Biggest health care impact on Ga. budget coming in 2016

As the U.S. House approved a sweeping health care overhaul Sunday, Georgians alternately were celebrating and bemoaning the changes.

Some, too, were wishing the long-labored legislation did even more.

“There’s going to be a lot of good, not only for Georgia, but all Americans,” said Lee Goodall, state director of Organizing for America, the Democratic National Committee’s grass-roots campaign arm.

Opinions are split over what impact the legislation will have on Georgians.

The major impact on the state budget — an expansion of the federal Medicaid program that provides health care coverage for lower-income people — will not take effect until at least 2016.

The White House projects that 95 percent of the state’s 1.7 million uninsured residents will gain coverage, more than half of them getting tax credits to help make it more affordable. But because the legislation requires people to have coverage beginning in 2014, those now uninsured will have to find insurance either through existing private plans or through new insurance exchanges that the plan will create. There is an exemption from the fine, however, for lower-income people.

Among the most vocal opponents of the legislation have been business owners, who fear the potential for a $2,000-per-employee fee if their workers get coverage through a government-backed insurance exchange.

But Democrats counter that the fee will only kick in for businesses with more than 50 employees and the legislation includes tax credits for small businesses to help provide coverage for their workers.

Goodall said more than 100,000 small businesses in Georgia will qualify for the credit. The White House says that while small businesses make up 74 percent of the state’s businesses, only 38 percent will offer insurance to employees. In the South Georgia district of Democratic Rep. Sanford Bishop, Goodall said, “it would give tax credits and other assistance to up to 181,000 families and 12,100 small businesses.”

Republicans, unsurprisingly, feel differently.

State Sen. Judson Hill (R-Marietta) has sponsored legislation that is intended to block the federal government from requiring anyone to have insurance. While a proposed state constitutional amendment to that effect failed on a vote last week, a separate bill that would do the same thing passed the Senate and is headed to the state House.

While it’s unclear whether a state can constitutionally block a federal initiative in this way, Hill’s measure is one of dozens proposed in state capitols across the country.

“Senate Bill 317 guarantees all Georgians the right to purchase private health insurance or join a government plan, but people can also exercise their right not to participate in any health care program without being fined,” Hill said.

Hill and Gov. Sonny Perdue have estimated that the eventual cost to the state from the expanded Medicaid program will be $500 million a year, while a U.S. Senate-backed analysis puts the figure at $145 million from 2017 to 2019.

The Medicaid expansion actually will occur in 2014 and will extend coverage to people who make up to 133 percent of the federal poverty level, or about $29,327 a year for a family of four. It will , for the first time, cover poor childless adults. The federal government will cover the entire cost for the first two years.

Georgia’s Department of Community Health has estimated Medicaid enrollment here will increase by 77 percent, or about 756,000.

“The state simply cannot provide basic services such as education and public safety with another billion dollars in spending forced on us by Washington,” Perdue said in a statement. “We all know Congress thinks they have a national credit card with no limit, now they seem intent on roping the states into their spending rodeo.”

But Democrats argue that Perdue and other Republicans ignore the savings the state will realize from the cut in costs for providing care to the uninsured.

White House estimates say state health care providers lose $1.7 billion each year from treating the uninsured. The state subsidizes a portion of that care.