ON AIR NOW

LISTEN NOW

Weather

cloudy-day
80°
Broken Clouds
H 94° L 74°
  • cloudy-day
    80°
    Current Conditions
    Broken Clouds. H 94° L 74°
  • cloudy-day
    90°
    Afternoon
    Partly Cloudy. H 94° L 74°
  • clear-day
    92°
    Evening
    Sunny. H 94° L 74°
LISTEN
PAUSE
ERROR

Wsb news on-demand

00:00 | 00:00

LISTEN
PAUSE
ERROR

Wsb traffic on-demand

00:00 | 00:00

LISTEN
PAUSE
ERROR

Wsb weather on-demand

00:00 | 00:00

State & Regional Govt & Politics
Consultant’s application suggests goals for Georgia health care waivers
Close

Consultant’s application suggests goals for Georgia health care waivers

Consultant’s application suggests goals for Georgia health care waivers
Georgia has one of the nation’s highest rates of uninsured people. Hospitals have to treat them whether or not they can pay, and Washington County Regional Medical Center in Sandersville, Ga. GA lost $1 million last year. Gov. Brian Kemp’s office is working on a program that may increase the number of people with health insurance coverage. An open question is how solid that coverage would be. (PHOTO by ARIEL HART / ahart@ajc.com)

Consultant’s application suggests goals for Georgia health care waivers

The consultant working to devise Gov. Brian Kemp’s health care “waivers” said early on that it expected Georgia to craft work incentives for people covered by its Medicaid program, according to documents released by Kemp’s office.

Following a law the Legislature passed this year, Kemp plans to seek waivers from the federal government to reshape Georgia’s health coverage, both for Medicaid and for insurance sold under the Affordable Care Act. Kemp has the ability to increase the number of people on Medicaid or to make changes to insurance plans offered in Georgia. But he hasn’t shown his cards yet and it’s his choice what to seek. His aides rebuffed the notion that decisions have been made, telling The Atlanta Journal-Constitution that the work has only begun.

But the consulting company he and state health officials chose, Deloitte, appears to have given clues to what the governor is seeking in its winning bid for the job.

The “critical goals” for the state, Deloitte’s application said, included standard aims for improved health, especially among lower-income Georgians, and broader insurance coverage. It also included items that suggest a conservative wish list. One could require Medicaid recipients to file paperwork showing they’re trying to work or be active. A second could give private-policy customers options that offer less coverage than what they would find on the state’s ACA exchange.

Some of those goals could advance the Trump administration’s deeply held goals of undoing regulations created in the ACA, also known as Obamacare. Some states that have already tested the waters saw their efforts brushed back by the courts. Deloitte is proposing to use those states’ experience to devise strategies that are different and could last.

“This is an opportune time for Georgia to think creatively as the federal government has signaled a new willingness to entertain ideas and flexibilities that heretofore they had not,” the application says.

Kemp’s spokeswoman, Candice Broce, said in an email that Deloitte had barely gotten to work and the governor’s office was sharing information when it has it.

“Governor Kemp is committed to reducing healthcare costs, protecting individuals with preexisting medical conditions, and improving healthcare access and quality for Georgia families,” Broce said. “I would say that, at this time, speculating on any specific plan, population, etc. is premature.”

“Work-related activities”

First among the critical goals Deloitte listed was “incenting work-related activities in Georgia’s Medicaid program.”

Georgia Republicans have long favored work requirements in exchange for benefits. And Kemp’s focus on “hard working Georgians” in health care is nothing new.

As Kemp aides have previously pointed out, Georgia’s current Medicaid program is heavily weighted to benefiting children, and most adults currently on it are new mothers. If working-age adults were required to do something work-related, those likely wouldn’t be people already on Medicaid, said Kyle Wingfield, the CEO of the right-leaning Georgia Public Policy Foundation.

Laura Colbert, the director of the patient advocacy group Georgians for a Healthy Future, says most of the goals Deloitte listed could be accomplished without having a waiver at all, unless, for example, making a work-reporting requirement mandatory was a goal.

“Frankly, the documents themselves, just the way the work incentive is framed, and the direction that the federal government is pushing states, indicate that this work requirement will be mandatory, not a voluntary work support program,” she said.

That could mean simply reporting to the government a person’s attempts to find work, or his or her status as a student, or even volunteer work. Where Colbert sees a bureaucratic barrier, the Trump administration sees an opportunity to make people happier and healthier by pushing them to get jobs.

Full coverage

Deloitte also cited the goal to “re-frame ACA requirements” to stabilize the individual insurance market.

