Mike Klein Online

TCC Debate: Barnes, Deal Disagree About ObamaCare Exchanges

This week The Commerce Club hosted a debate between Republican gubernatorial candidate Nathan Deal and his Democratic opponent Roy Barnes.  This article primarily focuses on Medicaid and ObamaCare.  All questions on these two subjects came from the audience and they were not consecutive questions.

Georgia’s two gubernatorial candidates can easily disagree when they sit down to discuss health care.  Former Governor Barnes has good things to say about the federal health care law known as ObamaCare and he thinks federal courts will uphold the law.  Former Congressman Deal has almost nothing good to say and he supports lawsuits to stop the law.

But these two men, one of whom will become Georgia’s next governor, are not that far apart on other critically important issues.  They share concern about costs associated with Medicaid, overcrowded hospital emergency rooms and inadequate community care facilities, all of which impact Georgia.

ROY BARNES: “I agree that we have to get these (Medicaid) folks out of the emergency room.  It is killing these hospitals and, yes, we should use low cost providers wherever is necessary.   Unfortunately, the way it is set up, the easiest place for them to get the service is the emergency room.  Looking at lower costs of providing those services is something we ought to look at when we revamp Medicaid.

“(ObamaCare) is going to be upheld. They can require you to have automobile insurance.  They require you to have workers comp.  I think under general welfare provisions they can require you to do this.  I do have some great concerns about the financial effect.  I do know what will happen.  The National Governors Association, the governors are charged with responsibility to implement this.  A group of them will work together.  They’ll come up with a series of amendments and try to get them through.

“Several years ago, trying to get (insurance coverage) to those that were uninsured, I asked the General Assembly for authority … to allow (a small business) employer to use the pooling of the State Health Benefit Plan. The state wouldn’t supplement it but they could get coverage there.  The insurance companies fought it.  They did authorize to do a pilot plan but we had not done that by the time I left.

“I think the exchanges are going to be probably the most interesting part of this (federal health care reform) bill.  For the first time you’re going to have some wide-open competition that exists.  I think it should be structured carefully but overall, it’s going to be beneficial.”

NATHAN DEAL: “The big challenge we have in Medicaid is to fight ObamaCare in terms of the mandate of the expansion of it to 133% of the federal poverty level.  The state of Georgia and I don’t know of any state that can afford that expansion. That’s why the litigation is so important to challenge that.

“One of the big cost areas is unnecessary (visits to) emergency rooms for non-emergency reasons. It’s five times more expensive than doing it in a lower cost setting.  I tried at the federal level to be able to divert from the emergency room and couldn’t get 60 votes in the Senate to do it. The state of Georgia, in my opinion, needs to make sure we have low cost clinics accessible to and close to high volume emergency rooms.   That will take some pressure off the system.

“If we’re not real careful with this (federally mandated insurance) exchange and the way it’s being put in place, you’re going to see a tremendous negative effect on the insurance industry in this state.  The people who have been the insurance brokers, the ones who have gone the distance with individuals and put forth proposals as to how they can purchase insurance, I am afraid the exchange is going to make them irrelevant.

“Most of us know that we are currently in litigation about mental health facilities in our state.  The place that I hear the most complaint is from the sheriff’s departments.   People who are not being treated in the normal routine mental facilities ultimately are going to end up in the prison system and generally, in the jails first.  That puts a huge strain on county budgets and the sheriff’s offices.  That is an area where I think we have to give greater attention.”

Mike Klein writes about contemporary issues as Editor at the Georgia Public Policy Foundation.

October 1, 2010 - Posted by mikekleinonline | Uncategorized