Health Care Takes Center Stage in Georgia Politics

Voters head to the polls Tuesday to replace HHS Secretary Tom Price while the state tackles its health care system ahead of 2018.

In this photo taken March 11, 2017, Georgia Democratic congressional candidate Jon Ossoff speaks to volunteers in his Cobb County campaign office. Ossoff is trying for an upset in a Republican-leaning district outside Atlanta. The primary is April 18 with a likely runoff on June 20. Republicans have begun to attack Ossoff, a move the candidates says "shows we can win."
AP Photo/Bill Barrow
Erin Durkin and Zach C. Cohen
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Erin Durkin and Zach C. Cohen
April 17, 2017, 8 p.m.

As voters cast their bal­lots in the At­lanta sub­urbs on Tues­day, they’ll do so against the back­drop of a na­tion­al health care de­bate that has en­er­gized Demo­crats and emerged as a top is­sue for con­stitu­ents.

Geor­gia voters will vote Tues­day in the spe­cial House elec­tion to re­place now-Health and Hu­man Ser­vices Sec­ret­ary Tom Price. A Demo­crat­ic up­set could send a threat­en­ing sig­nal to Re­pub­lic­ans for the 2018 midterms after their plans to de­liv­er on Obama­care re­peal stalled.

Demo­crats also hope next year’s open gov­ernor seat will be ripe for the pick­ing in the Peach State, with Re­pub­lic­an Gov. Nath­an Deal term-lim­ited. Geor­gia is one of a swath of South­ern states where Hil­lary Clin­ton im­proved on Pres­id­ent Obama’s reelec­tion-cam­paign res­ults. And Demo­crats have no­ticed: Geor­gia House Demo­crat­ic Lead­er Sta­cey Ab­rams has already grown her caucus’s sup­port­er list by thou­sands, two years be­fore the next statewide elec­tion, thanks to dis­sat­is­fac­tion with Pres­id­ent Trump.

“Geor­gia Demo­crats have seen a tre­mend­ous in­crease in en­gage­ment around the is­sue of health care,” Ab­rams said through a spokes­per­son Monday, “with the po­ten­tial re­peal of the Af­ford­able Care Act and en­ergy cata­lyzed by op­pos­i­tion to the Trump agenda draw­ing hun­dreds to town halls across the state.”

Price won a sev­enth term hand­ily in 2016, while Trump car­ried the dis­trict by only 1 point. But that was be­fore House Re­pub­lic­ans’ ef­forts to re­peal Obama­care came to a halt.

Robert Blendon, a pro­fess­or of health policy and polit­ic­al ana­lys­is at Har­vard Uni­versity, said this has no doubt en­er­gized Demo­crat­ic voters and a win would be a big warn­ing for Re­pub­lic­ans in 2018 elec­tions.

“Hav­ing is­sues that you said you would fix and not do­ing any­thing about them is not a way to get your own voters ex­cited,” Blendon said.

Demo­crats hope to make the race in part a ref­er­en­dum on Price. The lone ma­jor Demo­crat­ic can­did­ate in the race, Jon Os­soff, prom­ised in one ad to “find com­mon ground to fix Obama­care while keep­ing what works,” say­ing that “re­peal­ing it makes no sense.”

Polling re­cently con­duc­ted by Sur­vey­USA showed voters in the dis­trict agree­ing with that pref­er­ence. Mo­ve­ Polit­ic­al Ac­tion, a pro­gress­ive act­iv­ist group, re­leased its own polling earli­er this month by Lake Re­search Part­ners show­ing health care as “the top is­sue in this dis­trict.”

“As these num­bers show, Re­pub­lic­ans will pay a steep polit­ic­al price in even con­ser­vat­ive dis­tricts like GA-6 for their reck­less health care plans,” Mo­ve­On Polit­ic­al Ac­tion’s ex­ec­ut­ive dir­ect­or, Ilya Shey­man, said in a state­ment.

