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Governor Deal: Major Health Policy Decisions “In a Holding Pattern “

Mike Klein

Governor Nathan Deal expressed displeasure with the U.S. Supreme Court decision on federal health care reform during a Thursday afternoon news conference, describing it as “the largest tax increase in the history of the United States, at least $500 billion and perhaps significantly more.”  The Governor also admitted he was surprised by the decision because he thought the Court had given “pretty strong signals” that it had problems with the individual mandate.

The Governor appeared alone when he spoke to reporters and a large crowd that assembled in mid-afternoon inside the State Capitol.  Deal said the state will likely hold off making decisions on several questions until after the November national elections.  Presumptive Republican Party Presidential nominee Mitt Romney has vowed to dismantle the health care law if he is elected.

Deal said Thursday morning’s Supreme Court’s decision does appear to leave states with some flexibility, in particular, whether they will be forced to expand their Medicaid eligible populations.  “There was at least an area of indication that it was not an absolute mandate,” Deal said.  “The discretion for a state to participate in the expansion of Medicaid was a door that was left open.  The Court has said that would have been an unconstitutional mandate on states.”  (Click here to watch Governor Deal’s news conference on YouTube.)

Georgia estimates its Medicaid eligible population would increase by 620,000 in 2014 based on requirements in the Patient Protection and Affordable Care Act.  On Thursday, Governor Deal said that increase would cost $76.3 million additional state dollars in 2014, and it would result in 24.2 percent of all Georgians being Medicaid eligible.  The current number is 17.6 percent.

Governor Nathan Deal

“As you know, the original legislation (said) that if you did not accept the mandate for expanding the Medicaid coverage up to, in our case 138 percent of the federal poverty level, that you would have lost your federal participation in your existing Medicaid program,” Deal said.  “The Court has ruled that leverage and that coercion was not appropriate.”

Because the law was upheld, Georgia faces a mid-November decision about whether it will create some version of a state health insurance exchange or default to a federal exchange.  Deal said that decision also will likely not be made before the November election.  “We probably are going to be in a holding pattern until we see what the events of November bring us,” he said.

A special committee that considered health insurance exchange models last fall reported to the Governor that while it preferred no exchange, a Georgia created exchange would be preferable to one imposed by the federal government.  The Georgia model could be a state-operated exchange or, the committee recommended, a largely private model with some state oversight.

Responding to a question from the Georgia Public Policy Foundation, Governor Deal acknowledged that a regional, multi-state health insurance exchange “is an idea worth exploring.”  The Governor noted, however, that the state passed a law that would allow insurance companies licensed by other states to offer policies in Georgia but, “No company has taken us up on that offer.”

Governor Deal said decisions that need to be made this year – in particular, whether to expand Medicaid eligibility and what kind of exchange to create – should not require a Special Session of the Georgia General Assembly.  However, he thinks one might be necessary next year.

“We’re probably going to be finished with our 2014 budget before we know the answers to those questions that only Congress and the White House can provide,” the Governor said.  The 2013 General Assembly will likely conclude in late March or April, possibly well before Washington has given clear guidelines to states if there is a new administration.  Deal said that could require bringing lawmakers back to Atlanta.  “I will do everything in my power to avoid that,” he said.

The Governor opposed and fought against President Barack Obama’s federal health care reform law during the last of his nine terms as a congressman from Georgia.  “I was surprised by the decision,” Deal admitted.  “I honestly felt that the issue of the constitutionality of the individual mandate was one that the Court had given pretty strong signals that they had problems with.

“It is somewhat ironic to me that it is now constitutional not because it is a proper exercise of the power of federal government under the commerce clause but that it is appropriate only because of the federal exercise of taxation authority over the states and over its citizens.  That’s why I said, if we really want to know what the largest tax increase is, we have just now been given that opinion by the Supreme Court.  It is this piece of legislation that, ironically, is called the Affordability Act.”

