Posted: 6:00 am Wednesday, March 19th, 2014

Hints that Nathan Deal will back down-sizing of rural hospitals 

By Jim Galloway, Greg Bluestein and Daniel Malloy

State Rep. Sharon Cooper provoked backlash - and revived debate - when she mused about closing rural hospitals.

State Rep. Sharon Cooper provoked backlash – and revived debate – when she mused about closing rural hospitals.

When state Rep. Sharon Cooper publicly mused in January about closing some rural hospitals because their communities are too small to support them, she may have unwittingly revived a discussion among state leaders about what to do with the facilities.

Gov. Nathan Deal is set to speak at a rural caucus meeting at 12:30 p.m. today on the topic of healthcare. His office won’t comment on what he’ll say, but a Department of Community Health meeting last week offers a hint.

Your daily jolt on politics from the AJC's Political insider blogAt the meeting, commissioner Clyde Reese said board members would soon be asked to approve a plan for a “step-down rural access for communities that have lost their hospitals.” That could clear the way for struggling hospitals, or even those that were recently shuttered, to more easily drop expensive offerings and scale back to limited services such as emergency care.

The fate of rural hospitals has been a recurring theme of the session, which lurches to a merciful ending on Thursday. Andy Miller of Georgia Health News reports that four rural hospitals were shut down over the last two years, and six others have been shuttered since 2000. Healthcare activists worry more could be shuttered because of Gov. Nathan Deal’s rejection of the Medicaid expansion under Obamacare, which he views as far too costly in the long run.

Cooper sparked debate in January when she said that some faltering rural hospitals with few patients need to close and rely on regional hubs for healthcare. She quickly walked back those comments after a backlash from rural lawmakers and healthcare advocates, but her comments underscored the ongoing struggle over rural healthcare.

Deal, who has offered a separate bailout of safety-net hospitals, is said to have been developing this down-sizing plan over the past year with Rep. Terry England, a rural Republican who chairs the House Appropriations Committee. It will likely only involve administrative changes – no legislation this late in the session – with the possibility of more legislative proposals in 2015.

***

Clearly, at least in election years, angry tea partyers count more than angry parents of kids with autism.

Late Tuesday, House members stripped language mandating insurance coverage for autism treatment out of HB 943 – a bill originally had to do with the regulation of chemotherapy drugs.

In its place went most of HB 707, the anti-Obamacare bill that prohibits local and state governments from using their resources to direct consumers to health care exchanges under the Affordable Care Act. Erased from the HB 707 language was the portion that prohibited the state insurance commissioner from enforcing ACA mandates – like the ban on using pre-existing conditions to deny claims.

State Rep. Ed Lindsey, R-Atlanta, a candidate in the race to replace U.S. Rep. Phil Gingrey, took the credit. From an email to supporters:

After the original HB 707 stalled in the Senate Rules Committee on Monday, I worked with fellow bill co-sponsors and other parties to salvage as much as possible of the bill. “

Supporters of the autism insurance bill point out that they still have hope. Another version of the bill is attached to HB 885, which would legalize medicinal marijuana.

***

The GOP-backed proposed constitutional amendment that would cap the state’s income tax at 6 percent only mustered the two-thirds majority it needed with the help of two unlikely allies: Democratic Reps. Tyrone Brooks and Hugh Floyd.

Needless to say, Democratic leaders were not happy.

062913 brooks HS11

State Rep. Tyrone Brooks, D-Atlanta

“I can’t believe Rep. Tyrone Brooks and Rep. Hugh Floyd voted for SR 415. They have voted with Republicans, who have spent this entire session dismantling the very programs that we stand for,” said Democratic chair DuBose Porter. “Both have been there long enough to know what they were voting on. It appears that they have lost their dadgum minds.”

We don’t know what might have motivated Floyd, who is from Norcross. He’s running opposed this year, as is Brooks of Atlanta. But note that Brooks is a co-sponsor of HB 1080, the bill to permit a statue of Martin Luther King Jr. on the state Capitol grounds.

The vote on SR 415 was No. 811 of the session. Three votes later, HB 1080 came up for final passage. No public funds are to be used in raising the MLK statue. But the price may have been a ballot issue to drive Republican voters to the poll in November.

