By Ron Bachman, chairman editorial advisory board, The Institute for HealthCare Consumerism
In July 2012, that just might be the headline that throws the country into turmoil. If the constitutional challenge to the Patient Protection and Affordable Care Act 
(PPACA) health reform by 26 states is successful--then what? Part or all of the federal law will immediately be null and void. Insurance markets will revert back to inadequate state laws that existed pre-PPACA. We know those laws created 1.8 million uninsured Georgians and fewer than one in four Georgians working in small businesses were insured. So, is Georgia prepared to make needed health reform changes for the state to improve the insurance market and lower the number of uninsureds?
In preparation for that potential, the Georgia Public Policy Foundation (GPPF) facilitated a multi-stakeholder bipartisan discussion group that resulted in a detailed plan for Comprehensive Health Insurance Reform for Georgia. The plan was built on basic principles of:
(1) Free Markets,
(2) Personal Responsibility,
(3) Competition,
(4) Choice,
(5) Transparency, and
(6) a Level Playing Field for All.
Recommendations include three major areas of reform to be pursued simultaneously.
First, Georgia must restructure the insurance market to increase competition, transparency, access, and portability. Four major restructuring ideas emerged:
1) Georgia should show leadership in creating a regional marketplace with consistent insurance laws and interstate reciprocity of policy approvals. A larger 24-50 million person Southeast marketplace will bring Georgia lower cost products, more responsive wellness incentive programs, and increased choices through competition.
2) Georgia should encourage the development of nascent private health insurance information marketplaces. These entities will provide transparency of costs, quality and consumer health literacy to both private and public insurance.
3) Georgia needs a “Personal Responsibility High Risk Pool (PRHRP).” A PRHRP would stabilize the small group and individual markets, provide affordable coverage to those otherwise locked out of coverage, and increase access to insurance for all.
4) Georgia laws should allow for a group conversion policy for those who lose their jobs and coverage. A group conversion would maintain consistency with other group policies and add a valuable aspect of portability.
Second, Georgia needs new laws to strengthen the private market safety net. Areas needing change include: equalizing pre-existing conditions between self-insured and fully insured policies, expanding coverage to tax dependent children until age 26, allowing policy rescissions only for fraud and material misrepresentation, providing lower cost options for those selecting COBRA and Continuation of coverage. In addition, the state can provide planning, expansion grants, and HIT support for Georgia’s Charity Care Network.
Third, in addition to the above, the Comprehensive Health Insurance Reform for Georgia includes more than 30 specific recommendations to lower the cost of insurance for individuals and small businesses. Existing laws add unnecessary costs, limit incentives, and unfairly tax individual policies at higher levels than group plans.
In summary, the GPPF has produced a broadly accepted Georgia-centric health insurance reform roadmap for the 2012 Georgia General Assembly. This is a chance for states to say “Yes” to a positive agenda while awaiting the Supreme Court to say “No” to unnecessary federal intrusions on states.
Passing state reforms now will prevent the chaos that will come from a court decision that Georgia is advocating and hopes to win. These are real solutions that will show that states are prepared and positioned to help their own citizens. The Georgia solutions include ideas that could be useful to other states. Other states will have their own ideas and may need different reforms for their own situations. That is how it should work if the Constitutional challenge is upheld and states truly believe in the Tenth Amendment.
