Medically speaking, Georgia has a chronic illness when it comes to healthcare.
The state’s uninsured rate is among the nation’s highest. Approximately 500,000 Georgians qualify as “working poor.” Their incomes exceed Medicaid thresholds, yet they can’t afford insurance, even through the Obamacare exchange. Many live without coverage.
Georgia lawmakers of both political parties find this reality unacceptable. The newly appointed chair of the Senate Health and Human Service Committee, Savannah’s own Ben Watson (R-District 1), calls healthcare coverage a “right.”
Legislators disagree on a cure for this malady, however, and the 2019 session of the Georgia General Assembly will show the range of treatments.
The Republican-controlled legislature promises to discuss every option and is sure to prescribe those that foster greater competition among providers, thereby improving quality and driving down costs.
Those therapies are unlikely to include one many consider a panacea: Medicaid expansion. Under the Affordable Care Act, Georgia would qualify for a 9-to-1 federal match by expanding Medicaid coverage to the aforementioned “working poor.”
Georgia lawmakers, including Watson, a practicing physician, consider Medicaid a failed system when it comes to the quality of care. They have pledged instead to look at alternative ways to access those federal dollars, from “waivers” and “carve-outs” to government-funded Health Savings Accounts and reinsurance plans — and all combinations in between.
Members of the Savannah-area delegation in both chambers are active in drafting proposals. Watson’s Senate health committee is looking at waiver opportunities. In the House, Jesse Petrea (R-District 166) is among those exploring the possibility of creating a pool to fund premiums for high-risk individuals.
A call for deregulation
Insuring more Georgians is far from the only healthcare priority for the legislature.
Expect decisive action on two other fronts: Certificate of Need reform and expansion of the Rural Hospital Tax Credit.
Certificate of Need, or CON, is of particular interest locally because Watson is among those pushing the hardest for reform. CON is a decades-old state regulation meant to protect hospitals. The mandate requires medical businesses show that the local hospital is not meeting demand before adding specialty services, such as imaging or outpatient surgery, to their offerings.
By limiting competition, these lucrative revenue streams would offset the losses hospitals suffer in treating all medical conditions.
Many argue CON allows hospitals to fleece consumers instead.
Predictably, CON divides two powerful lobbies: Hospitals vs. entrepreneurial doctors.
Watson’s involvement muddies CON reform. He is a partner in SouthCoast Medical, a business with an interest in becoming an ambulatory services provider. CON currently prohibits SouthCoast from doing so; a repeal of CON could potentially enrich the company.
The situation raises ethical concerns. Watson maintains that he is not a surgeon and would not benefit— at least not directly — from ambulatory services revenue.
CON reform is “the right thing to do for the consumer,” Watson said.
Helping rural hospitals
The other healthcare must this session involves a campaign promise by Georgia’s new governor, Brian Kemp.
Kemp’s healthcare platform included doubling the cap for the Rural Hospital Tax Credit program to $200 million. Introduced in 2017, this initiative allows Georgians to claim a dollar-for-dollar tax credit for donations to the Georgia HEART Hospital Program.
HEART disperses these funds to the state’s rural hospitals, including nearby facilities Effingham Hospital and the Liberty Regional Medical Center. The program is meant to stem the rash of hospital closures; Georgia has lost six hospitals in recent years.
An increase in the cap could mean as much as $8 million a year for each hospital.
We encourage the Georgia General Assembly to explore these treatments and more to address our state’s healthcare crisis.