***

The most telling hint of the state’s plans for the soon-to-be-demolished Georgia Dome came in the letter from Frank Poe, the head of the Georgia World Congress Center, advocating for state funds to expand a parking deck near the new Falcons stadium.

Poe said the parking deck would “provide parking for potential future development of a convention center hotel on our campus.” We’re told that such a hotel is envisioned for the state-owned site of the Dome. How it will be financed is another story.

State authorities could consider public-private partnerships to get it built. Or they could go it alone and build it with public funds. And that would likely lead to another round of controversial legislation on using public-backed bonds to build a new facility on the campus grounds.

***

Now, about that $17 million for a Falcons parking deck – which popped up on Tuesday as the House and Senate gave final passage to the state budget. Opponents of the Falcons stadium are suggesting that Gov. Nathan Deal erase the parking deck with a line item veto. From Debbie Dooley of Atlanta Tea Party Patriots:

“Surely during an election year, he knows better than to allow such a huge boost to a private interest with state dollars when 75% of Georgians oppose public financing of the Falcons new stadium. Will he really give his opponents that much firepower?”

A likely answer: Not a problem, if his two GOP opponents are still polling under 10 percent.

***

How closely are Democrat Jason Carter’s voting patterns being watched as the session winds down? Consider this: Moments after Carter missed a vote on a piece of legislation that would authorize the sale of Board of Regents debt to the private sector, several Republicans sent us word that he had left the chamber.

The measure passed overwhelmingly and Carter’s camp said he had no issue with the legislation and that he was in the hall talking to constituents. They later produced documents from the Senate clerk’s office signifying his “yes” vote, just as they did in February when he later declared a “no” vote on a controversial vote in February to create new DeKalb cities after slipping out of the chamber.

But we have confirmed with David Cook, the secretary of the Senate, that such after-the-fact assertions in no way alter the recorded outcome of votes in that chamber. Or in the House, for that matter.

We’ve run into this issue before. Click here to refresh your memory.

***

The Moral Monday, er, Tuesday protest in the Gold Dome caught the attention of the New York Times. Here’s the Gray Lady’s assessment of the movement in Georgia, North Carolina and South Carolina:

“The movements are rare stirrings of impassioned, liberal political action in a region where conservative control of government is as solid as cold grits and Democrats are struggling for survival more than influence.

“The question raised by all three groups, which have echoes in at least four other states, is whether they can become more than an outlet for protests by liberal activists who feel shut out of state politics.”

***

National Journal’s Josh Kraushaar writes that national tea party groups are playing it more cautious in this year’s elections, and the lack of outside intervention in Georgia – so far – is evidence of this:

Republicans fear that weak, too-conservative candidates in these races could cost them valuable seats—with control of the Senate at stake. With the exception of FreedomWorks’ backing of physician Greg Brannon in North Carolina, most conservative groups have remained on the sidelines in these crucial contests.

But that could change if the Georgia and North Carolina races head into runoffs, or if the Iowa nominating fight heads to a convention (if no one wins 35 percent or more of the vote in a primary). For now there’s an uncomfortable GOP détente—with neither side tipping the scales yet.

If outside conservative groups endorse like-minded candidates like Rep. Paul Broun of Georgia, Iowa talk-show host Sam Clovis, and Brannon in these primaries, expect a heated ideological battle to break out over the future of the party. But if they pull their punches, it’s a sign that even tea-party sympathizers recognize their influence has peaked.

***
The Federal Election Commission has dismissed a two-year-old ethics complaint against Rep. Paul Broun for not properly disclosing the source of loans to his campaign.

The watchdog group Citizens for Responsibility and Ethics in Washington, which was started by Democrats but has gone after members from both parties, filed a complaint against the Broun campaign in 2012 for paying Broun interest on self-loans to his campaign from 2007. The Broun campaign later disclosed that the money actually came from a home equity loan, and the interest reimbursements went to the bank — not to enrich Broun himself.

The Broun campaign corrected its old, erroneous campaign finance reports in 2012, and the violations happened outside the FEC’s five-year statute of limitations, the FEC wrote in a decision this month. It also found that “Paul Broun has no personal liability for the reporting violations.”

