Pro & Con: Should Georgia implement federal health care reform?

YES: With the fight over, officials must come together to make reform work.

By Pat Gardner and Nan Orrock


Some in Washington and Georgia want to derail health insurance reform. Our Insurance Commissioner John Oxendine, a candidate for governor, even went so far as to reject the opportunity to set up the high-risk insurance pool called for in the bill.

Our constituents deserve better than a system that so easily turns their health and financial future into a political football. The nonstop campaign grandstanding for today’s 24-7 news cycle shows why the Patient Protection and Affordable Care Act President Barack Obama recently signed into law is so important to the security of the hard-working people we represent.

The historic legislation, while not perfect, is an important first step toward making health care more affordable and accessible for all Americans.

For legislators in Georgia and every other state, the passage of federal health care reform also began a process that will be crucial to the families affected by our current health care crisis. That’s because the bill leaves many critical decisions on implementation to the individual states.

As elected representatives and state lawmakers, we have been entrusted with the responsibility to ensure that these new federal reforms work for our families. Unfortunately, Commissioner Oxendine and some other Georgia politicians have engaged in partisan attempts to refuse to implement the law and leave it to the federal government, or to repeal the law.

While that may score political points, it is not good for our state. Instead, we should be working together to help the families across Georgia who face bankruptcy due to lack of coverage or whose claims have been denied due to pre-existing conditions, or who simply can’t afford to pay the skyrocketing premiums insurance companies charge.

The new federal law ends some of the worst abuses of the insurance industry, including the practice of denying coverage to those with pre-existing conditions, dropping coverage for individuals after they get sick, charging women more than men and imposing annual or lifetime limits. In return, and coupled with subsidies for families who need help to afford insurance, the law will also eventually require that those who can afford to buy insurance do so.

This prevents people from taking advantage of the system by signing up for insurance only after they get sick. This “mandate” is less of a burden than the “mandate” the current broken system places on families whose illness could mean financial ruin and the “mandate” that those of us who have insurance pay higher premiums to pick up the tab for those who don’t.

Health care reform is projected to reduce the federal deficit by over $1 trillion in the coming years. It will also be a great deal for Georgia. The expansion of Medicaid, which will cover about half a million Georgians currently without insurance, will be fully paid for with federal funds for its first three years (beginning in 2014); after that, Georgia’s contribution will remain low, inching up to only 10 percent after 2020. With fewer uninsured patients having to use emergency rooms, all of us will save money. The reforms will also reduce the tax burden on many Georgians, providing tax credits to individuals and to small businesses to help them afford coverage for themselves or their employees.

The goal is quality affordable health care coverage that can never be taken away. It will not come about by accident. It will only happen by design.

It is time to put aside partisan politics and get together as a state to address the urgent challenge of implementing and improving these reforms for our families.

State Rep. Pat Gardner and state Sen. Nan Orrock are both Democrats from Atlanta.

NO: The numbers don’t add up. States must approach this new bill with skepticism.

By Paul Broun

With states already struggling to balance their budgets, it is unreasonable for the federal government to continue to place unfunded and unconstitutional mandates on states. It’s no wonder at least 21 states, including Georgia, have filed lawsuits challenging the constitutionality of the federal government mandating states to provide and individuals to purchase health insurance.

Throughout the health care debate, President Barack Obama’s sales pitch revolved on two main ideas: Health costs would decrease, and insurance companies would no longer be able to refuse coverage to individuals with pre-existing conditions. In theory, the idea appealed to many, but less than two months later, the American people are discovering the devil is in the new health care law’s details.

While tax increases take effect immediately, the majority of the benefits created in the 2,700-page health care law do not kick in until 2014. In an attempt to provide immediate coverage to currently uninsured individuals with pre-existing conditions, lawmakers included a provision that require the states to establish their own high-risk pools, which presumably will allow individuals and businesses to purchase high-cost insurance plans. States were given the option of operating the high-risk pools themselves or allow the Department of Health and Human Services (HHS) to carry out the program. In addition, the federal government pledged to support the states’ creation of these pools with $5 billion of taxpayer-funded subsidies.

However, states did not have the luxury of time or details to make this decision. Without any specifics as to how these programs would run, they were requested to announce their decision by April 30.

Shortly before this deadline, the Centers for Medicare and Medicaid Services’ (CMS) chief actuary, Rick Foster, announced $5 billion would not be enough to fund the high-risk pools through 2014. Foster explained, “We estimate that the creation of a national high-risk insurance pool would result in roughly 375,000 people gaining coverage in 2010, increasing national health spending by $4 billion. By 2011 and 2012 the initial $5 billion in federal funding for this program would be exhausted, resulting in substantial premium increases to sustain the program.”

As a result, 18 states, including Georgia, announced their intention to allow HHS to create and operate their state’s high-risk pool. While HHS has assured governors the programs would be paid for 100 percent by the federal government, aka the American taxpayer, state governors’ skepticism is justified.

It is prudent for states to heed Foster’s warning that the funding will run short, especially considering HHS has provided no details or outlines regarding how these pools will run. Will the federal government pump more money into the program? Will states be held responsible? And will states use significant time and resources to start up a program that eventually could be canceled should the federal $5 billion fund be exhausted?

There is a better way to help the uninsured who have pre-existing conditions obtain the health services they need without the funding and regulatory uncertainty that HHS’ mandate brings.

I am continuing my work with other members of Congress on legislation that would strengthen, expand and create new avenues for affordable health care for sick Americans through high-risk pools and reinsurance mechanisms. As a practicing family physician, I assure you that I will fight to prevent this government takeover of health care from defining the relationship between the doctor and patient. It is never too late to do the right thing.

U.S. Rep. Paul Broun (R-Ga.) represents the 10th District.