Georgia task force on health care recommends more research


A high-powered task force led by Lt. Gov. Casey Cagle has completed nearly a year of meetings and research without producing a solution to some of the state’s biggest health care problems, such as the state’s hundreds of thousands of uninsured poor.

Instead, it recommended more research.

The Senate Health Care Reform Task Force’s steps may eventually lead to big solutions. It recommended the formation of two groups to research the state’s health care needs, form a strategic plan and make their own recommendations.

They would be called the Health Coordination and Innovation Council and the Health System Innovation Center. They would be formed without requiring new money from the state budget, Cagle said.

State Sen. Chuck Huftstetler, a task force member and a Rome Republican, has voiced support for covering more poor Georgians through what is called a Medicaid “waiver.” He said he was not disappointed by the outcome.

“I think we’ve got some great legislation that’s going to look at the person as a whole” — integrating data that is currently dispersed into a more coherent picture, Hufstetler said. Then the lawmakers could use the whole picture to make better decisions, he said.

The notion of a waiver has loomed large in the task force’s discussions. For its debut meeting in March, the task force brought in two national experts, both conservatives, who spoke about how waivers might benefit Georgia.

At this time, though, not all the lawmakers are ready to propose a statewide waiver, Hufstetler said.

“Everybody wants to talk about waivers. But waivers in my mind is kind of getting the cart before the horse,” said state Sen. Dean Burke, R-Bainbridge, as the panel’s members each gave concluding comments. “I think we need to know what our goals are before we start writing waivers.”

Waivers allow a state to work with the federal government to innovate programs for Medicaid money, that might show how to spend the money in a better way. States whose waivers cover the poorest uninsured must pay some of that additional cost, but they also are able to draw down several times that amount from federal coffers. State leaders have still cautioned that Georgia can’t afford full-on Medicaid expansion.

Federal law gives the power to negotiate a waiver to the governor’s office. But few Georgia observers think the governor would try to do that without first getting a green light from the Legislature.

Whether and how to cover the poor remains a political football in Georgia. That makes it tougher to go ahead with a waiver. In addition, the federal Department of Health and Human Services is undergoing convulsions of its own as the Trump administration changes its leadership following the resignation of Secretary Tom Price. So there’s uncertainty about what kind of waiver Washington would accept.

The task force and other committees in the state Senate and House this year have heard from health care experts across the state and the nation on issues such as Georgia’s uninsured population, rural health care access and the opioid crisis.

One thing that seemed clear at Monday’s meeting was the intent to use the task force’s findings to advance measures backed by state Sen. Renee Unterman, R-Buford, to help fund treatment for opioid addiction and behavioral health.

“It does no good to create laws if you don’t have the infrastructure to support it,” Unterman said. “And we all know it takes money to be able to support it.”

Later, a more narrowly targeted waiver to deal with that addicted population might make it through this year and serve as a test case for lawmakers, Hufstetler said.

There’s a cost to waiting to cover the poor through a waiver, though, said Bill Custer, a health care expert at Georgia State University.

“The economics of it say that waiting does not help you. You’re leaving a lot of money on the table,” he said, and all the while people who need medical services can’t pay for them. He acknowledged, however, that Medicaid coverage was a tough political issue in this conservative state, especially in an election year.

“The economics and the politics don’t mix very well,” he said.

Other goals of the council and the center proposed by the task force include eliminating duplication in government and streamlining the process in looking for locally relevant health care solutions.

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