CREW remained indignant about the matter in a press release this morning from executive director Melanie Sloan:

“A real enforcement agency would take its duties seriously, meting out severe penalties for the Broun campaign’s deliberate violations of campaign finance law. Rep. Broun deliberately concealed the source of the loans and the FEC let him off scot-free. Given Rep. Broun’s track record, the FEC should be reviewing his Senate campaign reports with a fine-tooth comb.”

116 comments
td1234
td1234

Kyle Wingfield is reporting that the Democratic savior of Georgia (Jason Carter) voted on a state Constitutional Amendment that will freeze income taxes in the state at their present level. 


I guess that means he just ruined all the hopes and aspirations of the far left of this blog that was hoping he would get in office and raise taxes on those evil rich to pay for more government spending on the poor. Hahahahaha


Like I have said before if you Dems want to see real change in the state then you have to vote in the Republican primary on May 20th for John Barge to replace Deal. 

honested
honested

Considering the degree to which much of 'rural Georgia' is dependent on tourist largesse, has it dawned on anyone that those areas deemed to be grossly underserved by adequate hospital availability will soon be devoid of any tourists or their money?


Who wants to have an auto accident, be bitten by a snake while hiking, have a water related accident or accidentally be shot in church in an area without a hospital?


I don't know what is more offensive, a Government that enforces such nonsense upon it's Citizens in the name of cheapness, or a group of blind sheep voters that would accept it!

hamiltonAZ
hamiltonAZ

Closing hospitals. Leaving hundreds of thousands without access to medicaid. Improving the likelihood of gun encounters. Ensuring that funds will be unavailable in the future for essential health and safety functions. Ignoring transportation and infrastructure.


But very pro-life.

DS
DS

...Gov. Nathan Deal’s rejection of the Medicaid expansion under Obamacare, which he views as far too costly in the long run.

That's his excuse, but everyone knows the truth: Deal has rejected Medicaid expansion because of political ideology, not a pragmatic review of the numbers. 

Because if you look at the numbers, Medicaid expansion is a great deal for states. That's why Jan Brewer, conservative Republican governor of Arizona, opted for Medicaid expansion in her state. She knows a good deal when she sees one.

Medicaid was originally launched in 1965. State participation was optional then, too. Oddly enough, Arizona was the last state to sign up for that round, when they joined the Medicaid program in 1982, seventeen years after it started.

States will eventually expand Medicaid under the auspices of ACA. It's too good of a deal to pass up. Voters will just have to push aside cranky ideologues like Deal and get some pragmatic leadership to make it happen.

Veritasthorn
Veritasthorn

GA already has an Autism Mandate. See 33-24-59.10

Autism Speaks - an Autism "advocacy" organization that many Adult Autistics DESPISE and which seeks to promote hopelessness, despair, and the eradication of Autistics - wants to REDUCE insurance coverage for Autism in the State of GA while giving a $35K per patient per year handout to docs.

MaryElizabethSings
MaryElizabethSings

"Healthcare activists worry more could be shuttered because of Gov. Nathan Deal’s rejection of the Medicaid expansion under Obamacare, which he views as far too costly in the long run."

++++++++++++++++++++++++++++++++++++++++++++++++++


Truly heartless, imho.  The link provided in the last paragraph, above, states that Gov. Deal might bail-out safety-net hospitals to some degree.  Of course, the money for that bail-out would come from the taxes placed on Georgians, and not from federal funds.


In rejecting the ACA, or Obamacare, in Georgia, most Republican politicians will cost Georgians more money than I believe most Georgians can yet conceive. More importantly, these Republican politicians - by being in lock step agreement with one another to stop the advancement of the ACA in Georgia - will, more than likely, cause lives to be lost in Georgia.


Yes, truly heartless.


Vote Democratic, Georgians, and take control of your lives in this state.

The_Centrist
The_Centrist

From above referencing Governor Deal:  "Not a problem, if his two GOP opponents are still polling under 10 percent."  This is the first I have heard of any polling, but seems about right.  "Downton Abbey Democrats" whose children are seeking their ancestors' titles is not likely going to work.