(Mike Klein is Editor at the Georgia Public Policy Foundation)

June 28, 2012 Posted by | Uncategorized | , , , , , , | Leave a comment

Medicaid Dominated when Governor’s Policy Advisors Took Questions

Mike Klein

Medicaid is a beast.  About one-in-five Georgians receives Medicaid health care.  That is 1.7 million people.  Fifty-nine percent of statewide births are Medicaid babies.  Another couple hundred thousand children are enrolled in PeachCare, the state children’s health insurance program.   Medicaid could grow by hundreds of thousands more if the U.S. Supreme Court upholds the federal health care reform law in its decision expected next month.

Not at all surprisingly, Medicaid redesign questions were abundant when three of Governor Nathan Deal’s advisors met with Georgia Children’s Advocacy Network members at the Freight Depot in Atlanta.  The advisors made no presentations and took questions for 90 minutes.

Health policy advisor Katie Rogers named telehealth reimbursement policies, portable electronic records, better outcomes for vulnerable children, physician shortages in some specialties, how to manage health care in counties that are medically underserved and treatment options for chronic childhood illnesses as part of the wide-ranging Medicaid redesign conversation.

Next month the U.S. Supreme Court will rule on constitutionality of the 2010 federal health care reform law.  If upheld the Patient Protection and Affordable Care Act provisions often known as ObamaCare could add 620,000 new Medicaid patients to the state program.  Rogers predicted, “People who haven’t had access to services are going to seek services probably very quickly.”

Georgia Medicaid cost $7.78 billion in fiscal year 2010, according to Kaiser State Health Facts.  Federal funds pay 66% and the state is responsible for the rest, about $2.7 billion.  Georgia Medicaid program redesign is being managed by the Department of Community Health with private partner assistance from Navigant. The project is described in a comprehensive design strategy report available on the DCH Medicaid website.

This project is so important to Georgia’s health care community that it is being closely monitored by many organizations outside government.  Cindy Zeldin is executive director at Georgians for a Healthy Future which advocates for improved statewide access to quality health care.

“The three buckets when we look at improving Medicaid would be one, just coverage, getting kids who are eligible but who are not enrolled today into the program so they at least have that front door access,” Zeldin told the Public Policy Foundation this week.

“Second, improving access to care, just making sure there is a mechanism to make sure that being in Medicaid means you can see a provider if you need to,” Zeldin said.  For instance, the state has no OB-GYN practitioners in 39 counties, which is an impediment to women’s health.

“Third would be improving outcomes and accountability, what you are asking managed care companies to report on and making sure you are measuring outcomes that ensure quality care.”

The Supreme Court opinion expected next month will also decide whether Georgia must create a health insurance exchange.  Last December a state report to Governor Deal said a private or quasi-governmental exchange would be preferable to one imposed by the federal government, but Georgia would prefer that it is not required to create any exchange.  Georgia opposes the federal health care reform law and it joined the suit that challenges the constitutionality.

“If the law is upheld as it stands now we will work very quickly to implement a state exchange,” Rogers said.  “If the law is not upheld the discussion will begin again on whether or not to move forward with a state exchange.  Part of the concern is without the individual mandate would people want to buy insurance through the exchange?”

Education and Public Safety Issues

Education and several public safety issues were also discussed during the open forum.

Education policy advisor Kristin Bernhard said several early childhood education programs lead the priority list heading into next year’s General Assembly.  Do not expect support for private school vouchers or increasing the age for compulsory school attendance from 16 to 18.

“The voucher conversation isn’t on the table for us,” Bernhard said.  “We’re more interested in increasing the quality of public education for all students everywhere.”  On compulsory school attendance she said, “The evidence is not necessarily compelling that raising the age of mandatory school attendance automatically results in an increased graduation rate.”

Education headlines over the next year will include incorporating the state’s version of new national core curriculum coursework, dual enrollment for middle school students taking high school courses or high school students taking college courses, tenth grade college readiness testing, and preparation to expand career pathways education now scheduled for fall 2013.

