Georgia’s Tax Breaks to Increase Use of Health Savings Accounts Did Not Expand Health Coverage
Plan Promoted by Gingrich Group Has Failed to Deliver
End Notes
[1] On average, some 319,000 more Georgians were uninsured in 2009 and 2010, the latest years for which these data are available, than in the two-year period preceding the law's enactment (2006-2007).
[2] Georgia’s unemployment rate rose by 5.6 percentage points, compared to 4.9 percentage points in the rest of the South and five percentage points in the United States as a whole. This somewhat greater increase in unemployment appears to be only one contributing factor to the large increase in the number of uninsured Georgians. Even after adjusting for the difference in growth in the unemployment rate, the increase in the uninsurance rate in Georgia appears to be greater on a statistically significant basis than the increase in the rest of the South.
[3] For Newt Gingrich’s health care proposals, which include expanding HSAs, see www.newt.org/solutions/healthcare. For Mitt Romney’s health care proposals, see www.mittromney.com/issues/health-care. For Rick Santorum’s health care proposals, see www.ricksantorum.com/repeal-and-replace-obamacare-patient-centered-healthcare. Also, see John Goodman, “What Would Republican Replacement Look Like?,” National Journal, January 30,2012, available at healthcare.nationaljournal.com/2012/01/what-would-republican-replacem.php.
[4] See, for example, Ronald E. Bachman, "A Guide for State Legislators: Creating an HSA State," Center for Health Transformation, March 2007.
[5] For more information about the specific tax provisions in the Georgia law, see Judith Solomon, "New Georgia and Florida Health Plans Unlikely to Reduce Ranks of Uninsured," Center on Budget and Policy Priorities, July 1, 2008, and Timothy Sweeney, "Analysis of HB 977," Georgia Budget and Policy Institute, March 2008.
[6] For the working group's report to the state Assembly, see Center for Health Transformation, "Recommendations for Free-Market Solutions to Insure All Georgians for Healthcare," 2008.
[7] Paul Gessing, "State should follow Georgia's model on health care," Las Cruces Sun-News, June 3, 2008.
[8] To generate its estimate, CHT used a ten-year-old CBO analysis of mental health parity legislation that included an outdated estimate of the sensitivity of employer-sponsored coverage to premium increases. CHT also assumed, without any basis, that the cost of high-deductible plans would fall by 41 percent as a result of the law. For more information about the deficiencies in the methodology, see Solomon, op.cit.
[9] America's Health Insurance Plans, "January 2011 Census Shows 11.4 Million People Covered by Health Savings Account/ High-Deductible Health Plans (HSA/HDHP)," June 2011.
[10] Georgia Department of Audits and Accounts, Letter to the Honorable Judson Hill, March 25, 2008.
[11] Georgia Department of Audits and Accounts, "Georgia Tax Expenditure Report for FY 2013," December 12, 2011.
[12] In Georgia, the state income tax rate starts at 1 percent for the first $750 of taxable income for individuals and $1,000 for married couple filing jointly, rising to 6 percent for taxable income in excess of $7,000 for individuals and $10,000 for married couples filing jointly. The standard deduction is $2,300 for an individual or head of household and $3,000 for a married couple filing jointly. Additionally, the personal exemption is $2,700 for an individual or head of household and $3,000 for each dependent.
[13] For more background on Health Savings Accounts, see Edwin Park, "Informing the Debate About Health Savings Accounts: As Examination of Some Misunderstood Issues," Center on Budget and Policy Priorities, June 13, 2006.
[14] Alison Galbraith, et al., "Delayed and Foregone Care for Families With Chronic Conditions in High-Deductible Health Plans," Journal of General Internal Medicine, January 2012. Also, see Jeffrey Kullgren, et al., "Health Care Use and Decision Making Among Lower-Income Families in High-Deductible Health Plans," Archives of Internal Medicine, November 22, 2010 and Paul Fronstin and Sara Collins, "Findings from the 2007 EBRI/Commonwealth Fund Consumerism in Health Survey," Commonwealth Fund, March 2008.