Mentioning the Citizens for Responsibility and Ethics as if it were a legitimate organization is a liberal trick.  In 2010 Politico's Ben Smith described CREW's founding in 2003 as "one of a wave of new groups backed by liberal donors" and called CREW "a vehicle for assaults on largely – but not entirely – Republican targets". In 2006 Congressional Quarterly reported, "Citizens for Responsibility and Ethics in Washington has taken aim almost exclusively at GOP members of Congress. A report by McClatchy News Service described CREW as "a Democratic-leaning watchdog group". In 2006, Time magazine referred to the group as "the liberal watchdog group" and reported, "Since its founding in 2003, CREW has worked through legal and regulatory channels to press allegations of impropriety almost exclusively against Republicans." Then-U. S. Senator Hillary Clinton and her associates played a role in the early stages of CREW's history. A key staffer to Clinton, Jodi Sakol, attended brainstorming sessions that established CREW. Sakol made Clinton aware of CREW's need for "Democratic progressive money." Mark Penn, Clinton's pollster and chief strategist, became a director and vice president at CREW. "We are progressive," said Naomi Seligman, the group's deputy director. The Washington Post has described CREW as a "liberal watchdog group". The New York Times, USA TODAY, and Roll Call have also referred to CREW as "liberal," with Roll Call also describing CREW as "controversial." The journal Broadcasting & Cable described CREW's chief legal counsel as "a Democrat-recommended witness and so the closest to an [Obama] administration defender". CREW was described as "left-leaning" by both the Chicago Tribune and Lexington Herald-Leader, and The Daily Caller columnists called CREW "a Democrat-leaning group" without a "contributor base to play watchdog over the Obama administration." Roll Call reported in January 2008 that CREW files most of its complaints against members of Congress, and "all but a handful... have targeted Republicans". Donors to CREW include such liberal groups as George Soros' Open Society Institute, Democracy Alliance, Service Employees International Union, the Arca Foundation, and the Gill Foundation.

The_Centrist
The_Centrist

Healthcare has undergone a radical transition, and it will continue as fallout from the delayed and changing terms of Obamacare continue.  Subsidized and required healthcare insurance has arrived - at the cost of shrunken insurance networks, higher premiums/copays for those who already had it, and Medicare is being shrunk (especially Medicare Advantage).  Expanding Medicaid makes no sense since (subsidized) insurance is now required.  Hospitals that can't financially continue via insurance payments instead of government subsidies are naturally going to go out of business.  The government can only do so much in nudging the law of supply and demand with subsidies.  Our elected legislators are representing the generous and compassionate electorate - but generosity and compassion only goes so far - despite liberals dreams.

DS
DS

Regarding the Falcon stadium parking deck  ("State authorities could consider public-private partnerships to get it built. Or they could go it alone and build it with public funds"), why not a revenue bond, which would be backed by revenue from the stadium, which the state owns, not taxpayers? Or am I missing something?

The_Centrist
The_Centrist

From the New York Times about the liberal fringe "Moral Monday" group which must be going nuts over this:

While some supporters see a movement in its early stages, others, even many who are sympathetic, see an exercise in futility on the wrong side of the state’s political and cultural divide.

[Concerning the arrests in Atlanta] after the political theater ended Tuesday, lawmakers adopted the Medicaid bill the protesters had come to oppose, which reinforces the state’s decision not to expand the program.

Republican officials have been less charitable. The party’s chairman in North Carolina, Claude Pope, dismissed the state’s protest group as having a “fringe liberal agenda,” while State Senator Thom Goolsby called it “Moron Monday.”

Shar1
Shar1

No public funds to educate citizens about how to reduce their healthcare bill or to force insurers to comply with the law but $17 million slipped in without debate or announcement for a billionaire's parking deck.


Gosh these Georgia Republicans are honest upright representatives of the people.  As long as the people are rich.

DontTread
DontTread

“I can’t believe Rep. Tyrone Brooks and Rep. Hugh Floyd voted for SR 415. They have voted with Republicans, who have spent this entire session dismantling the very programs that we stand for,” said Democratic chair DuBose Porter.


How dare they vote to keep the tax rate the same!  It really puts the brakes on the "programs Democrats stand for", like wealth redistribution and confiscation.


If you liberals want more influence in state politics, try moving to a blue state.  Your anti-freedom policies are on glorious display there.

AuntieChrist
AuntieChrist

@td1234" the far left of this blog that was hoping he would get in office and raise taxes on those evil rich..."

