Search for Georgia health care solutions won’t look at Medicaid

Concerned about the growing lack of health care access across the state, one of the state’s largest pro-business groups is stepping in to launch a nine-month study to come up with solutions to what is becoming a health care crisis, particularly for those in rural areas.

The Georgia Chamber of Commerce, in conjunction with partners such as the Georgia Alliance of Community Hospitals, the Georgia Hospital Association, doctors, insurers and policy experts, will look at ways to close not only the insurance coverage gap in the state, but also how to provide health care in counties without enough doctors and those with shuttered hospitals.

“It’s really about economic development,” said Chris Clark, president and CEO of the Georgia Chamber. “Some of the recent rankings (in health care access) list Georgia near the bottom, and you can’t attract business like that.”

Clark said the study and the task force will not make Medicaid expansion a goal, even though advocates for the uninsured believe that expanding the program would provide care for more than 600,00 additional Georgians. About 1.8 million already are covered by the program.

“Everything is on the table except Medicaid,” Clark said.

The issue of Medicaid expansion has divided Georgia lawmakers since the 2012 U.S. Supreme Court ruling that upheld the constitutionality of the Affordable Care Act, commonly called Obamacare.

Medicaid is the federal and state insurance program for low-income children, pregnant women, the disabled and elderly. Obamacare called for states to expand Medicaid to very low-income people, with the federal government picking up no less than 90 percent of the tab. In Georgia, that would have meant the federal government would have given the state about $35 billion during the first decade of expansion.

But dozens of states, including Georgia, bucked that part of the law in their opposition to Obamacare.

Georgia "is leaving a lot of dollars on the table," said state Sen. Chuck Hufstetler (R-Rome).

“I don’t think it’s fair to tell our hospitals, particularly our rural ones, that they can’t have that money,” said Hufstetler, who was an Obamacare opponent.

Rural hospitals, struggling under the strain of treating the poor and uninsured, in particular could benefit from Medicaid dollars.

Since 2013, five rural hospitals have closed, and a sixth, Hutcheson Medical Center in Fort Oglethorpe, is scheduled to close by the end of the month unless a deal is struck.

The governor remains opposed to Medicaid expansion because "Georgia can't afford the program," said Jen Talaber, a spokeswoman for Gov. Nathan Deal.

“However, with more flexibility from the federal government, Georgia could provide more and greater coverage to vulnerable populations through innovative solutions,” Talaber said.

But improving health care access across the state is "not just (about) Medicaid," said Monty Veazey, president of the Georgia Alliance of Community Hospitals. It includes access to doctors, telemedicine and first responders as providers in areas underserved by hospitals and by doctors.

Bill Custer, health care policy expert at Georgia State University, said he agrees that the Chamber study should not be solely about expansion.

“There are other components, workforce issues, distance health care. You have to finance the health care, and you have to have access to health care,” Custer said.

Georgia is falling behind in both.

“One of the points that we’re going to be stressing is that the coverage gap doesn’t just affect those without insurance,” said Chamber spokesman Brian Robinson. For example, say a person with medical insurance has a stroke. If that person lives in an underserved area, he or she still might not be able to reach a hospital in time for life-saving treatment.

Not having a hospital also “makes economic development in these areas much harder,” Robinson said.

“Employees and employers pick up the cost. It’s one of those things that affects us all as a family, as Georgians, and we need to come up with a long-term strategy that is going to be fiscally responsible and sustainable,” Robinson said.

Clark, the Chamber president, said the health care study should take about nine months. He does not yet know the final cost, he said.