Ga. panel looks into health insurance exchange

In Georgia, like many other Southern states, opposition to the new federal health-care law runs deep. Yet a conservative committee of experts has, without rancor, outlined a plan to give the state a health insurance exchange, a cornerstone of the legislation enacted last year.

The panel had the blessing of Republican Gov. Nathan Deal, a former congressman who describes himself as the first House member to denounce the health-care law as unconstitutional. Georgia has joined 25 other states in a legal challenge to the legislation that is now on the Supreme Court’s schedule.

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But if the law is not overturned by the court or repealed, states will have two choices: to comply with it or wait for the federal government to force it on them.

This reality, and the opportunity to address the dysfunction in state health-care systems, has tempered opposition to the Affordable Care Act, not only in Georgia but also in some other Republican-led states.

In Alabama, Gov. Robert Bentley, a physician, also opted to set up a committee to plan for an exchange and fought his legislature’s decision to scale back Medicaid after enhanced federal funding expired. In Virginia, a task force appointed by Gov. Robert F. McDonnell has completed a review of state health-care policies and produced a set of recommendations designed to implement the law if it is not repealed.

Twenty-six of 29 Republican governors have accepted up to $1 million each in federal grants to design state health insurance exchanges, marketplaces where individuals and businesses can shop for medical coverage. In addition, three of these states — Indiana, Mississippi and Nevada — have received $31 million to implement the plans, according to the most recent federal listing of the exchange grants. Arizona Gov. Jan Brewer has requested $29.8 million for one of these grants despite opposition from her own party.

The exchanges aim to encourage competition among insurers and give consumers access to a variety of insurance options. Under the health-care law, each state must have its exchange in place by Jan. 1, 2014. If not, the federal government will set one up.

The deadline has prompted states to “take a more practical approach,” said Tricia Brooks of the Georgetown University Health Policy Institute, which tracks the progress of the health-care law. Conservatives in many states have been forced to take a sobering look at their health-care delivery systems, “and when they can get away from the politics of all this,” Brooks continued, “they can see that maybe the [new law] isn’t all bad.”

In Georgia, this may be the case. More than 20 percent of the state’s population lacks medical coverage of any kind, ranking Georgia 45th out of 50 states in this category. Only 29 percent of Georgia firms with fewer than 10 employees offer health-care coverage. Many small businesses are so crippled by insurance costs that they say they either cannot hire new employees, are losing the ones they have or are unable to expand because they cannot afford it.