I would love to see evidence of what you have asserted as a fact, that the 'far left' is hoping he will raise taxes on the 'evil rich.'  Or is that just another one of your 'facts' that have been asserted by no one except the voices in your head and those voices heard only by the 'far right?' 

You, and the other tp's also like to throw out the term 'savior' here everyday to describe how the left views its candidates, yet no one on the left has ever viewed our candidates thusly. You on the other hand talk of john barge each day as if he were sent by St Peter to save Jawja from the clutches of the evil nathan deal. Sounds like you have a personal savior yourself, and it ain't brother Jesus. Sounds like you have a little shrine to john barge tucked away in your basement, and like St Paul you must go forth and spread the gospel of St barge.

Lastly, a tax rate cap does not preclude more taxes. More taxes can be collected by eliminating sweetheart deals to corporations like Gulfstream Aeronautics' exemption from a sales taxes on their products,eliminating deductions that benefit only the rich, and making arthur blank pay his own way

honested
honested

@td1234  

Also, an Amendment will require a vote.

Do the majority of Georgians think the pittance we pay in income tax is such a crushing blow?

honested
honested

@td1234  

That's just a stall until next session when those who think 6% is too much try to shift the burden of things like port funding and a new Crackers stadium to a sales tax.

Why do those who benefit the most from Civilization work the hardest to avoid paying for that benefit?

The_Centrist
The_Centrist

@DSSubsidized healthcare premiums, subsidized heat, free cell phones, Medicaid, food stamps, Supplemental Security Income (SSI), welfare -Temporary Assistance to Needy Families (TANF), (WIC), food stamps, free/reduced school lunch, public housing, and never ending unemployment benefits will never be enough for the sponges and liberals who want their votes.  Ignoring the tremendous deficits and debt on top of the high level of taxation compared to GDP is what liberals like you call pragmatism.

MaryElizabethSings
MaryElizabethSings

@DS


You nailed the truth.


Now, however, Georgians are going to have to make Georgia Legislature Democratic-controlled instead of Republican-controlled, if they want the ACA to be fully implemented in Georgia.  HB 990, sponsored by Republican Rep. and Speaker pro tem of the House, Jan Jones, as well as Speaker David Ralston, (and just passed in the Senate as well as the House) gives Georgia's Legislature as much control, as the Governor, to stop Medicaid's expansion in Georgia as a part of the ACA.


Vote Democratic.

Parent12
Parent12

It wasn't an Autism bill. It was a blank check for $35K to ABA providers handed out yearly. So glad it was taken out of the bill. Now it needs to go away for good.

DontTread
DontTread

@MaryElizabethSings  I don't vote Democrat because I would like to retain control of my life instead if ceding it to the state.

honested
honested

@The_Centrist  

Railing against CREW again.

What is it you find so offensive about ETHICS?

Ralph-43
Ralph-43

@The_Centrist Me thinks he protests too much.  We all know Deal and Broun are unethical and corrupt.  The facts speak for themselves regardless of your diatribe.

The_Centrist
The_Centrist

@PeterHoover - It is not entirely socialized yet, and the push-back is strong.  The liberal dream of full single payer socialization is taking a huge hit.  The pendulum is swinging back from the left.

DontTread
DontTread

@The_Centrist  There's nothing "moral" about a group that wants to erode the Constitutional rights of the law-abiding and reduce punishment for criminals.

CherokeeCounty
CherokeeCounty

Sorry 'centrist', but it is a moral issue.  People's lives are at stake.

And you - along with the Republican leadership of this state - have chosen the wrong side.

honested
honested

@DontTread  

At least with your mindset, the insane destruction of the Savannah River won't happen!

DontTread
DontTread

@honested @td1234  Do the liberals who think taxes should be raised voluntarily pay more than currently required to match what they think others should be forced to pay?  (After all, paying taxes is patriotic and all that.)


Didn't think so.

