experts said the flexibility that Obama offered is limited.

“It’s just a public relations move,” said David Merritt, a health policy expert at Newt Gingrich’s Center for Health Transformation. “He said you’ll have flexibility but you still have to hit all these goals, and all the goals are what is in the reform law.”

Other experts said the option would probably be more attractive to states that already have programs in place to provide insurance to most of their residents.

Experts could devise incentives for Georgians that might result in widespread insurance coverage without a legal mandate, said William S. Custer, a Georgia State University professor who is an insurance expert.

“The problem is, there is not a lot of time,” Custer said.

States must have plans for their insurance exchanges complete by 2013, so that they can be up and running by 2014.

About 1 in 5 Georgians has no insurance coverage. The federal plan envisions a big chunk of those people gaining coverage by joining Medicaid, the government health plan for low-income people. It’s a complicated undertaking since Georgia is starting from scratch on the issue.

“I don’t see how Georgia could change course and set up a separate system that would get nearly everyone covered and meet those affordability provisions without doing it under the federal framework,” Cindy Zeldin, director of Georgians for a Healthy Future, a group that supports federal health care reform.