November 15, 2012

Georgia should take the lead on health care

With some Republican governors wavering on their opposition to creating new health care exchanges, the federal Department of Health and Human Services (HHS) has extended the deadline for states to create those exchanges.

The exchanges are heavily regulated “marketplaces” in which insurance companies can offer plans to those who lack insurance or to small companies that don’t currently provide insurance. Low-income Americans who lack health insurance will get government subsidies to buy it through an exchange, making the exchanges a mechanism to subsidize big insurance companies.

States originally had until Friday to declare whether they would create those exchanges, which are called for but not mandated by the health care overhaul Congress passed two years ago. But HHS earlier this week extended the deadline to Dec. 14.

Leaders of six states have definitely said they won’t create the exchanges. Another dozen or so say they are leaning strongly against it. Leaders of less than 20 states have definitely said they will set up exchanges. But as the initial deadline neared, some of the opponents, such as Florida Gov. Rick Scott, have had second thoughts and said they may create the exchanges. And in Tennessee, Gov. Bill Haslam and his fellow Republicans who control the state Legislature seem split on the issue, with Haslam saying he’s open to creating an exchange and other GOP leaders firmly opposed.

In Georgia, Gov. Nathan Deal and most other Republicans have been leaning against the idea. They don’t seem to be wavering in their opposition, and they shouldn’t.

If Georgia doesn’t create an exchange, the federal government will. It will bear all of the responsibility and it will bear all of the costs. If a state creates an exchange it will be initially subsidized in part by the federal government. But those subsidies aren’t guaranteed, and after a few years, the state could be looking at a massive bill.

Further, the law creating the exchanges and the regulations surrounding them effectively gives the federal government control over the exchanges, so the state would have little say in how any exchange it creates is actually run.

Deal and Georgia’s other leaders should step up now, not wait until Dec. 14, and tell the feds the Peach State will not create a health care exchange. Maybe by taking a firm stand they can stiffen the spines of those in some of our neighboring states.

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