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Georgia’s health care future

POSTED: January 9, 2013 8:27 a.m.

My family and I have been lucky enough to escape the terrible flu that is going around (knock on wood). Sure, we've had a few sniffles, but nothing that some tissues and a movie night at home couldn't fix.

For the most part, we have escaped the long waits in the waiting room at the doctor's office.

The long waits that used to be caused by a large amount of sick people at the doctor's office have the potential to become even longer in 2013 as a result of ObamaCare.

Doctors and nurses are working more hours but seeing fewer patients as a result of rising health care costs and already effective mandates.

What are the next steps for ObamaCare in Georgia, and how will these measures affect both families and businesses in our district?

In my last column, I mentioned that Gov. Nathan Deal recommended some tough cuts to state agencies and Medicaid in order to try and generate more state funds.

However, Medicaid is enrolling more individuals at the same time that program revenues are declining; meaning Georgia needs to find almost $375 million in new Medicaid for our state.

This means the July 2013 expiration and potential extension of Georgia's Hospital Provider Payment Program, a large source of funding for state Medicaid services, will take center stage during the 2013 legislative session.

The Hospital Provider Payment Program, or "hospital provider fee," was originally passed during the 2010 legislative session to fill an earlier Medicaid shortfall of nearly $600 million and was allowed to be collected for three years.

If the fee isn't renewed this year, Georgia's Medicaid program will lose 11.88 percent in reimbursement add-on payments. This reimbursement percentage is critical, because it is how Georgia hospitals and clinics are paid for Medicaid patient visits.

In addition, Georgia will need to figure out how to come up with almost $150 million in state general funds to trigger the 65/35 match in federal funding - in other words, for every 35 cents our state uses to fund Medicaid, the federal government contributes 65 cents. This will be an issue that must be weighed carefully, as a rejection of the hospital fee could prevent access to health care and negatively impact the finances of hospitals statewide.

The U.S. Supreme Court ruled in July that a requirement to expand the number of people eligible for Medicaid in any given state couldn't be enforced and that states should individually choose whether or not to expand existing Medicaid programs.

In August, Deal said that Georgia could not afford the high cost of expanding the program. Many other states have already said they won't expand Medicaid for this same reason, proving that ObamaCare was passed with no concept of the future financial hardship on taxpayers and individual states.

Georgia has also joined a number of growing states that will pass on building its own online health insurance exchange and will allow the federal government to implement the program instead.

The idea behind it is great - it would let people compare the quality and cost of health insurance plans and choose the one best-suited for their needs. There is more than meets the eye, though. Health care exchanges would shut out opportunities for small businesses to provide quality health care options for employees.

The new provisions under ObamaCare are already crushing small businesses in Georgia. Increasing health care costs have been named the number one problem for small business owners over the past two decades, and ObamaCare is only fueling the fire. There is now a forced decision between health care costs and payroll, and the result isn't good any way you roll the dice.

Employees aren't getting deserved raises, and even worse, are being let go because of rising health care costs.

Although the exploding and rapidly rising cost of implementing ObamaCare seems like reason enough to repeal the law, it's not the solution for Georgia or any other state. We have to be ready to replace the law with real healthcare reform that creates a competitive marketplace, personalized insurance plans and properly compensates the doctors and nurses who work so hard to provide each of us with quality medical services.

It will be important for Georgia to come up with ways to fight Medicaid fraud and kick out people who may be abusing the system. We will also need to generate ideas on how to use the free markets to build better insurance exchanges, explore how to sell health insurance across state lines, and allow businesses to contribute a certain amount of pre-taxed money towards an employee's health care purchase. If we don't come up with ideas that really work and can replace the ObamaCare requirements, we will only be wasting time and energy.

I think it is safe to assume that each and every person in District 51 believes in health care reform, but "one size fits all" health care paid for by taxpayers is not the solution.

Individuals and families should be able to choose the coverage that best fits their needs, not the federal government.

Please feel free to reach out and contact me with questions or concerns about health care in Georgia at any time.

Be sure to change our information in your address books, because we are now in room 421 of the State Capitol. You can continue to contact me by e-mail at steve.gooch@senate.ga.gov or by phone at (404) 656-9221. We look forward to serving you this coming year.


Sen. Steve Gooch represents the 51st Senate District which includes Dawson, Fannin, Gilmer, Lumpkin, Pickens and Union counties and portions of Forsyth and White counties. He may be reached at (404) 656.9221 or via e-mail at steve.gooch@senate.ga.gov.

 

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