Georgia will not create the health insurance exchanges required under President Barack Obama’s health care overhaul, Gov. Nathan Deal announced Friday.
That means the federal government will operate the exchanges instead, but exactly how that will affect the state is still uncertain.
“I think we’re just going to have to wait and see what really does transpire after this and what does it mean,” Greater Hall Chamber of Commerce President Kit Dunlap said Friday afternoon.
Deal, a Republican, outlined his stance in a letter to the U.S. Department of Health and Human Services in which he criticized the Democratic health care plan for what he called its “one-size-fits-all approach” and the financial burdens it places on state governments.
“We believe that a well designed, private free-market approach to small business exchanges could be beneficial to small businesses but the regulations promulgated by your administration take those options away,” Deal wrote to Health and Human Services Secretary Kathleen Sebelius.
Since the U.S. Supreme Court upheld most of Obama’s health care overhaul as constitutional, Deal has strongly suggested that Georgia would not move to implement portions of it. He delayed taking any action on the plan until after the presidential election in the hope Republican candidate Mitt Romney would win.
Georgia Republicans wanted Romney to repeal or eliminate all or part of the law had he been elected.
Phaedra Corso, a Gainesville resident who teaches in the University of Georgia’s Department of Health Policy and Management, spoke Tuesday at a Greater Hall Chamber of Commerce seminar for small businesses on the postelection implications of the Affordable Care Act.
“There are heavy, heavy regulations, even if it’s a state-based exchange,” Corso said at the meeting.
She said she doubted the ease with which even federal exchanges can be set up based on the diverse makeup of states.
“We have such a rural community here in Georgia, they might just have to operate it in a very different way here than in California,” Corso said.
Deal’s resistance shows the philosophical and political wrangling that surrounds implementation of the health care overhaul.
Deal seemed to strongly signal that he would not move to expand eligibility for Georgia’s Medicaid program, a government health insurance plan for low-income Americans, primarily children. It is jointly funded by the state and federal government.
Obama’s health care plan initially required that states expand Medicaid to cover anyone in homes earning up to 133 percent of the federal poverty level. That expansion would add about 620,000 people to Georgia’s current enrollment of 1.5 million.
However, the U.S. Supreme Court ruled this summer that any expansion has to be optional.
“The state of Georgia takes seriously its legal authority over the state’s Medicaid program,” Deal said in his letter. “We will continue to determine eligibility for all individuals seeking Medicaid in our state.”
Dunlap said the health care law in general has been confusing for local businesses.
“I think people are just still puzzled about the whole health care reform. How is it going to affect my business? Can I afford it? Can I afford to hire people? What’s the cost going to be?” she said. “And so right now there’s still misnomers out there and a lot of the rules and regulations haven’t even been written yet.”
The Associated Press contributed to this report.