AuntieChrist
AuntieChrist

@The_Centrist @DS Subsidies built the railroads, built hospitals, wiped out diseases that you and your family no longer have to worry about, subsidies built hospitals, schools, municipal water and sewage systems, the power grid that gives you your affluent life style, the freeways that facilitate commerce, the internet that allows you to make your ignorant a$$ comments, subsidies to timber and oil companies allow them to tap resources from land that belongs to the people, subsidies to universities allow them to do the research that keeps us ahead of the curve in science and technology, subsidies to farmers keeps milk below $5 a gallon and meat less than $15 a pound and ensures that they can keep their land when drought and floods devastate their crops, subsidies make people in Oklahoma and Kansas whole when tornadoes wipe out entire towns, or floods in Alabama and Louisiana bring damage in the $Billions, subsidies for flood insurance for jack kingston's constituents living on Tybee Island allows them to keep living there, subsidies to municipalities keep more cops and firefighters on the job, subsidies to Toyota, Nissan and every other company that has a new plant to build allow them to build their new plant.


Thank goodness our forebears had the vision to allow these subsidies, and had the vision to see how government can partner with it's citizens to make this country what it is.  You and the other teatards are as blind as the three mice of Mother Goose, and just as irrelevant to any debate on governance. So go off and enjoy your nice comfortable middle class existence, that could not be possible without government subsidies, and leave the commenting here to people of intelligence.

honested
honested

@The_Centrist @DS 

Griping about pennies while throwing full support to the most expensive MIC in the universe.

It must be difficult to retain such contradictions within one's head.

MaryElizabethSings
MaryElizabethSings

@DontTread


Imho, you are buying into Republican simplistic propaganda - generalities without detailed meaning, in other words. 

Ralph-43
Ralph-43

@DontTread @The_Centrist Better explain your comment.  You sound a bit off and may not understand the issues.  Medicaid Expansion reduces punishment for criminals?  I think you have the issue reversed.

td1234
td1234

@CherokeeCounty  So when people refuse to take the correct paths in life and mess their life up then it a moral issue for the rest of us to bail them out? 

honested
honested

@DontTread @honested@td1234 

Also, do you use roads, bridges, air traffic control and safety, police services, fire services, coastal conveyance, or do you just hide in the basement and peep out the window through your binoculars?

honested
honested

@DontTread @honested@td1234 

If I didn't have to waste money on supporting the free security the MIC provides to offshore companies, I would be glad to kick in the savings to help forward improvements in onshore Civilization.

Hows about you?

MaryElizabethSings
MaryElizabethSings

@DontTread


I didn't state you were a Republican.  I stated that, imho, you are buying into Republican simplistic propaganda.

DontTread
DontTread

@MaryElizabethSings @DontTread  No, I'm just looking at the Democrat voting record.  Many laws recently overturned by the Supreme Court and the appellate courts as being unconstitutional were originated and supported by Democrats.  FYI - I'm not a Republican.

CherokeeCounty
CherokeeCounty

Sorry nope not what I said.

Try again.

Then, when you're done, please go to the Bible and show me even one verse where the Savior you claim to follow told someone that He wasn't going to help them because they made poor choices in their life.

What an arrogant and vile misreading of Scripture, td.

Andy123
Andy123

@td1234 @Andy123@CherokeeCounty

It's the liberal way.  Next thing you know, people will be demanding those who actually pay income taxes to make their car payments and pay for their vacations.   

td1234
td1234

@Andy123 @CherokeeCounty  Wow, Cherokee believes it is everyone elses responsibility to take care of people that do not want to take responsibility for themselves. 

Andy123
Andy123

@CherokeeCounty

No, once again he/she is asking for personal responsibility.  The overwhelming majority of low income people of working age are poor because they have made stupid decisions in their lives.    As a taxpayer, it's not our problem.  

CherokeeCounty
CherokeeCounty

And once again you prove that your Bible ends at Leviticus....

Trackbacks

  1. […] The Atlanta Journal Constitution: A Down-Sizing Of Rural Hospitals Seen As A Solution For Struggling Health Care Facilities When state Rep. Sharon Cooper publicly mused in January about closing some rural hospitals because their communities are too small to support them, she may have unwittingly revived a discussion among state leaders about what to do with the facilities. Gov. Nathan Deal is set to speak at a rural caucus meeting at 12:30 p.m. today on the topic of healthcare. His office won’t comment on what he’ll say, but a meeting Department of Community Health meeting last week offers a hint. At the meeting, commissioner Clyde Reese said board members would soon be asked to approve a plan for a “step-down rural access for communities that have lost their hospitals.” That could clear the way for struggling hospitals, or even those recently shuttered, to more easily drop expensive offerings and scale back to limited services such as emergency care (Bluestein, 3/19). […]