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Healthcare a potential crisis
The Georgia Report
Tom Crawford

To get an understanding of the major problem facing state legislators this year, you have to have been watching a town hall meeting televised on CNN last week.

U.S. House Speaker Paul Ryan of Wisconsin was fielding questions from the audience when an Arizona businessman named Jeff Jeans challenged him about the move by congressional Republicans to repeal the Affordable Care Act,  also known as Obamacare.

Jeans described himself as a lifelong Republican who did not like the ACA when it was passed in 2010. “I told my wife we would close our business before I complied with this law,” he said.

But then, reality intervened.

Jeans lost his health insurance when his company filed for bankruptcy. He was subsequently diagnosed with throat cancer and was unable to get cancer treatments because he didn’t have health coverage.

His situation took a turn for the better when his wife was able to purchase an insurance policy for both of them through the ACA. That enabled him to get badly needed cancer treatments.

“Thanks to the Affordable Care Act, I’m standing here today alive,” Jeans told Ryan. “Being both a small-business person and someone with pre-existing conditions, I rely on the Affordable Care Act to be able to purchase my own insurance. Why would you repeal the Affordable Care Act without a replacement?”

Despite the objections of Jeans and many others, the Republicans who control the House and Senate are already holding votes to kill Obamacare, which has provided health insurance coverage for more than 20 million Americans.

Initial votes were taken last week in both chambers to start the process of repealing the ACA. Georgia senators Johnny Isakson and David Perdue, as well as all of the state’s Republican House members, voted with their colleagues to get the ball rolling.

Ryan and the GOP leadership claim they will pass a replacement for Obamacare that won’t cost anybody their coverage, but they aren’t being truthful. Congressional Republicans have been unable to come up with an Obamacare replacement for seven years now, and even with a new president who won’t veto their bill, they aren’t any closer to having a viable replacement.

Whatever slapdash legislation they pass after the repeal of Obamacare is going to result in many millions of Americans losing their health insurance coverage. You can count on that.

Quite a few of those who will be stripped of their health insurance are people who voted for Donald Trump. It’s possible they won’t mind that. They may even think that losing their coverage and dying from some dread disease as a result will be the greatest thing since sliced bread because Trump supported it.

But even so, there will be large numbers of people who aren’t quite so enthused about the fact that they no longer have access to healthcare.  Many of them will be right here in Georgia.

Nearly half a million Georgians have enrolled for health coverage through the insurance exchange provided by the ACA.  That number was 482,445 at the end of December, to be precise.

When Obamacare is repealed, those enrollees lose their coverage.

The total number of Georgians who are uninsured could increase by more than one million, according to estimates by the Urban Institute. That number includes those who are pushed off Medicaid as a result of expected cutbacks in that program.

All of this becomes a problem for Georgia legislators because their constituents who no longer have health insurance are going to demand that the state do something about it. Hospital emergency rooms will also be flooded by uninsured patients seeking medical treatment.

The legislative leadership is well aware of this problem. Lt. Gov. Casey Cagle has already appointed a special committee in the state Senate to recommend ways of dealing with the fallout from Obamacare repeal.

I’m not sure how much good that will do. If Georgia is suddenly forced to take care of 500,000 or one million people who are stripped of their health coverage, it could bust the state’s budget.

For now, all we can do is wait and see what happens in Washington.  If you are a legislator and you’re not nervous about what lies ahead, you haven’t been paying attention.

Crawford is editor of The Georgia Report, an internet news service at that reports on state government and politics. He can be reached at

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