The doctor is in

Georgia congressman tapped for Trump job could shake up Obamacare, Gold Dome politics

Tuesday December 6, 2016 06:20 pm EST

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With the nomination of Georgia Congressman Tom Price for the top job at the federal Department of Health and Human Services, two things are clear: A noted opponent of the Affordable Care Act is in line for the country’s top health administration post. And the race to take over Price’s north suburban Atlanta seat in Congress is already on.First, what’s coming up for the ACA, also known as Obamacare, and the Georgians who use it or love it or hate it? The short answer: We don’t exactly know yet. The ACA is, well, pretty unpopular among Republicans in Congress. The U.S. House Speaker has said he wants to go ahead and start repeal, like, ASAP.Price, who was a surgeon before heading to Washington, D.C., has prescribed a pretty thorough operation on the U.S. health system, starting with the removal of Obamacare. He argues it’s driving up the cost of health care while driving down choice.Price wrote a repeal-and-replace plan that includes a tax credit to offset the cost of buying insurance — the tax credit would rise based on age, not income. By leaving Congress and moving to HHS, he would be in a position to help craft whatever replaces ACA. “My sense is that there’s a lot of political pressure for the Republicans, now that they control both houses of Congress, to make good on the promise to repeal,” says Assistant Professor Erin C. Fuse Brown, who studies law and health care policy at Georgia State University. “The big question is … how they’re going to repeal it,” she says.They could go deliberately, pairing repeal with replacements or reforms. The changes might, or might not, look like Price’s proposal. But a slow-go repeal and replace would bring some comfort to insurers, hospitals, and others because they could see what’s coming.Or Republicans could do a repeal-delay-replace tactic: repeal the parts they can quickly with their simple majority, delay the effect until a certain deadline, and work on a replacement until that time. Indeed, repealing some parts would take more votes than the GOP’s bare majority.A quick repeal might bring joy, but it would also come with the anxiety of a deadline. As the clock ticks, politicians could expect headlines about desperate patients fearing that they’ll lose their chemotherapy. And it’s yet more complex! Some of Obama’s changes are broadly popular, like letting people in their early 20s stay on their parents’ health insurance. Laura Harker is a policy analyst at the Georgia Budget and Policy Institute, a think-tank that says ACA is beneficial to Georgia. She says GBPI would want to see a plan in place that allows people to maintain their coverage, especially when it comes to coverage for those who have pre-existing conditions and young people staying on their parents’ insurance — “some of those really important provisions that have helped Georgians gain access to health care,” she says. And ideally, the plan would be published ahead of time, giving people time to review what’s going on.Another unknown is when Price would resign his seat, assuming he’s confirmed, so we don’t know when the state will schedule the race to replace him. But it looks likely that some political veterans, including some from the Gold Dome, will try a move for Congress. There’s a bit of chatter that the long-red district could turn blue. The New York TimesNate Cohn tweeted that it’s a possible Democrat pick-up, citing Hillary Clinton’s win in Cobb County. Clinton also won Gwinnett, an election-night surprise. The Daily Kos says the Dems should try to compete, but they also note that Price is more popular than Trump in the district. It might simply be that Trump is the kind of Republican who’s not a good fit with Atlanta’s affluent northern suburbs.“There’s still a question right now of what a Republican is,” says Charlie Harper, executive director of the center-right PolicyBEST think-tank and publisher of GeorgiaPol.com. He thinks the big issues in the district election could almost be philosophical, giving one example: “Are you gong to run on fiscal responsibility? So what is that?”The race could look something like the early Republican presidential debates: a lot of people and more than one vision of what a “Republican” is. The first confirmed major-party candidate is Republican Judson Hill, a Marietta state Senator. Possible candidates include: Alpharetta state Sen. Brandon Beach, former Secretary of State and gubernatorial candidate Karen Handel, former Dunwoody state Sen. Dan Moody, and Roswell state Rep. Betty Price.   

And those are just the Republicans listed in an early poll, not all the names on various lists of rumored candidates. Among those in the poll, Handel came out tops, though all were beat by “undecided.”

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