Small audience pans governor’s health plan at Macon hearing

MACON — Trudy Posner told state officials at a public hearing this week her son’s serious heart condition could have worsened if he had not found a new job a month before he turned 26. That’s when he would’ve lost insurance through his parents’ coverage.

The Posner’s spent $600 per month on their son’s health insurance until he got employer-sponsored insurance. But if Georgia Gov. Brian Kemp’s proposed limited Medicaid expansion plan with work requirements was in place when he turned 26, he would have gone without coverage.   

The Macon mother says she fears other Georgians will be unable to pay for insurance and fall short of Kemp’s proposed Georgia Pathways program that would require someone below the poverty level to be a full-time college student or spend 80 hours a month working, volunteering or undergoing job training.

The state is asking federal officials to approve a pair of waivers from the Affordable Care Act to let Georgia create its own more conservative approach to government-subsidized health care. One waiver would allow Georgia to bypass full Medicaid expansion and require work in exchange for about 50,000 poor residents to get health insurance. A second waiver would allow Georgia to become the first state to opt out of the federally subsidized insurance exchange market, or Healthcare.gov.

The new state-operated system would send people directly to insurance companies or brokers, combine government subsidies with employer contributions and create a “reinsurance” program, which has been done in at least a dozen other states.

Posner was one of a handful of people who spoke at Macon’s public hearing on Wednesday about the health care plans. Others pushed for full Medicaid expansion which could insure up to 500,000 Georgians, or expressed concern that the state-run insurance plan is a better deal for insurance companies than patients. The Macon hearing was the second in a series the state is holding to solicit public comments in coming weeks before a federal comment period begins.

“(My son) thought he was getting part-time work and ended up getting five hours a week,” Posner said at a hearing held at Mercer University. “With that definition of 80 hours per month, he would have had to work four jobs, figured out how to manage to get them all in and on top of that having a heart condition, it doesn’t become feasible.”

Scarce turnout at the first two public hearings held this month in Savannah and Macon stand in contrast with the power that commenters can wield.

A federal judge tossed out a limited Medicaid expansion with a work requirement in Arkansas in part because the state did not appropriately respond to some public comments that challenged its waiver application.

Three more hearings in Georgia are scheduled through Nov. 22 and the written comments can be filed online and turned into the state’s Department of Community Health by Dec. 3.

The Georgia Pathways program would cost the state about $36 million – with the federal government picking up the rest of the $120 million cost for the program. The state would also contribute another $104 million toward the new reinsurance program, with the federal government chipping in $264 million.

But for Dr. Kimathi Blackwood, a full expansion is a better investment. 

The Macon kidney specialist said he’s recommended people move out of state in order to get better insurance options than Georgia offers. His take is Georgia Pathways is better than doing nothing, but is a missed opportunity.

Blackwood said many of his patients require dialysis treatment after not being able to afford medication. They often have trouble balancing a job with getting treatment several times a week, he said.

“This is the first step, but I think it’s a very half-hearted anemic step,” Blackwood said Wednesday. “I really think you need to look at seriously investing in the population and saving money long term by having greater coverage for Medicaid.”

Kemp’s proposed private insurance waiver to opt out of Healthcare.gov would combine government subsidies with employer contributions, as opposed to offering sometimes large subsidies directly to the insurance policy customer paid under Obamacare.

Kemp’s plan provides financial incentives to insurance carriers to expand their coverage area and it aims to reduce overall premiums statewide by 10%. Rural communities, where consumers often have the fewest options, could see the largest reductions.

Russ Childers, former president of the Georgia Association of Health Underwriters, said the reinsurance program should work well if the state works closely with insurance agents.

Most agents alert customers of the subsidies available, said the Americus insurance agent and member of the Georgia Department of Community Health board. That board has already voted to give Kemp’s Medicaid proposal initial approval. 

“We would urge some caution because there are insurance organizations in the state of Georgia that are taking advantage of (customers) and offer plans at excessive premiums,” Childers said.

Macon resident Lynn Snyder is not a fan of the state’s alternative to Healthcare.gov. She said the new program favors insurers over consumers and could lead to a more complicated way of finding the right insurance.

“What’s left for the consumer who needs comprehensive coverage?” Snyder wondered. “This puts a lot of Georgians at risk.”

 What to know:

Three more public hearings on Medicaid expansion and private insurance marketplace waivers are scheduled across Georgia through Nov. 22. Public comments can be submitted to the Georgia Department of Community Health through Dec. 3 and here online.

Georgia Pathways Medicaid waiver hearings are held in the morning, while the private insurance waiver hearings are held in the afternoon

• Monday, Nov. 18. Gainesville Civic Center Chattahoochee Room 830 Green Street Gainesville, Georgia 30501. 9 a.m. and 1 p.m. 
• Thursday, Nov. 21, West-Rome Baptist Church The Well Building 914 Shorter Avenue Rome, Georgia 30165. 9 a.m. and 1 p.m.
• Friday, Nov. 22, North Cobb Regional Library Multi-Purpose Room 3535 Old 41 HWY Kennesaw, Georgia 30144. 10 a.m. and 2 p.m.