The policy stakes are high in Geor­gia, which U.S. News and World Re­port ranked as one of the worst states for health care ac­cess. The fate of Obama­care’s in­sur­ance ex­changes, in Geor­gia as well as oth­er states, will be closely watched as in­surers await a de­cision on wheth­er cost-shar­ing re­duc­tion pay­ments will con­tin­ue.

While the mar­ket­places in large metro areas like At­lanta are health­i­er with more com­pet­it­ors, large areas of the state have only one avail­able in­surer, said Wil­li­am Custer, dir­ect­or of the Cen­ter for Health Ser­vices Re­search at Geor­gia State Uni­versity. He ad­ded that, in the rur­al areas, there is ad­verse se­lec­tion and the pop­u­la­tion is not large enough to “spread risk in a real way.”

The counties in Price’s former dis­trict have between two and four in­surers par­ti­cip­at­ing this year, ac­cord­ing to the Kais­er Fam­ily Found­a­tion.

Sen. Dav­id Per­due has re­portedly ex­pressed the need to work with Demo­crats on the health care over­haul, while the ad­min­is­tra­tion has re­cently blas­ted Demo­crats for not con­tact­ing them to help save Obama­care.

Geor­gia Re­pub­lic­ans have shown a de­sire to en­gage on the is­sue. Soon after Re­pub­lic­ans pulled le­gis­la­tion that would have re­pealed sub­stan­tial por­tions of the Af­ford­able Care Act, Deal re­portedly said he is eye­ing changes to the Medi­caid pro­gram, po­ten­tially in­clud­ing changes to “man­dated min­im­um cov­er­age” pro­vi­sions. (Trump, for his part, doesn’t seem to mind. While meet­ing with first re­spon­ders to the I-85 bridge col­lapse on Thursday, he called Deal, a former con­gress­man, “a ter­rif­ic guy” who he knows “very well.”)

“We are ex­plor­ing a vari­ety of solu­tions that bring Geor­gi­ans great­er flex­ib­il­ity and ac­cess to care,” spokes­wo­man Jen Talaber Ry­an said when asked about the gov­ernor’s plans for Medi­caid. “No spe­cif­ic pro­pos­als have been de­cided upon, but he will con­tin­ue work­ing with mem­bers of the Gen­er­al As­sembly to eval­u­ate all op­tions.”

Lt. Gov. Ca­sey Cagle, who last week filed to run to re­place Deal, said earli­er this year that 14 per­cent of Geor­gi­ans don’t have health care, “rank­ing our un­in­sured among the highest levels in the na­tion.” Cagle launched the Health Care Re­form Task Force to part­ner with the new ad­min­is­tra­tion on changes to the health care sys­tem.

“We can po­s­i­tion our state to ex­plore full flex­ib­il­ity with block-grant fund­ing in or­der to give pa­tients bet­ter care at more af­ford­able costs,” he said in a speech in Janu­ary.

Nick Ay­ers, an aide to former Gov. Sonny Per­due and a polit­ic­al ad­viser to a pro-Trump su­per PAC, Amer­ica First Policies, is also re­portedly con­sid­er­ing run­ning for gov­ernor. Ay­ers has been a con­fid­ant to Vice Pres­id­ent Mike Pence, Trump’s ap­par­ent li­ais­on to con­ser­vat­ive Re­pub­lic­ans on the Hill as they seek an Obama­care over­haul. Per­due him­self is ex­pec­ted to enter the Trump ad­min­is­tra­tion, pending his con­firm­a­tion as sec­ret­ary of Ag­ri­cul­ture.

One thing Re­pub­lic­an gubernat­ori­al hope­fuls are not do­ing is pub­licly sign­ing on to any plans to ex­pand Medi­caid. A spokes­man for Sec­ret­ary of State Bri­an Kemp, the oth­er ma­jor Re­pub­lic­an in the race, did not re­spond to a re­quest for com­ment.

“For a Re­pub­lic­an can­did­ate to sur­vive a Geor­gia primary, … to be for Medi­caid ex­pan­sion would prob­ably be a killer,” Re­pub­lic­an polit­ic­al con­sult­ant Seth Weath­ers said. “I can’t ima­gine a can­did­ate sur­viv­ing that.”

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