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Insurance bill launches debate

ATLANTA - Sen. Judson Hill's lawmaker colleagues, insurance industry officials and health policy experts are praising him for putting much-needed health insurance reform on the Legislature's plate this winter.

But no one, even Hill himself, expects the wide-ranging 60-page bill the Marietta Republican introduced last week to pass in anything near its current form.

"You can eat an apple one bite at a time,'' said Sen. Ralph Hudgens, R-Comer, chairman of the Senate Insurance and Labor Committee, which will begin considering the bill this week.

"But if you put the whole apple in your mouth, you're probably going to get strangled.''

The comprehensive measure is the product of a study committee that Hill chaired last year to look for ways to reduce the ranks of Georgia's 1.7 million uninsured by transforming the way health insurance is delivered.

His bill promises a major shakeup that would begin moving away from the employer-based insurance system that has been the status quo in Georgia and the rest of the nation since World War II.

"Tweaks don't work,'' he said. "What we've done for years is tweak the system. ... If we want to continue to do the same thing and expect a different result, we're foolish.''

Wrong solution

But critics say the bill wouldn't work because the tax incentives at its heart wouldn't help the low-income Georgians who make up a huge segment of the uninsured population.

"A tax break isn't going to help a family of four with an income of $25,000,'' said Alan Essig, executive director of the Georgia Budget and Policy Institute, which released a report last week critical of the "health savings accounts'' Hill's bill would encourage. "It's not the solution for the problem that we have.''

But Hill said his proposal would help the largest growing group of uninsured Georgians, those making more than $60,000 a year.

It's a group most people don't associate with being uninsured. Many are temporarily uninsured because they're between jobs, Hill said.

That's why the crux of the bill is aimed at disconnecting health insurance from employment.

Under the legislation, people who make more than $60,000 a year would be allowed to deduct their medical expenses and claim a personal exemption on their state income taxes if they have at least minimum health coverage or if they post a bond comparable to that level of coverage.

Health-savings accounts, which consumers would buy on their own rather than through work, typically offer high deductibles in exchange for lower premiums.

"A lot of uninsured Georgians are people who can afford insurance but choose not to,'' said state Insurance Commissioner John Oxendine.

"They'd rather take their chances, and if they do run up a big medical bill, they'll take bankruptcy. ... He's found a way for these people to get insurance.''

Coverage expanded

Glenn Landers, senior research associate at Georgia State University's Health Policy Center, praised a provision in the bill that would let parents cover their children as dependents until they reach age 27.

He said young adults are another group that tend to be uninsured in large numbers.

"That group is commonly called the 'young invincibles,''' Landers said. "They believe nothing's going to happen to them.''

But Linda Lowe, an Atlanta-based consumer health advocate, said offering low-cost, high-deductible health savings accounts to young adults and high wage earners would siphon them off from traditional group plans, driving up premiums for the rest of the population.

"Health insurance is like fire protection or building a road,'' she said. "It's something we need to treat as a mutual obligation, not an individual obligation. ... You spread the risk across the entire population.''

The one argument for the bill that all sides seem to agree on, from enthusiastic supporters to staunch critics, is the need to give consumers more information on competing health insurance plans. To help them make informed choices, the legislation would establish a Web site containing prices for medical services and prescriptions.

Hudgens said that "transparency'' element of the bill probably will be among the two or three provisions his committee will focus on as it takes up the measure.

Even if the rest of the bill never gets out of Hudgens' committee this year, Hill said he at least will have started a debate that needs to happen.

Others agree.

"He is taking all these different ideas that people talk about theoretically and putting it into legislation to force the issue,'' Oxendine said. "I commend him for doing that.''