Also, Georgia admits that it has too many high school graduates who require remedial courses when they enter college.  “We know that students are graduating from high school not ready for college,” Bernhard told 100 Georgia Child Advocacy Network members.  Part of this discussion is how these students can be assisted by resources inside the state technical college system.

This week the Illinois Senate President proposed his state enact internet gaming legislation to get in front of a potential federal law that would grandfather existing state programs but prevent other states from creating new ones.  Do not expect anything like that in Georgia.

It is well documented that the lottery-funded HOPE scholarship, grant and pre-K programs can no longer afford to fully fund their commitments.  Governor Deal opposes a proposed casino-style project and Bernhard says, “What we’re looking at is what we can do to boost the existing revenue streams.”

Several folks applauded when public safety advisor Thomas Worthy said, “I have no doubt that we will probably see and definitely sign a juvenile code rewrite next year.”  HB 641 was a substantial effort to rewrite piecemeal juvenile laws that are decades old.  It passed the House but then was stopped before Senate consideration so more work could be done on cost.

“Everybody is in agreement on the policy side of things,” Worthy said.  “We are there.  The stakeholders are there.  Agencies are now there.  Now what we are tasked with doing is figuring out a way to not only pay for implementation but actually ascertain savings that will come under the bill.”  Worthy said consultation has begun with the Pew Center on the States; Pew assisted with criminal justice reform legislation that Governor Deal signed this month.

Worthy also acknowledged, “Not only do we have a horrible child trafficking problem within our state, (Interstate) 75 is used to move folks going to other states.”  This year HR 1151 in the General Assembly created a commission to study child trafficking and make recommendations.

(Mike Klein is Editor at the Georgia Public Policy Foundation)

May 17, 2012 Posted by | Uncategorized | , , , , , , , , , , | Leave a comment

History Up Close at U.S. Supreme Court Health Care Arguments

Mike Klein

Monday morning millions will pay attention via media reports but only a few dozen will be inside when the U.S. Supreme Court begins three days of hearings that will decide the constitutionality of President Barack Obama’s federal health care reform law.  Georgia Attorney General Sam Olens will be among those few who have a seat in the Court where history will begin to unfold.

“We won’t know the opinion until the end of June,” Attorney General Olens said this week when he discussed the case before Georgia Public Policy Foundation members and guests.  The lawsuit that reached the U.S. Supreme Court is just one of several filed nationally that all had the same goal: Throw out the Patient Protection and Affordable Care Act and start over.

Georgia is among 26 plaintiff states that are challenging the law before the Supreme Court.  U.S. District Court Judge Roger Vinson ruled the individual mandate unconstitutional in his January 2011 decision.  Vinson further ruled that the mandate is the essential component of the entire law and, therefore, he declared the entire law unconstitutional.

The federal government appealed to the 11th Circuit Court of Appeals in Atlanta.  Last August the appellate court upheld Judge Vinson’s individual mandate decision by a 2-1 margin but the three-judge panel also ruled that the mandate could be severed from the entire Act, so the remainder of the law could stand.  “We didn’t like that part of the ruling,” Olens said.

That is a very condensed version of how this case got to the Supreme Court.  As the Attorney General outlined, six hours of arguments over three days will be conducted as follows:  Monday the Court will consider whether legal challenges are premature or whether challenges must wait until after the law takes full effect in January 2014.  Individual mandates will be argued Tuesday and Medicaid expansion Wednesday.

Georgia Attorney General Sam Olens

Olens explained the question-at-hand for Monday.  “The issue is simply that you cannot file a lawsuit on the imposition of a tax before the tax is collected,” the Attorney General said.  “Since the tax, or penalty, is not collected, until January 2014 the theory goes this case has been prematurely brought and you would have to re-file it after January 2014.”

The individual mandate section to be argued Tuesday has generated the most headlines since the Obama administration began to pursue health care reform legislation.  It would require that every adult American – “with minimal exceptions,” Olens said — must obtain health insurance or pay a penalty to the federal government starting in 2014.

