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Early voting began last week ahead of the upcoming November 6^th 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.

One of the most visible positions on the ballot and one that plays a meaningful role in health care policy for the state is Georgia’s Governor. The Governor heads the state’s executive branch, which is broadly responsible for implementing, supporting, and enforcing Georgia’s laws.

As head of the executive branch, the Governor has the authority to appoint and provide direction to the leaders of most of Georgia’s executive branch departments, including the Commissioners of the Departments of Community Health (the state’s Medicaid agency), Public Health, Behavioral Health and Developmental Disabilities, and Family and Children Services. Because most health-related programs in the state are run by one of these agencies, the ability to appoint department leadership provides the Governor with outsized influence on the direction, priorities, and initiatives within each.

Ahead of the state legislative session, the Governor has the added responsibility of proposing an annual state budget for the General Assembly’s consideration. Health care is regularly the state’s second largest expenditure, making up almost 20% of the annual budget. Aside from expected items like Medicaid expenditures, the Governor may propose special investments that promote his/her health-related priorities. For example, Georgia’s FY19 budget includes an additional $21.4 million to improve and expand children’s behavioral health services as recommended to Governor Deal by his Commission on Children’s Mental Health. Once the legislature has considered and passed a budget, the Governor has the power to veto or approve the spending plan.

At the end of each year’s legislative session, the Governor has 40 days to approve or veto (“veto” means “to reject”) legislation. Most laws passed by the General Assembly are approved but a few each year are rejected by the Governor because they are ill-informed, controversial, or contrary to the Governor’s priorities. In recent years, Governor Deal has vetoed some health-related laws like SB 357 in 2018, which would have established a Health Care Coordination and Innovation Council.

Once a bill is approved, the Governor may direct the executive branch agencies about how the law should be carried out. For example, if the Georgia General Assembly approves future legislation to expand Medicaid in Georgia, the Governor may provide the Commissioner of Community Health with instructions about how the expansion should be implemented, including program elements that make it easier or harder for people to enroll in or use their new coverage.

Georgia’s next Governor will have a significant role in shaping the state’s health care landscape over the next four 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 blog, Eight questions for health care voters to ask Georgia candidates, where you can find a list of questions to help health care voters get to know the candidates on their ballots.

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