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As Obamacare comes to Georgia, keep your eye on Washington — and Atlanta


Obamacare is coming to Georgia, so strap on your waterproof skeptic’s cap. And make sure it’s rated to repel both Republican and Democratic fire hoses.

Last week began with a panicked letter from state Insurance Commissioner Ralph Hudgens to Kathleen Sebelius, the secretary of the U.S. Department of Health and Human Services — who is in charge of implementing the new requirements of the Affordable Care Act.

Hudgens’ letter was sent via Fedex on Monday and asked that Sebelius — by 7 p.m. Tuesday — extend a Wednesday deadline that required him to approve premium rates for health care policies that will be offered this fall by an insurance exchange set up to sell policies to the uninsured, whether they’re unemployed or have no coverage at work.

Hudgens’ duty is one of the few points at which Georgia Republican officialdom has intersected with Obamacare. Heretofore, the “10-foot pole rule” has been in effect. The federal government is setting up the Georgia exchange after state officials declined the honor.

“Insurance companies in Georgia have filed rate plans increasing health insurance rates up to 198 percent for some individuals,” the Republican commissioner told the Democratic Sebelius.

Hudgens would later concede that the example he cited was the most extreme — some distance from the norm: “An individual policy for a young person that would go from $66 a month up to $197 once they cover the mandates of Obamacare,” he said.

Sebelius never replied, and Hudgens approved the rate increases.

Now, look. The Obama administration has certainly soft-pedaled the increased cost of near-universal health care. Pre-existing conditions aren’t cheap. Nor has the White House yet sold invulnerable young people on the need to buy it — a key to whether the program will work.

But it would be unwise to keep one’s eyes solely on Democrats in Washington over the next several months. Even if your insurance company tells you to — which, in Georgia, is required.

You didn’t know that? As of July 1, with any notices of premium increases, insurance companies are required to let policyholders know how much of the increase can be attributed to Obamacare — with this exact wording:

“These increases are due to the federal Patient Protection and Affordable Care Act and not the enactment of any laws or regulations of the Governor of Georgia, the Georgia General Assembly, or the Georgia Department of Insurance.”

Translation: “No matter what happens, it’s not our fault.”

The legislation mandating this, Senate Bill 236, was requested by Hudgens and passed by the Legislature this spring. It remains conveniently in effect for the next 17 months, until the end of campaign season. Needless to say, Hudgens, Gov. Nathan Deal and the entire Legislature are up for re-election.

Republicans in the Senate beat back a Democratic attempt to also mandate that insurance companies make public how they calculated Obamacare’s share of the blame — and to require insurers to credit the law should rates go down.

“We’re going to let them decide how much of it is due to the federal bill. Who’s going to decide that? Who’s going to audit it? Who’s going to write it? The insurance companies,” state Sen. Steve Thompson, D-Marietta, said in arguing against the legislation.

The language in SB 236, practically speaking, attempts to absolve Republicans in the Capitol of all responsibility for increases in health care costs through next year. But saying so don’t make it so. The measure didn’t strip Hudgens of his authority over insurance rates — as the commissioner admitted Friday in a radio interview.

“If an insurance company files a rate increase with us, we can say, ‘This is excessive,’ and they have to roll it back,” Hudgens said. “So I guess you’d say we really do regulate the rates.”

He explained the normal bargaining that takes place with insurance companies asking to up their customer’s bills. “If they say, ‘We want a 25 percent rate increase,’ we’ll say: ‘We’ll give you a 10 percent rate increase. Come back to us next year and tell us how your reserves are doing.’ ”

In the case of seven companies seeking to sell health insurance policies through the Georgia exchange, Hudgens said he handed off the rate proposals to an independent actuary, who deemed only one to be excessive. Hudgens said he bargained that firm down. (Two of the seven firms, Aetna and Coventry, later announced they would sit out the debut of Obamacare.)

Hudgens did have the power to reject out of hand all the rate proposals and their increases. But a spokesman couldn’t say why the commissioner didn’t do that.

I want to be very careful about what I write next. I have known Ralph Hudgens for a very long time. He’s a nice guy, and I have nothing bad to say about him.

The actuarial documents that Hudgens used to approve those policy rates last week haven’t been made public. A spokesman said they soon will be, and we trust that this is so.

But Hudgens heads up a state department that has, under both Democratic and Republican rule, generated more than its share of corruption and influence peddling. (Hudgens replaced Republican John Oxendine, whose 2010 bid for governor crashed and burned largely because of his shadowy doings as insurance commissioner.)

“Ralph has been a personal friend for years. But that office is tainted because of the way it’s constructed,” Thompson, the Marietta lawmaker, said during an interview last week. “No one contributes to (the insurance commissioner’s) race except insurance companies or their employees. When you’re elected in that posture, your constituency is actually insurance companies and their employees.”

Obama is attempting an unprecedented expansion of federal authority, and that requires unending scrutiny. Or repealing, if you’re so inclined. But in the short term, health care insurance companies have an interest in seeing that the costs of his program are as generous as possible. And no matter what they say, at least in Georgia, Republicans are in control of the levers that could make that happen. Or not.

Anyone who doesn’t watch both Washington and Atlanta isn’t watching his wallet.

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