This raises the question: can the federal government force citizens to purchase any product, and if they choose to not purchase the product, can the government then impose a fine?  The U.S. District Court in Florida and the Appellate Court in Atlanta both said no.  Other courts have issued different rulings, causing confusion and requiring a Supreme Court final decision.

Medicaid expansion under this law – without federal funds to support the expansion – is the Wednesday discussion.  Olens said Georgia’s Medicaid-eligible population could swell by 650,000 to 750,000.  The reason is the bill establishes Medicaid eligibility at 133 percent of the federal poverty level starting in 2014.  Medicaid is a shared federal – state partnership but states increasingly are being forced to absorb expanded costs even before this new law takes effect.

“We already know that (fewer) doctors will accept Medicaid,” Olens said.  “What happens when we have a 35 percent increase in the number of Georgians that are then on Medicaid?  It is an additional $2.5 billion cost (to Georgia) over the decade.”

Attorney General Olens also said the federal health care law will require large employers that include state governments to offer a minimum level of benefits, as decided by the federal government.  “They are telling us what coverage we need to provide to state employees,” Olens said.  “That ought to be your decision, not the federal government’s decision.”

(Mike Klein is Editor at the Georgia Public Policy Foundation

March 23, 2012 Posted by | Uncategorized | , , , , , , | Leave a comment

New Possible Strategy for Georgia Health Insurance Reform

Mike Klein

A behind-the-scenes coalition that believes the U.S. Supreme Court will overturn the federal health care reform law is working on a new health insurance strategy for Georgia.

Almost certainly, this summer’s biggest headline will be the Supreme Court decision to uphold or overturn the Patient Protection and Affordable Care Act which President Barack Obama’s administration counts as one of its finest achievements.  Two federal appellate courts upheld the law and one rejected it.  Supreme Court arguments are scheduled for the final week of March.

Federal law trumps state law, so nothing in the evolving state strategy could be implemented in Georgia if the Supreme Court upholds the federal health care reform law.  The Georgia Public Policy Foundation has hosted meetings of interested parties working on state health insurance reform options, but the Foundation has not assisted with drafting legislation nor has it taken a position on possible legislation.

A staggering 1.8 million Georgians have no health insurance.  They are not in group plans.  They do not have individual plans.  One-in-five men, women and children living in Georgia have no health insurance.

Coalition principles include restructuring the private market to increase competition and improve portability, protection against loss of coverage, and improved affordability for people and small businesses.  A core strategy is the expansion of defined contribution plans administered by employers.

Employers who cannot afford to offer health insurance will be able to make a defined contribution to a tax-free Health Reimbursement Account or HRA. Employees may use these pre-tax dollars to pay insurance premiums.  Pre-tax dollars in health savings accounts, another type of tax free account, could be used for deductible co-pay charges and a wide variety of wellness programs.

Consumers who do not have access to employer health plans would be allowed to deduct 100 percent of health insurance premium expense from their state income tax.  Current law does not allow for that deduction.   In addition, the proposal would allow small businesses to take advantage of “list billing” that would allow employees to pay for their individual health policy premiums with pre-tax dollars.

All of these efforts address the tax inequity of the current system that critics contend needlessly places the cost of health insurance beyond the reach of many families.

Small firm employers often find it almost impossible to offer comprehensive major medical insurance benefits.  The strategy proposes several ideas.  Companies with 10 or fewer employees could receive state tax credits for each employee who is enrolled 12 consecutive months in a major medical program.  Credits would be available for three years.  The entire program would end after ten years.

The strategy includes a focus on keeping currently insured Georgians insured.  Small businesses and their employees would have the same access and protections available to large firms and their employees. People who lose jobs after age 55 would have better access to COBRA extended coverage.  They could purchase extended coverage until Medicare eligibility at age 65.

Another idea addresses health insurance access for employees who leave small firms.  Currently small firm employees are eligible for just three months while large firm employees can extend and pay for insurance coverage for 18 months.  The proposal would equalize both groups at 18 months.

