Some may recognize Ralph Hudgens as Georgia’s insurance commissioner, charged with the task of regulating the claims industry and protecting consumers from insurance fraud. Nationally, however, the 71-year-old is better known as the Republican who promised his department would do “everything in our power to be an obstructionist” against the Affordable Care Act.
Hudgens has softened his tone from a year ago, saying he was throwing the conservative crowd “some red meat.” Nonetheless, the controversial health care law known as Obamacare remains the core issue in his re-election race against Democrat Elizabeth “Liz” Johnson and Libertarian Ted Metz.
The Affordable Care Act
The state health care insurance exchange has settled despite a rocky start from a website dogged by technical troubles.
About 316,000 Georgians signed up through HealthCare.gov in its initial rollout. There are roughly 200 navigators to help guide the uninsured through the process of gaining coverage. Insurers have jumped aboard, too, with four new agencies, nine total, signed up for the program’s second year of open enrollment starting Nov. 15.
“They took a wait-and-see attitude and now they’ve come in,” Hudgens said of insurance companies. “The pricing is not going to be the same, but the coverage is.”
At every turn, Hudgens has repeated his distaste for the law.
With the clock ticking on a federal deadline only hours away in July 2013, he penned a letter demanding a 30-day delay from Kathleen Sebelius, then the secretary of the U.S. Department of Health and Human Services. He also championed a state law that required navigators to take a licensing exam, which led to a shortage of guides when his office reported that only four navigators were licensed before the health exchange went live last October.
Recently, Hudgens acknowledged his office has limited power to stop the changing tide.
“I’m not a fan of it. I don’t think it’s going to work,” Hudgens said about the federal health care law. “But there’s nothing I can do about it.”
That’s where Johnson, 60, enters. The recently retired insurance agent from Bulloch County has criticized Hudgens for putting what she called his “misguided personal agenda” ahead of easing the process for uninsured Georgians.
“His focus is on one area: blocking affordable health care,” Johnson said.
The Democrat said she would support Medicaid expansion under the Affordable Care Act, which Hudgens and other state Republicans have opposed. Expansion would add coverage for about 650,000 Georgians, but Gov. Nathan Deal ruled it out after saying it would cost $4.5 billion over 10 years. Advocates of extending the health care program estimate the price tag at half that amount.
“This is a bread-and-butter issue,” said Johnson, who also hopes to decrease premiums by increasing the number of insurance providers on the state exchange.
“There are other commissioners around the country who utilize their roles to address areas of excessive premiums,” she said. “Expanding the marketplace will help.”
Johnson trails the incumbent in fundraising, having raised $27,151 to Hudgens’ $615,750 through the 2013-14 reporting periods. While polling for down-ticket races is rare, Public Policy Polling found Hudgens leading Johnson, 41 percent to 34 percent, on Oct. 7.
In September 2013, before the Affordable Care Act came into effect, an Atlanta Journal-Constitution poll found that 57 percent of Georgians viewed it unfavorably, while 31 percent said they had a favorable opinion of it. That same poll, however, showed that 60 percent of Georgians favored expanding Medicaid under the law.
“If this election comes down to I’m opposed to Obamacare, and Liz Johnson is for it,” Hudgens said, “then I’m going to win big.”
Third-party hopeful Metz, 56, pulled 10 percent of the vote in the Public Policy Polling survey.
An insurance agent specializing in plans for Medicare recipients, Metz said he would use the commissioner’s platform to lobby state legislators against the Affordable Care Act. Instead of expanding Medicaid, Metz believes the state should move to a direct primary care model where health care is offered from doctor to patient without going through insurance. Florida is one state that allows this.
“I can walk door to door at the offices of our state legislators and bend their ears,” Metz said. “The Affordable Care Act is not addressing the actual problems we see in America.”
Insurance fraud and regulation
In October, Hudgens dug into his campaign funds and sprung for the only television commercial yet in the insurance race.
The spot touted Hudgens’ record of protecting constituents, saying he won consumers more than $30 million in additional payments after insurance companies refused to pay claims. It also referenced the dozens of insurance fraud cases that were reported under the commissioner’s direction.
“We have indicted 60 agents we found out were taking your premium but weren’t buying your insurance,” Hudgens told The Atlanta Journal-Constitution. “They were just putting your premium in their pocket and hoping you didn’t have a claim.”
With a Statesboro headquarters hours away from the state Capitol, Johnson had to be picky about when and where she hit the campaign trail early on. She has recently added a satellite office in Atlanta and said voters often tell her they are worried about the stability of their insurance.
“If you don’t have access to affordable health care, when you don’t have reasonable insurance rates, we see economic security threatened instead of being protected,” Johnson said.
A 40-year veteran of the insurance industry, Johnson said the department should serve both consumers and businesses equally. She was tired of rhetoric that just talked about health coverage but didn’t mention other fields, such as automobile insurance.
“Companies need insurance agents and consumers,” Johnson said. “We all need each other.”
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