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A consumer health advocates guide to the 2018 elections: Georgia’s General Assembly

Early voting is underway ahead of the upcoming November 6th Election Day. Georgians across the state are heading to the polls to cast their votes for Governor, Insurance Commissioner, state legislators and other elected positions, and voters’ decisions about the candidates in each race will have a critical impact on consumers health issues in Georgia.

All of Georgia’s state legislative seats are on the ballot this fall and a record number of seats are being competitively contested. The resulting changes in the General Assembly could have a big impact on the future of health and health care for Georgia consumers.

Georgia’s General Assembly is made up of two chambers: the House of Representatives and the Senate. Georgia has one of the largest state legislatures in the nation with a total of 236 members, made up of 56 Senators and 180 Representatives. Every Georgia resident has one Georgia Senator and one Georgia House member, both of whom are up for re-election every two years.

Constitutionally, the General Assembly is only responsible for proposing and passing an annual state budget; however, during the body’s annual 40-day session, legislators also propose, debate, and pass laws for the state of Georgia, including those that regulate health care, health coverage, or that impact health through another sector (like education or transportation).  

All appropriations bills, which designate how state funds are to be spent, must originate in the House. Health care is the state’s second largest expenditure and made up almost 20% of this year’s annual budget. Each year, after the Governor proposes a state budget, the legislative leaders of the House turn the proposed budget into a bill for consideration by the House’s appropriations committee and then by the full chamber. When the House has approved the budget, the budget goes through the same process in the Senate. Once approved by both chambers, any differences are worked out in a conference committee, before sending the budget back to the Governor to be approved or vetoed.

The decisions made during the General Assembly’s budget considerations can have a big impact on health care and coverage for Georgians. For example, the General Assembly has over the last three years approved pay increases for primary care and OB-GYN doctors and dentists treating Medicaid patients, which improves access to care for the almost 2 million Georgians who rely on Medicaid for health coverage.

Members of the General Assembly may also propose laws to address issues of concern for their constituents. These issues can range from surprise out-of-network medical billing to the opioid crisis to Medicaid expansion to Georgia’s health insurance Marketplace. Many legislators receive ideas for legislation from concerns and complaints brought to them by their constituents (an important reason to get to know your legislators!).

Each year, hundreds of bills are proposed and only a fraction successfully pass both chambers. Health-related bills typically pass through the Health & Human Services and Insurance Committees in each chamber. Legislators can consider bills until Sine Die, the 40th and last day of the legislative session. When approved by both chambers, successful legislation goes to the Governor for approval or veto.

One of the most impactful pieces of health-related legislation passed by the state legislature in recent years is HB 990 (2014), which requires the General Assembly to approve any expansion of Medicaid. This bill effectively revoked the Governor’s ability to act independently to close Georgia’s coverage gap, making it more difficult to expand health coverage to low-income adults in Georgia. 

Georgia’s General Assembly will have many new faces after the upcoming election, each of whom will play a role in shaping the state’s health care landscape over the next two years or more. Whether and how the state addresses issues like access to care, health care affordability, the opioid crisis, and the sustainability of the rural health care system may be decided by voters at the ballot box this November.


This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2018 election on timely consumer health issues. Please check out our previous blogs in the series:

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.


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