Another effort would focus on providing access to primary care for the uninsured.  A new “Georgia Charity Care Network Tax Credit” would be similar to the existing private school tax credit.  The credit could be taken by an individual or corporation that makes a cash contribution to an approved charity health care network.  There would be maximum annual contribution levels and the program would be capped at $2 million maximum per year for three years.

Federal health care reform requires that Georgia must create an insurance marketplace or the federal government will impose one in 2014.  A state health insurance advisory committee report published in December said the state should opt for its own program, but it stopped short of saying the General Assembly should begin to plan for that program now.  Georgia is waiting on the Supreme Court ruling.

The coalition believes a private, free market health exchange would provide all the benefits of a government-run model, but without the drawbacks. Georgia, which leads the nation in health information technology, is home to several companies already providing similar services.

A regional health insurance idea would enable Georgia to partner with four or more states to create a large private marketplace.  Major medical and group insurance carriers whose policies are approved in any member state would be able to offer those policies in other member states.  Georgia’s insurance commissioner would be authorized to explore major medical partnerships with other states.  Any plan approved by a partner state would be available to consumers in the other partner states.

One feature of federal health care reform enables children to remain on their parents’ health insurance policies until age 26.   The Georgia twist would revise that to “tax dependent” children.  The distinction is that insurance eligible young adults must be dependents, not just grown children who have begun their independent lives, except where they are riding on parents’ health insurance policies.

Several other strategies are being considered.  One would create a high risk pool for people with pre-existing conditions, which would help stabilize the individual and small group market.  Pre-existing conditions restrictions would be standardized to not more than 12 months in group and individual plans.  Expanded physician choice options would benefit health care consumers.

Overall, the emerging Georgia health insurance strategy is not an attempt at medical care reform – who gets medical treatment, how much they get and who decides their treatment.  All of the ideas currently being discussed pertain only to insurance factors.   By one estimate, it might be possible to reduce the number of uninsured, non-Medicaid eligible Georgians from 1.8 million to 600,000.

(Mike Klein is Editor at the Georgia Public Policy Foundation

February 13, 2012 Posted by | Uncategorized | , , , , , , , , | Leave a comment

The Whale in the Room: Federal Health Care Reform

Mike Klein

There was a whale in the room Thursday morning at the State Capitol.


Community Health commissioner David Cook had nearly finished his hour-long budget testimony when a question came from the floor:  In years ahead, what is the expected fiscal impact of federal health care reform?    “The 2014 budget is going to be a whale,” Cook said.  “We’re going to have to be prepared to answer a lot of questions. Where we come up with the money is going to be a challenge.”

Cook said new projections are the ACA will cost $2.5 billion additional dollars between 2014 and 2019, and up to $5 billion between 2019 and 2023.  “As the Act becomes more mature, there is less and less federal money to support it,” Cook said.  “The biggest part of the Affordable Care Act is the expansion of the Medicaid population.  We estimate 650,000 additional people. We’ve got 1.7 million now.”

Georgia’s $7.8 billion annual Medicaid budget is a combination of state and federal funds.  Medicaid payments cost the state $11.5 million per day.  Fifty-nine percent of Georgia births are Medicaid babies.  Some 1.7 million Georgians use Medicaid.  The good news – always look for any good news – is Cook said the state 5.2 percent Medicaid annual growth rate is less than the 7.3 percent national growth rate.

Georgia is among more than two dozen states that filed suit to overturn the Affordable Care Act.  The U.S. Supreme Court will hear arguments this spring and a summer opinion is anticipated.

The State Health Benefit Plan is the other big business model at Community Health.  SHBP is actually three plans to cover state employees, teachers and non-certified school personnel.  The program faced several hundred million dollars of deficits over Fiscal 2012 and 2013, but Cook said changes that include higher premiums and the elimination of some medical options have significantly pared down the deficit.

“Today our State Health Benefit Plan is on a better financial footing,” Cook said.  He said changes were considered essential for Georgia to maintain its triple AAA bond rating.

