Gov. Nathan Deal said Thursday that it's too early to determine if the state will expand its Medicaid rolls as the federal health care law now allows.
The Supreme Court ruled Thursday that states may choose not to expand Medicaid eligibility without losing all of its federal funding as the new health care law original required. That flexibility means the state must decide whether to add about 620,000 individuals at a cost of more than $76 million when the eligibility begins in 2014.
Deal said there "are a lot of unanswered questions," including whether the state would have the option to eventually roll back eligibility to its current levels.
"Those are questions we don't know the answer to," Deal said. "It's too early to say in this point and time."
Deal said it's also too early to say if Georgia will create its own healthcare exchange or allow the federal government to create and operate one here. The new law requires states to show "intent" of creating an exchange by Nov. 16 of this year.
Georgia originally began studying an exchange in 2011 but stopped in part over Tea Party opposition, and in part over uncertainty over what the law would require exchange policies to cover.
Deal said Thursday that he intends to wait until after November's election before making a decision.
"The elections in November will determine a lot of those decisions that will have to be made at some point in time," Deal said, noting that should Republican presidential hopeful Mitt Romney win the White House and Republicans claim Congress there is a strong likelihood the law will be repealed or changed.
"We can then make the judgment call whether or not there will be significant legislative action to repeal or modify significantly this legislation that has now been approved by the court," Deal said. "We are probably going to be a in a holding pattern until such time we see what the events of November elections bring us."
If President Barack Obama wins re-election, Deal said, Georgia's Legislature will go into session in January and have "adequate time" to act."
He said he realizes, however, that there is a "short window" between the Nov. 6 election and the Nov. 16 deadline. "We will have to make some decisions in that regard," he said, and promised to continue to work with Insurance Commissioner Ralph Hudgens on a plan.
Much of what the federal government will require of policies issued by the exchanges remains unknown, he said. Federal agencies have issued some mandates, but not all.
"As long as that is in limbo it leaves everyone in a quandary about how you would approach it from a state standpoint," Deal said.
Deal, a former congressman who voted against the health care bill in 2010, said he does not believe it will take a special legislative session this year to decide whether to move forward with a state exchange. While he said he would consult with leaders of the House and Senate on a plan, the federal government needs only to know the state's intent.
If Washington does require an act of the state Legislature, Deal said he would hope there would be "leniency" and ability and an extension until January when lawmakers are scheduled to return.
A special session is a real possibility in 2013, he said. He and the General Assembly will likely have finished the state budget for the next fiscal year before all of the questions surrounding Medicaid expansion and the health care exchanges are known. "If something major happens after we adjourn next year that would be one of those kinds of situations that might require a special session," Deal said. "Let's hope not. I will do everything in my power to avoid that."
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