That could mean opening wide the door to insurance plans that offer less coverage in the hopes of being cheaper.

The Centers for Medicare and Medicaid Services, or CMS, oversees the ACA, which was written to mandate more comprehensive coverage for all individual health insurance plans. That meant insisting on coverage for mental health care, prescriptions and other “essential benefits” whether a policyholder wanted them or not. It meant preventing plans from pricing out coverage for people with pre-existing conditions. The Trump administration is trying to weaken those requirements.

Jennifer Tolbert, the director of state health reform at the research organization the Kaiser Family Foundation, said the Trump administration had “loosened the guardrails” around waiver applications that previously aimed to make coverage as comprehensive as possible.

“It is possible that Georgia may be contemplating something along the lines of what CMS has encouraged states to do,” Tolbert said, “by directing people to these alternative health plans, if you will, that don’t have to meet the consumer protections laid out in the ACA — these plans can deny coverage based on their health status; can refuse to cover pre-existing conditions; can charge people with health conditions more than other people.”

Healthy people would take those plans, Tolbert said, leaving the regular market with sicker, more expensive patients and requiring prices to go up.

Colbert, from Georgians for a Healthy Future, like Kemp, advocates for increased health coverage and better health of Georgians. She disagrees on the way to get there though, preferring Medicaid expansion for the poor and stabilizing the ACA insurance exchange with its comprehensive plans for the rest of the individual market.

She said it’s “confusing to consumers” to increase access to plans offering less coverage than what’s required by the ACA. She’s afraid customers won’t know they’ve bought skimpy coverage until it’s too late.

Wingfield, of the Georgia Public Policy Foundation, supports such conservative solutions and said the alternative is living a fantasy.

“Look — here’s what everybody seems to fail to acknowledge,” Wingfield said. “Yes, plans on the individual market right now cover a wide range of benefits. But they’re also really expensive. That’s why the market has been battered. People are opting out.

“What these other plans let you do is you have an option,” he said.

Stay on top of what’s happening in Georgia government and politics at www.ajc.com/politics.

