The day after President Barack Obama’s re-election, Turner, Wood & Smith Insurance in Gainesville shared with its clients a document that states flatly, “Health Care Reform Law Here to Stay.”
The company, along with the Northeast Georgia Health System and Greater Hall Chamber of Commerce, had sponsored a Sept. 13 forum about the controversial law, which had been Obama’s signature legislation during his first term.
“Obama’s victory in the election, along with last summer’s Supreme Court decision upholding the health care reform law, cements the Democratic Party’s dedication to the legislation,” the insurance company’s memo to clients says.
Chatter about the law’s future began in earnest Wednesday, with the chamber’s health care committee discussing the matter in an early morning meeting. And the chamber has scheduled a Tuesday meeting, “Affordable Care Act: Implications for Small Business in the Wake of the 2012 Election.”
Also, Gov. Nathan Deal suggested Wednesday that he would not implement a Georgia health insurance exchange as part of the law.
He said he wouldn’t disclose his decision until notifying federal authorities. But he noted that the state stopped planning an exchange once federal agencies wrote regulations that he says restrict Georgia’s ability to design its own program.
The decision to stop, Deal says, is “probably a pretty good indication of where we are headed.”
The law gives states the option to run the exchanges or default to the federal government. The exchanges would allow individuals to shop for private insurance.
Congress set a Jan. 1, 2013, deadline for states to have an operable exchange. Deal has until Friday to submit an outline for an exchange or notify federal authorities that Georgia declines to open its own.
In 2011, Deal appointed a committee that advised him on how to proceed concerning a state-run exchange, and that panel opted against recommending one.
Earlier this month, the North Georgia Tea Party Alliance called on Deal not to implement a health care exchange in Georgia. The local Lanier Tea Party Patriots is a member of the alliance.
“The law relies on the states to implement two of its essential components: health exchanges and the expansion of the Medicaid program,” said Jack Smith, head of the alliance, in a press release. “Georgia should simply sit on its hands. Our economy is already far, far too squeezed.”
The alliance also is looking at a petition drive to “nullify” health care reform in Georgia.
Phaedra S. Corso, a Gainesville resident and professor in the University of Georgia’s Department of Health Policy and Management, said she believes, in referring to the exchanges, that “the state that cares about states’ rights should want to run their own programs.”
“One of the reasons (Deal) should consider it is, starting in 2013, (federal disproportionate share hospital) payments are going to be reduced significantly,” said Corso, who spoke at the Wednesday chamber meeting.
The U.S. government provides funding to hospitals that treat indigent patients through DSH programs. Under health care reform, the indigent payments are going down because the idea is that all Americans would have health insurance by 2014.
“Georgia passed up two years of funding to get those exchanges up and running, and it might come back to bite us,” Corso said.
She went on to add: “Anytime you stop implementation of anything because of politics, you are doing a disservice to your population.”
The conventional wisdom has been that if the GOP’s presidential candidate, former Massachusetts Gov. Mitt Romney, was elected and entered his first term with a majority-GOP U.S. House and Senate, health care reform would be repealed promptly.
Richard D. Sanders, an Atlanta lawyer who has served as vice chairman of the American Health Lawyers Association’s Health Reform Task Force, said at the Sept. 13 chamber forum that he believed Congress would expand on health care reform if Obama won a second term and entered with a majority Democratic House and Senate.
Neither scenario happened, resulting instead in what some have called a “status quo” election.
U.S. Rep-elect Doug Collins, R-Gainesville, who won the newly drawn 9th District seat on Tuesday, said he believes health care reform “is not only disastrous for businesses but also state economies, with the expansion of Medicaid.
“We talk about the fiscal cliff now, 2014-15 is going to be an interesting time when the problems with this legislation really come home to roost,” he said in an interview Wednesday.
“That is when $500 billion-plus in tax increases kick in. That’s when the (individual) mandate kicks in. That’s when businesses are going to be forced with choosing between paying to help their employees stay in the health care system or put them in the government system.”
Collins said he will “continue to fight against it, fight for changes in it, and I’m going to continue to fight for the repeal of it. I just think that’s what’s good for the 9th District and the country.”
Rob Fowler, executive vice president of Turner, Wood & Smith, said he believes that “with no major shift in the balance of power in Congress, a full repeal of the Affordable Care Act is no longer a viable option.”
He expects to see the federal government pick up the pace on the Affordable Care Act’s rule publication spelling out the law’s mechanics.
“Getting the law in place is one thing,” Fowler said. “But there’s thousands of pages of regulations that spell out how the law will be implemented. Those have been slowly trickling out ... and some of that, I think, is they didn’t want to put it out prior to the election.”
Carl Cavalli, a political science professor at North Georgia College & State University, said he’s not sure what the future holds for health care reform’s implementation.
“I think the least likely (scenario) is that it will go ahead as planned,” he said. “There might be some tweaks to it, possibly to try to weaken opposition to setting up the exchanges.
“It is possible we might see some hard-line opposition,” Cavalli said. “ ... I would not be entirely surprised to see a state not only set up its own exchange but to also challenge the federal government’s right to set up an exchange in that state. So, I think there’ll be more legal action somewhere along the line.”
In June, the U.S. Supreme Court found that Obama’s health care overhaul was constitutional, including the individual insurance requirement.
“I don’t think John Roberts had the last word, by any means,” said Cavalli, referring to the chief justice, an appointee of Republican President George W. Bush, who voted with the majority to back the law.
The Associated Press contributed to this report.