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A consumer health advocates guide to the 2020 elections: U.S. Congress

Three images of people advocating for health care at the Capitol

This year, no Georgian has been left untouched by the health or economic impacts of COVID-19. America’s singular failure to control the pandemic has spotlighted the importance of public policy decisions that prioritize the health and wellness of populations, the consequences of underfunding essential public infrastructure (like departments of public health), and the disparate impact that public policies have had on Black Americans and other people of color. National, state, and local leaders, many elected by the public, are responsible for the policy decisions made ahead of and in response to COVID-19, its economic fallout, and the movement for racial justice.

Ahead of the 2020 election season (October to November 3, 2020), Georgians have the opportunity to learn more about these elected positions, the decision-making power each has, and how those positions impact their health and the well-being of Georgians. This year, Georgians will cast their votes for the U.S. President, members of U.S. Congress, state legislators, state supreme court judges, and other positions. Voters’ decisions about the candidates in each race will have an unprecedented impact on consumers health issues in Georgia as we continue to battle through the current health crisis.

In this blog, we cover the U.S. Congress’s impact on the health and well-being of Georgians and their families. To jump to a specific section, click these links:

U.S. Congress

The U.S. Congress is made up of 535 members each of whom serve in the Senate or the House of Representatives (“House”). The U.S. Senate is made up of two Senators from each state. Both Senators represent their entire state and serve staggered six-year terms. Each member of the House represents a specific region of their state (called a Congressional District). There are 435 U.S. House members under current law, and 14 of them represent congressional districts in Georgia. U.S. Representatives serve two-year terms. (Remember that U.S. Senators and Representatives are different from Georgia’s state senators and representatives. All of these positions are all on the ballot this November.)

Congress is in charge of the country’s budget—including what gets passed along to states like Georgia

The U.S. Constitution puts Congress in charge of raising revenue (most commonly through taxes), borrowing money, and approving spending.

In January or February of each year, the U.S. President proposes a budget, but it is largely ignored by leaders in Congress. Instead, Congressional leaders in the House and the Senate set overall spending levels in a document called a budget resolution. The House and Senate appropriations committees then divide the broad spending plan between 12 subcommittees who will determine the details of the country’s spending for that budget year. As these subcommittees consider the budget, they hear from leaders of government agencies, lobbyists for various interest groups, advocates like GHF, and from members of the public about how the country should spend its budget for the next year.

When the subcommittees finish their work, all Senators and Representatives vote on their chamber’s respective version of the budget. Once approved by both chambers, the differences are worked out in a conference committee, before sending the budget to the President to be approved or vetoed.

How the U.S. budget impacts Georgia

Congress’s budget contains mandatory funding for social programs like Social Security, Medicare, Medicaid, and food assistance. These social programs keep Georgians insured, fed with healthy foods, and, hopefully, financially stable.

The budget also includes “discretionary” spending which goes to federal agencies like Departments of Health & Human Services or Housing & Urban Development, the Centers for Disease Control & Prevention, and the Occupational Safety and Health Administration. In many cases, these agencies grant dollars to states like Georgia for specific projects (ex: substance use prevention) or for on-going operations of public agencies like public health departments.

Congress passes laws that impact Georgia

Senators and Representatives may 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 maternal mortality to rural broadband access for health care providers. Many members of Congress (MoC) receive ideas for legislation from concerns and complaints brought to them by their constituents (an important reason to get to know your members of Congress).

Each year, hundreds of bills are proposed and only a fraction successfully pass both chambers. Health-related bills typically pass through the House’s Committee on Energy & Commerce, Subcommittee on Health (among others) and the Senate’s Health, Education, Labor & Pensions Committee. Legislators can consider bills for the two-year term of a Congress (ex: 2021-2022). When approved by both the Senate and House, successful legislation goes to the President for approval or veto.

Federal laws impact Georgians

In response to the COVID-19 pandemic, Congress has considered and passed a number of new funding bills and federal laws. Congress passed the CARES Act in March 2020, which provided stimulus checks to many Georgians and their families; extended unemployment benefits to Georgians and other Americans out of work; required that health insurers cover COVID-19 testing and treatment; established programs to open access to testing for uninsured Georgians and other Americans; and placed a temporary moratorium on housing evictions for some Americans.

On other issues, Congress has failed to act on issues of importance to Georgians. While Georgia adopted consumer protections from surprise billing for 2.5 million Georgians, Congress has not been able to agree on legislation to solve the issue for Georgians with job-based health insurance. Among other stalled health issues, Congress has not acted to improve health care costs in a significant way since the passage of the Affordable Care Act in 2010. 

Senators approve important public appointments

Senators have the additional power to approve certain important public appointments such as the Secretary of Health & Human Services (HHS) and justices of the U.S. Supreme Court. Cabinet secretaries and Supreme Court justices regularly make decisions that shape the health and well-being of Georgians.

The federal agencies run by appointed Secretaries and other officials implement or enforce federal laws that directly impact Georgians. For example, HHS oversees the implementation of the Affordable Care Act (ACA) and directs the Medicaid & Medicare programs. The agency has made decisions that have real day-to-day impacts on Georgia consumers, like the decisions to cut funding for unbiased, local health insurance enrollment assistance in Georgia by 85% or to reverse a rule that allows doctors and other health care providers to discriminate against LGBT Georgians and other diverse Georgians. In the coming months, the agency will approve or reject of Georgia’s flawed plans to only partially expand Medicaid and separate from the ACA’s health insurance marketplace.

The justices appointed to the U.S. Supreme Court by the Senate regularly weigh in on federal laws that shape health and health care for Georgians. The Court will hear arguments on the Health Care Repeal lawsuit this fall, and their decision on the case will determine if protections for people with pre-existing conditions under the ACA (and all other parts of the ACA) can continue or are erased.

This year’s election

Georgia has several highly competitive U.S. House and Senate races on the November 2020 ballot. Whether and how Georgia can address issues like COVID-19, health care affordability, the opioid crisis, and the sustainability of the rural health care system will depend on the actions of those elected to these positions by voters this November. Check your ballot to see who is running for these positions and find out how they plan to act on the health issues that are important to you.

This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2020 election on timely consumer health issues. Please be on the lookout for more blogs in this series, including our recent blog on the Georgia General Assembly.

*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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