Thursday morning’s third and final day of annual budget hearings focused heavily on social service and health care agencies.  Human Services commissioner Clyde Reese told legislators the state expects to lose $37 million next year in federal support for Temporary Assistance to Needy Families, welfare.  “We’ve been told that money is going to go away,” Reese said.  He also said the state food stamp caseload is up 52 percent since 2007, with some 1.65 million active food stamp assistance recipients.

State Office of Planning and Budget Director Debbie Dlugolenski said the Governor’s Office will continue to ask state agencies for budget cuts going forward, even in years when revenue improves.

(Mike Klein is Editor at the Georgia Public Policy Foundation)

January 19, 2012 Posted by | Uncategorized | , , , | Leave a comment

At Least One Republican Supports Health Insurance Exchange

Mike Klein

Republicans seem almost united that the General Assembly should not consider legislation this session to create a health insurance exchange.  “The House, the Senate and the Governor have all agreed to wait on that,” Sen. Renee Unterman said Thursday morning.

Well, united with at least one exception.  Former lawmaker and second-year Insurance Commissioner Ralph Hudgens said, “I would like to see the legislature move forward with an exchange,” when he sat next to Unterman at “Health Care Unscrambled” hosted by Georgians for a Healthy Future.  Think of it as “Eggs and Aspirin” under dim lighting at the Freight Depot.

“Wait on that” means wait for this summer’s hotly anticipated U.S. Supreme Court opinion that will decide whether the federal health care reform law survives a constitutional challenge.  Unterman started a spirited conversation that was the highlight of the morning conference.

“I was dismayed to hear, as you just heard, the Senator (Unterman) say there will be no health exchange legislation this year,” Democratic Sen. Nan Orrock said moments later.  “We are headed for a cliff.  There are those who oppose (the Affordable Care Act) and those who are for it.  I am for it.  We move forward when we can bring different ends of the political spectrum together. We’re missing the boat to keep kicking the ball down the field.”

Orrock found an apparent insurance exchange soul mate in commissioner Hudgens who said, “I don’t want the federal government setting up an exchange in Georgia.  I want Georgia setting up an exchange for Georgia.  I don’t think moving forward with an exchange is giving tacit approval to the Affordable Care Act.  I’m just telling you where I stand.”

Orrick: “Mr. Commissioner, I vote with you on that.  That exactly makes my point.”  Hudgens: “Well, that’s rare, isn’t it!”   As politicians of different political feathers, Orrock and Hudgens agreed that they seldom agree but on this issue, both said Georgia should move toward implementation of a health insurance exchange.

If upheld by the Supreme Court, the health care reform law requires that states must create health insurance exchanges before 2014 or the federal government will impose an exchange.

The National Conference on State Legislatures maintains a comprehensive website that says 13 states have enacted exchange laws.  Nineteen states including Georgia considered but did not pass legislation. Bills are pending in five states and the District of Columbia.

Governor Nathan Deal did not discuss health insurance exchanges Tuesday during his State of the State address.  Last month an advisory committee created by the General Assembly said Georgia should establish a health insurance marketplace authority, but it did not call for 2012 legislation.  Cindy Zeldin, who is executive director of Georgians for a Healthy Future, wrote the committee minority report that recommended moving forward with an exchange now.

“Georgia has an unprecedented opportunity to address our high rate of uninsurance by developing a health insurance exchange for individual consumers,” Zeldin wrote.  “Federal dollars and resources are on the table to help us craft a Georgia solution.  We should seize this opportunity.”  Nearly two million Georgia residents have no health insurance.

Georgians for a Healthy Future unveiled a seven-point legislative agenda that includes trying to plug an insurance hole created by federal health care reform.  Health insurance policies written only for children have dried up in the state’s insurance marketplace.

“This is a market in which parents would buy a health insurance plan for their child but not themselves,” Zeldin told the Public Policy Foundation.  “It might happen if the parent has a plan at work but is not offered dependent coverage, or if they cannot afford a family policy.”