Read More

News

  • Authorities in Michigan are searching for a 2-year-old girl who reportedly vanished from an Oscoda County campsite Monday morning. >> Read more trending news According to the Oscoda County Sheriff's Office, family members of Gabriella Vitale, 2, of the Monroe area, 'lost track' of the girl as they were getting ready to leave the campsite near state Highway 33 and Reber Road. They reported her missing about 8:15 a.m., authorities said. By late Monday, search crews, including deputies, state troopers, police dogs, a police helicopter and Michigan Department of Natural Resources officers, had not found the child, authorities said. Gabriella was wearing a pink zip-up coat, a gray shirt, pink bottoms and tennis shoes when she disappeared, the Sheriff's Office said. Authorities later found the coat 'several hundred yards southeast of where she went missing,' Michigan State Police said. Gabriella 'may have autism,' WWTV reported. If you have any information about Gabriella's whereabouts, call 989-826-3214. Read more here or here.
  • A Tennessee man was indicted on first-degree murder charges after his girlfriend’s 2-year-old son was taken to the hospital and later died. >> Read more news stories Alan Johnson, 41, of Memphis, was taking care of the child while his mother was at work on Oct. 10, 2018, according to officials. He told investigators he was throwing the 2-year-old up in the air and catching him, but the boy slipped on the last throw, authorities said. According to investigators, Johnson said he swung the child – identified as Dylan Meeks – to “keep him from hitting the ground.” He said he saw the boy’s neck go back and noticed he was not responding, so he called police, authorities said. The child died two days later. The staff at Le Bonheur Children's Hospital told police that the injuries, which included a skull fracture, brain swelling, internal injuries and rib fractures, were not consistent with Johnson's story. The medical examiner found new and healing fractures of the child's ribs and also lacerations of several organs.  Johnson was later charged with murder. He was indicted Monday on charges of first-degree murder in the perpetration of aggravated child abuse and neglect. Johnson is being held without bond in the Shelby County Jail.
  • Police have apprehended a Pennsylvania man wanted on charges related to the death of his girlfriend's infant daughter, authorities said.  >> Read more trending news Pennsylvania State Police confirmed that Derrick Bass, 29, was arrested in Ohio on Monday, two days after the 11-month-old was found dead in a Pack ‘n Play at an apartment complex in East Huntingdon Township, Pennsylvania. He has been charged with homicide. The baby’s mother told police that Bass was supposed to be watching her daughter and his two children. He also was supposed to pick her up from work, but never showed up, she told police. When the girl’s mother got home, she noticed her daughter and various electronic items were missing, according to a complaint. She called police shortly after 11 p.m. Police responded to the apartment shortly after 12:30 a.m. after the mother reported finding her daughter unresponsive in the Pack ‘n Play, the complaint said. She did not see her until that time because the baby was covered in blankets, according to the complaint. Family identified the girl as 11-month-old Niomie Miller. An autopsy was conducted Sunday morning, and the preliminary cause of death was determined to be drowning, authorities said.
  • An electric company worker in eastern Kentucky took every precaution recently as he prepared to head out to a job untangling a tree from a power line, but little did he know there was no way to prepare for what was about to happen to him.  >> Read more trending news  Chris Prater told WYMT-TV that he sprayed himself down with insect repellent and joined his crew for the task ahead. After finishing the job, he said his eye bothered him. “I noticed I just started having irritation in my eye,” Prater said. He said he flushed his eye out several times and had a co-worker take a look, yet a spot he noticed didn’t move, WYMT reported. Prater was hesitant to go to a doctor, but finally made an appointment with an optometrist. 'When the doctor finally comes in, he was looking at it. He said, 'I know what's in your eye.'' Prater said he was stunned when the doctor explained what he had found. “He said, ‘It's a tick.’ That's when I got scared a little bit,” Prater told the news station. “I leaned around and looked at him and I asked him if he was joking and he said, ‘No, you have a deer tick or some type of tick.’ It was very little.” The doctor numbed Prater’s eye and used a pair of tweezers to extract the tick. “Once he grabbed ahold of it and pulled it off, the tick made a, like, a little popping sound when it came off of my eye,” Prater said. Luckily there was no lasting damage to his eye, but Prater wanted to warn others about the importance of using insect repellent, even though he knows that wouldn’t have helped his eye.
  • New York authorities are investigating the death of a 3-year-old boy who fell into a grease trap Monday morning in Rochester and died. >> Read more trending news  The tragedy happened behind a Tim Hortons restaurant around 11 a.m., according to WROC-TV. A witness found the boy, pulled him out of the pit and administered CPR but the boy died a short time later at a local hospital. “It’s a horrible, tragic accident,” police investigator Frank Camp told WROC.  There was no fencing around the trap and it was “flush with the ground,” Camp said.  The trap was covered with a green plastic lid and it blended in with the surrounding grass, Camp told CNN. “The lid was on there. It looks like the child ran across it and it popped open and he fell into the trap,” Camp said. The pit is 2.5-feet in diameter, and the city was called in to pour concrete around the trap and replace the plastic lid with a metal one. Right Now: A crew is working to secure a grease trap at Tim Hortons on University Avenue. This is following a tragic accident earlier today. A 3-year-old boy has died after falling into this grease trap. Police attempts were made to save him but were unsuccessful. @SPECNewsROC pic.twitter.com/fubViueURN — Natasha Acrie (@NatashaAcrieTV) July 15, 2019 “We have a horrifying episode here that happened today,” Camp said, according to CNN. “We're asked all the time, ‘What's the worst thing you encounter as a police officer?’ and this is No. 1.” It’s unclear how the child, who was not publicly identified, wandered behind the restaurant. The medical examiner will issue an official cause of death in the next few weeks “We have a horrifying episode here that happened today,” Camp said, according to CNN. “We're asked all the time, ‘What's the worst thing you encounter as a police officer?’ and this is No. 1.” It’s unclear how the child, who was not publicly identified, wandered behind the restaurant. The medical examiner will issue an official cause of death in the next few weeks.
  • A biologist diving off the English coast over the weekend had a stunning and rare encounter with a jellyfish so large, it was easily the size of a grown man. >> Read more trending news  Researcher and broadcaster Lizzie Daly described the encounter as “breathtaking,” according to CNN. “What an unforgettable experience,” said Daly, who was diving as part of her Wild Ocean Week campaign to raise awareness and money for the United Kingdom’s Marine Conservation Society. “I know barrel jellyfish get really big in size but I have never seen anything like it before!” she said.She was diving off the coast of Falmouth, where she and her diving partner spotted the massive jellyfish. “It really humbles you to be alongside an animal that size,” Daly told Vice News. “It’s an experience we’ll never forget.”  Barrel jellyfish inhabit the British seas and are the largest species of jellyfish in U.K. waters, CNN reported. They can grow larger than three feet and weigh more than 55 pounds.