Anti-Obamacare bill close to passage

Strips the governor of authority to expand Medicaid under the ACA and gives it to the General Assembly.

Where it stands: Has passed the House, 118-57, and a Senate committee. Could reach the Senate floor Tuesday.

House Bill 707

Bars any state or local government from creating a health care exchange or navigator program, makes it illegal for any state office or employee to advocate on behalf of Obamacare.

Where it stands: Passed the House last week, 115-59. Was amended in a Senate committee, meaning if it passes the Senate it must return to the House.

House Bill 292

Originally passed the Senate as a way to create a statewide Alzheimer’s registry to collect data about the disease. Was amended Thursday on the House floor to include much of HB 707.

Where it stands: Passed Senate and House, but the House changes must be approved by the Senate. If that happens, it goes to Gov. Nathan Deal's desk. If the Senate refuses, it could lead to a conference committee of House and Senate negotiators, who must try to reach a compromise.

An anti-Obamacare bill once dismissed as an election-year gimmick unexpectedly sailed through a key Senate committee on Thursday and moved closer to final passage.

In just five minutes, the Senate and Insurance Committee voted to move House Bill 707 from long shot to potential reality. Hospital officials, health care advocates and some lawmakers had pronounced the bill too extreme to pass. But tea party activists, among HB 707’s strongest supporters, were jubilant Thursday as their measure moved out to the Senate floor.

The bill, proposed by Rep. Jason Spencer, R-Woodbine, would bar local or state government from advocating for the expansion of Medicaid in Georgia — a key provision of the Affordable Care Act — and forbid the state’s insurance commissioner from enforcing any elements of Obamacare.

“We have stood up to the federal government,” Spencer said shortly after Thursday’s vote. “We said no to a bad idea today. We’re going to protect state resources because we cannot afford the ‘Unaffordable Care Act.’”

The legislation would also prevent any state or local government or agency from creating a health insurance exchange or a navigator program to help Georgians enroll in coverage through the federally run Health Insurance Marketplace. It’s one of two contentious bills targeting the health care law. The second, House Bill 990, which also cleared a key hurdle Thursday, would take the decision of whether to expand Medicaid away from the governor and put it in the hands of the General Assembly.

Both bills passed through their respective committees without debate or public comment.

“The fact that the Senate Health and Human Services Committee heard no testimony or looked at no studies … is shocking,” said Sen. Nan Orrock, D-Atlanta, who opposed HB 990. “It’s no way to do the business of the people.”

Sen. Renee Unterman, R-Buford, who heads the committee, said she did not allow discussion on HB 990 because of time constraints and that “everyone in this room is very very familiar” with the legislation.

“It’s a philosophical difference,” Unterman said. “It would not have changed the votes one way or another.”

Adding to the drama, the House on Thursday attached language from HB 707 to Senate Bill 292, also sponsored by Unterman, that would create a statewide Alzheimer’s registry.

‘The current system is flawed’

The lightning speed with which both bills swept through committee hearings Thursday stoked worry among Democrats, hospital lobbyists and advocates who warned the proposed pieces of legislation could hurt access to care for many of Georgia’s poorest and most vulnerable citizens.

HB 707 is so overly broad that it limits the state from operating its current Medicaid program as efficiently and effectively as possible, said Earl Rogers, president of the Georgia Hospital Association, which opposes the bill. It could prevent the Department of Community Health, which runs Medicaid, from covering new medications or expanding coverage of telemedicine and other technologies, Rogers said.

“It would prohibit the state from exploring alternative ways to expand insurance coverage for low-income Georgians, such as allowing them to purchase private insurance instead of joining the Medicaid rolls,” he said.

Spencer rejected complaints from hospitals that the bill will hamstring the state’s ability to make changes to the Medicaid program. In fact, he said, hospitals have a reckoning coming.

“Hospitals have been dependent for too long on the current (Medicaid) reimbursement structure,” he said. “The current system is flawed. We have to admit that.”

Medicaid expansion would extend coverage to about 650,000 Georgians, most of them adults without children. The government health program already covers low-income children, pregnant women, the elderly and the disabled.

Gov. Nathan Deal, a staunch opponent of Obamacare, has said repeatedly that Georgia can’t afford to expand a program that is already overwhelmed and ineffective. Rep. Jan Jones, R-Milton, who sponsored HB 990, said last week that expansion would cost the state nearly $2.8 billion over 10 years.

Expansion supporters, however, argue the real price tag would be much lower and that the state can’t afford to pass up the more than $30 billion in federal funds it would bring. Tim Sweeney, a health care policy expert at the left-leaning Georgia Budget & Policy Institute, said the cost of expansion would likely be closer to $350 million over a decade, after sales tax and other new revenues are factored in.

“Stifling conversation about the importance of Medicaid expansion does nothing for the hundreds of thousands of uninsured Georgians who are seeking health coverage options,” Sweeney said.

‘Let’s be honest: it’s an election year’

The bills come during a quick-paced legislative session designed to get lawmakers back home to campaign for a historically early May 20 primary. Rep. Dar’shun Kendrick, D-Lithonia, said she has an idea of why Republicans, who control the House and Senate, are jumping through hoops to pass anti-Obamacare legislation.

“Let’s be honest,” she said. “It’s an election year.”

But, Kendrick said, HB 707 — in whatever form — seemed too extreme even for the Republican-led General Assembly.

“I’m not really sure how it got this far, to tell the truth,” Kendrick said.

House Republicans, she said, might have passed it with the hope that the Senate would kill it.

“Maybe (House Republicans) sent it to the Senate on purpose to say, ‘We passed it, but those darn senators …,’” she said.

Before the House voted Thursday to add the anti-Obamacare language to SB 292, the Alzheimer’s registry bill, Minority Leader Stacey Abrams, D-Atlanta, argued that the legislation could subject state lawmakers to prosecution if they held a town hall meeting to discuss the Affordable Care Act, or responded to a constituent with a question about the law.

But Rep. Ed Lindsey, R-Atlanta, who proposed adding the anti-Obamacare amendment, said lawmakers are public officials and not state employees. Later, Lindsey said the General Assembly would quickly act if compelling evidence comes out that legislators would be limited in their ability to communicate with constituents under the bill.

If any of the bills are to become law, lawmakers must not tarry. The Legislature will meet again Tuesday and Thursday and then quit for the year.