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

Three images of people advocating for health care at the Capitol

During the run-off election period (Dec. 14, 2020 to Jan. 5, 2021) for Georgia’s two U.S. Senate seats, Georgians have the opportunity to learn more about these elected positions, their decision-making power, and how Georgia’s U.S. Senators impact our health and well-being . Voters’ decisions about our Senate candidates will have a tangible and long-running impact on our state’s recovery from COVID-19, health costs and insurance, and other important consumer health issues in Georgia.


The U.S. Senate

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. 


The Senate partners with the U.S. House to decide the country’s budget (including funding that comes to Georgia)

The U.S. Constitution puts the U.S. Senate & House in charge of raising revenue (mostly 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 decide the details of the country’s spending for that budget year. As these subcommittees figure out 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 money 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 both chambers pass their budget versions, 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 (or required) 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 (give) dollars to states like Georgia for specific projects (ex: substance use prevention) or for on-going operations of public agencies like public health departments.

The Senate & House pass laws together 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 Senators receive ideas for legislation from concerns and complaints brought to them by their constituents (an important reason to get to know your Senators & Representatives).

Each year, hundreds of bills are proposed and only a fraction successfully pass both chambers. Health-related bills typically pass through the Senate’s Health, Education, Labor & Pensions Committee. Senators can consider bills for the two-year term of a Congress (ex: 2021-2022). When approved by both the Senate and House, a bill 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 few 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 stop on housing evictions for some Americans.

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

Federal agencies are run by the Secretaries and other officials approved by the Senate. These agencies implement and enforce federal laws that directly impact Georgians. For example, HHS oversees the ACA and directs the Medicaid & Medicare programs. The agency makes 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 allows doctors and other health providers to discriminate against LGBT Georgians and other diverse Georgians. The agency also approved 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 heard arguments on the Health Care Repeal lawsuit in November 2020, 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 two highly competitive U.S. Senate races on the ballot right now. 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 who voters choose at the ballot box. Check your ballot to see who is running 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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