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Senator readying for round two of health-insurance reform fight

ATLANTA - While lawmakers haggled loudly over Sunday beer sales, gun rights and private school vouchers this year, a proposal with much greater potential to affect Georgians was quietly swept aside.

A bid to reduce the ranks of the state's 1.7 million uninsured through market-based incentives prompted several committee hearings.

Only a remnant - the least controversial portion - made it into law.

But Sen. Judson Hill, R-Marietta, the driving force behind the effort, didn't sound discouraged last week as he geared up for another crack at pushing a major overhaul of Georgia's health insurance system.

He had just been named by Lt. Gov. Casey Cagle, the Senate's presiding officer, to head a study committee that will craft a new version of the legislation for the 2008 General Assembly. The panel will hold its first meeting next month.

"We need to encourage people who can afford their own health insurance to buy it and give them a financial stake in their health care," Hill said.

The 60-page bill that Hill introduced early in this year's session would offer Georgians incentives to buy individual insurance policies instead of relying on employer-based group plans.

Studies show that fewer and fewer companies are offering insurance to their workers, a consequence of the ever-increasing costs of health care and, thus, health insurance.

Incentives offer

Here's how the legislation would work: 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 minimal health coverage - a low-cost, high-deductible plan - or if they post a bond comparable to the cost of catastrophic coverage.

However, if they choose not to pursue either of those options, they wouldn't be entitled to the tax breaks.

Hill said the current employer-based insurance system gives people no reason to compare prices for medical services and prescriptions, which contributes to the overconsumption that drives up premiums.

"Health care spending is not tied to any market incentives," he said. "If it's a co-pay, who cares?"

Hill said decoupling a person's health insurance from his or her job would help reduce the number of uninsured. Some 400,000 to 500,000 Georgians a year lose coverage because they change jobs, he said.

But Hill's legislation struggled during the weeks after he introduced it, a victim of its own weight.

He eventually decided to break it into three separate bills that would be easier for his Senate colleagues to digest. Still, most of his proposals didn't make headway.

Wrong approach

Health care activists at the Capitol sympathized with Hill's goal of shrinking the uninsured population but found little else to support in his approach.

"Everybody recognizes that employer-based health insurance is going the way of the loon," consumer health advocate Linda Lowe said last week. "But there are different answers for what you do about that."

The Georgia Budget and Policy Institute, which advocates a strong safety net, concluded that Hill's answer wasn't the right one, and the Atlanta-based think tank also opposed the legislation.

Tim Sweeney, a health policy analyst for the institute, conceded that part of the state's uninsured problem stems from higher income Georgians who choose not to buy health insurance.

But Sweeney said that's not the appropriate group to target with tax breaks financed with state dollars.

"It's giving tax incentives to people who can buy insurance already," he said. "If we're going to divert public resources to address the uninsured, we should divert those resources to the people who most need the help."

Sweeney suggested that tax incentives wouldn't attract many uninsured low-income Georgians because they wouldn't see the savings that would accrue to higher income taxpayers.

But Rep. Mickey Channell, R-Greensboro, who pushed some of Hill's proposals in the House this year, said the legislation's critics are underestimating its potential impact across the wage scale.

"I think people respond to incentives, and low-income people are no different," said Channell, chairman of the House budget subcommittee with jurisdiction over health care spending.

"Somebody who makes $20,000 a year probably knows as much about managing their income as someone who makes $200,000 a year."

Web site

The only piece of Hill's legislation that survived was a provision instructing the state Department of Community Health to develop a Web site to allow consumers to compare the costs of medical services and prescriptions and the quality of hospitals, pharmacies, nursing homes and rehab centers.

It was attached to a House bill that passed on the last day of the session.

But the DCH already was working on the project before this year's legislative session began. Gov. Sonny Perdue ordered up the Web site in an executive order last fall.

The site, funded with $1 million in this year's budget, is targeted to debut at the beginning of January.

"Information is never a bad thing," Sweeney said. "But I don't know that it's going to revolutionize health care and make it more affordable."

Channell said he wasn't surprised that none of the bigger-picture reforms made it through the legislature this year.

"I think these kinds of things are where our health care delivery system has got to go," he said. "(But) it's somewhat new. A lot of times, when you deal with something new, there's resistance."