Zeldin said companies pulled out of the child only market after health care reform mandated that they could not deny coverage to children because of pre-existing conditions.  Zeldin said her organization and others have been trying to identify the number of children affected in Georgia.

“We would like to follow the footsteps of several other states that have addressed this issue by passing legislation requiring insurance companies” to offer child only coverage, Zeldin said.  Colorado passed a bill for that purpose.

There may be bipartisan support.  Conference panelist Rep. Richard Smith, who is Republican chair of the House Insurance Committee, cited stand alone child policies and giving Georgians the right to purchase health insurance across state lines as two possible priorities for the 2012 General Assembly.

(Mike Klein is Editor at the Georgia Public Policy Foundation)

January 12, 2012 Posted by | Uncategorized | , , , , , | Leave a comment

Deal, Olens Welcome Supreme Court Health Care Review

Mike Klein

Governor Nathan Deal and Attorney General Sam Olens issued strong statements on Monday in support of overturning federal health care reform, just a few hours after the U.S. Supreme Court said it will review  legislation that became law 20 months ago.

Olens said the Supreme Court hearing scheduled for early next year is “a crucial step in our long fight to reign in the federal government’s unconstitutional over-reach into the healthcare marketplace.”  Deal’s statement recognized “the fight against the crippling mandates of Obamacare,” which has become a popular term for federal health care reform.

Georgia is among 26 states that sued President Barack Obama’s administration to overturn the Patient Protection and Affordable Care Act, which became law in March 2010.  The central and dominant point of contention is whether a federal government individual mandate could require that each American purchase health insurance or face financial penalties starting in 2014.

Governor Deal said, “Obamacare would vastly expand our state’s Medicaid enrollment, creating a huge new tax burden on Georgia taxpayers. Frankly, our state can’t afford these new unfunded mandates, and what we’re seeing is that the majority of states feel the same way. The outcome of this case is hugely important to the future of Georgia, and we have high hopes for a favorable decision from the Supreme Court next year.”

Governor Nathan Deal

During his State of the State address in January Deal said the federal health care law would add 650,000 Georgians to state Medicaid rolls, costing $2.5 billion in new state expense over ten years.  “It’s appropriate and expected that the court would rule on an issue so central to Americans’ individual liberties. As governor, I’m especially happy to see the court look into whether the federal government can force state governments to take on huge new spending programs.”

Olens outlined the scope of the Supreme Court review: “The Court has agreed to review whether the individual mandate exceeds the limited powers of Congress; whether the individual mandate, if unconstitutional, can be struck down on its own or whether the whole law must fall; whether the federally mandated expansion of Medicaid exceeds Congress’s powers under the Spending Clause of the Constitution; and whether the Anti-Injunction Act affects the Court’s jurisdiction to hear the challenge to the individual mandate.”

The timetable established by the Court – arguments in February or March and a decision likely in June – means the justices will deliver their opinion before Republican and Democratic presidential nominating conventions, and months before November 2012 national elections that could become a referendum on the expansion of federal government ala the health care model.

Petitions and briefs are posted on the U.S. Supreme Court website.

Attorney General Sam Olens

Four federal appellate courts have heard Patient Protection and Affordable Care Act cases.  The Supreme Court accepted the case that came through Atlanta’s 11th Circuit Court of Appeals where justices ruled the individual mandate is unconstitutional.

Opponents include the National Federation of Independent Business, a small business group, and states that argue the law’s expansion of Medicaid eligibility will become a budget buster.  Medicaid expenses are the single fastest growing segment of the Georgia state budget.

Supporters counter argue that reform — sometimes known as Obamacare — will make health care more accessible to millions of Americans.  Some supporters consider the measure to be as historic as the creation of Social Security, Medicare and the Civil Rights Act.

Federal appellate courts in Cincinnati and Washington upheld the law.  One in Richmond, Virginia declined to rule because the individual mandate provision is not in force until 2014.

(Mike Klein is Editor at the Georgia Public Policy Foundation)

November 14, 2011 Posted by | Uncategorized | , , , , , | Leave a comment