Lawmakers looking to cure broken insurance system

ATLANTA - The General Assembly should do away with laws blocking market-based reforms that could reduce the number of Georgians without health insurance, the head of a think tank on health care policy said Monday.

Ronald Bachman, president and CEO of Atlanta-based Healthcare Visions Inc., told members of a Senate study committee that insurers in other states are luring middle- and upper-income customers who have never bought health insurance with high-deductible plans loaded with rewards for healthy behaviors.

So-called "uninsurables," the least healthy people who have always been the most expensive to insure, are also being enrolled in other states through high-risk pools, Bachman said.

But he noted current Georgia insurance laws make it difficult to insure either group because they throw up barriers to giving incentives to people with chronic diseases who take their medications and otherwise follow their doctors' orders.

The study committee, which held its first meeting Monday, is tackling a complex assignment: crafting legislation to overhaul a health insurance system that is now primarily employer-based.

Evidence abounds that the system is broken. About 1.7 million Georgians are uninsured, more than 18 percent of the state's population, tied for fifth highest in the country.

Even as those numbers escalate, the number of businesses providing health insurance to their employees continues to shrink. A recent survey by the state chapter of the National Federation of Independent Business found fewer than half of its member businesses offer insurance to their workers.

Witnesses who testified Monday praised state officials for making some progress on the issue during the past year.

The Georgia Department of Community Health is preparing to launch a Web site Jan. 1 to provide consumers with information on the costs and quality of prescription drugs and various health care services at hospitals, pharmacies, nursing homes and rehab centers.

Carrie Downing, the agency's director of legislative and external affairs, said it's the kind of consumer-driven initiative that will lead to more competition in the health care industry, in turn leading to lower costs and lower insurance premiums.

"When a person really takes control of their health care, they will look at more cost-effective alternatives," she said.

Bachman supported a proposal unveiled by Gov. Sonny Perdue two weeks ago to allow small businesses that aren't currently offering health insurance to buy into a state-subsidized health plan.

The governor said an initial investment of $20 million by the legislature would extend coverage to more than 30,000 low- and middle-income Georgians.

Bachman said Perdue's plan is "laudable" as far as it goes, but the state could do better with market-based reforms aimed at driving down the costs of insurance premiums.

"If he thinks he can reach 30,000 people, think how many more he could reach if we had a more competitive market with lower prices," he said.

While Bachman was preaching the use of incentives as the best way to market health insurance to people who can afford it but are choosing not to buy it, he also urged lawmakers not to leave out the more than 300,000 poor Georgians who are eligible for Medicaid but don't sign up.

He said the state should undertake an aggressive outreach effort to make those people aware that they can get help.

"It has to be a campaign drumbeat for an extended period, not just a one-time enrollment," he said.

The committee is planning at least two more meetings to craft a bill in time for this winter's General Assembly session.