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GHF legislative update: January 22


The 2024 legislative session has begun

The Georgia General Assembly convened Monday, Jan. 8th to officially kick off this year’s 40-day legislative session. 

Just two days later, Speaker Burns shared his optimism for closing Georgia’s coverage gap, and Democrats held a hearing about the very same issue. You’ll find details about both below. 

On Thursday, Jan. 11th, GHF hosted Health Care Unscrambled 2024 and discussed our 2023-2024 policy priorities. Thank you to those who attended HCU! To revisit HCU 2024 or see what you missed, check out our recap, a full recording of the event, and materials here.

On the same day, Governor Kemp delivered his State of the State address and released his budget proposals for the current state budget and next year’s budget. We detailed some health-related highlights for you below. 

Last week began with Martin Luther King Jr. Day and continued as “budget week”. House and Senate Appropriations Committee members held joint hearings during which state agency leaders presented their budget requests and reviewed agency spending. 

Lawmakers are set to reconvene today for Legislative Day 6. The full legislative session calendar is available here.

Health Highlights in Governor’s State of the State Address and Announced Budgets

Governor proposes increased mental health spending in the coming year

When Governor Kemp delivered his State of the State address, he used the opportunity to lay out his legislative and budgetary priorities for 2024.

Health care was a smaller topic in the Governor’s address than it has been in recent years. While he did not mention his slow-to-start Pathways to Coverage program (aka “Pathways”), he did tout the large increase in health insurance enrollment through the ACA Marketplace this year (which will transition fully to Georgia Access this fall). The Governor also focused time on new proposals to increase access to mental health services and supports throughout the state. If his proposed spending is maintained by House and Senate budget leaders, Georgia will spend more on mental health in the coming year than it ever has before. 

Gov. Kemp’s budget report details his recommended changes to the current budget (known as AFY24 or the amended budget) and proposals for the FY25 budget (known as the “big budget”, which begins July 1, 2024). The specifics of the Governor’s budget proposals were presented by state agency leaders last week and are detailed in the next section.  

State agencies present budget requests 

State agency leaders presented the Governor’s budget requests for their respective agencies to House and Senate Appropriations committees during last week’s “budget week”. This week, the House Appropriations Committee will begin its work by first reviewing the amended FY24 budget before making changes. When House budget leaders have moved the AFY24 budget to the Senate, they will then turn to the FY25 budget.

Two important items in the budgets include: 1) $315 million in the AFY24 to provide $1,000 bonuses to state employees, including those who carry out important public health, health coverage, and health care; and 2) and $283 million in the FY2025 to provide a 4% cost-of-living adjustment for state employees.

The state agencies budget recommendations include:

Department of Behavioral Health and Developmental Disabilities 

  • AFY24:
    • No major changes other than $1000 employee bonuses.
  • FY25:
    • $9.3M to make permanent 500 NOW and COMP waivers, plus $2.3M for 100 new waiver slots.
      • NOW & COMP waivers allow people with intellectual and developmental disabilities (IDD) to receive support and health services that help them live in their communities rather than hospitals or long-term care facilities. Even with these new slots, 7,300 Georgians with IDD are still on the waiting list for a waiver.
    • $79M to increase pay to the providers and workers who deliver the support and health services to people with IDD.
    • Eagle-eyed advocates will notice that the budget includes a decrease of $11.4M for core adult mental health services. This reduction is because Georgia’s community service boards (CSBs) do not have enough workforce to deliver the mental health and substance use services that Georgians need. As they build up their staff numbers, we expect this budget line item will increase again.
    • $9.4M for a new crisis center in DBHDD Region 1 (in north Georgia).

Department of Community Health  

  • AFY24:
    • Reduction of $152M in Low-Income Medicaid to reflect lower enrollment (and therefore lower use of health services) because Georgians have lost their Medicaid coverage during the “Medicaid unwinding” (also called redeterminations).
  • FY25:
    • The federal government will pay Georgia slightly more for our Medicaid expenses. The Federal Medical Assistance Percentage (FMAP) will increase from 65.89% to 66.04%. These changes are reflected throughout DCH’s budget.
    • Reduction of $104M in Low-Income Medicaid to reflect lower enrollment and use of services because of the Medicaid unwinding. 
    • To better oversee the performance of Georgia’s Medicaid insurers (usually called Care Management Organizations or CMOs), the budget calls for $1.5 million to fund 20 new positions for employees who will monitor, evaluate, and support improvements in their performance. 
    • $1.49M increase to the Georgia Board of Health Care Workforce for 79 new residency slots in primary care medicine. This is an important step for reducing the shortage of doctors in areas that lack primary care. 
    • An enhanced rate for emergency service (ambulance) providers for a program called “treatment without transport.” This helps to provide health care to people with certain urgent health needs who do not need to go to the emergency room (which is one of the most expensive places to receive care).   

Department of Human Services

Beginning April 1, 2023, DHS and DCH began to assess the eligibility of 2.7 million Medicaid members, including PeachCare for Kids. For many members, this is the first time they’ve gone through the “redetermination” process, because it has been paused since the start of the pandemic in March 2020. The state’s 14-month window to complete redeterminations, disenrollment, and appeals will end around May 2024.

  • AFY24:
    • $1.5M for Medicaid redetermination notice mailings to Medicaid members.
    • $1.7M to integrate Pathways into the Georgia Gateway public benefits system and connect Georgia Gateway to the new Georgia Access health insurance marketplace.
  • FY25:
    • $3.24 M for 300 additional Medicaid eligibility caseworkers for redeterminations.

Department of Insurance 

  • AFY24:
    • $​​​​134M for the state reinsurance program to lower insurance premiums on the health insurance exchange.
    • $16.4M to implement the new Georgia Access health insurance marketplace.
  • FY25:
    • Add another $20M added to the reinsurance program to lower health insurance premiums.

Department of Public Health 

  • AFY24:
    • Addition of one epidemiologist position for surveillance and data analysis for the Low THC Oil Registry program.
  • FY25: 
    • Because of the way Georgia structures its public health system, 4300 county public health employees will receive the 4% pay increase slated for all state employees. This is incredibly important for employee retention in county PH departments that are often thinly staffed. 
    • $1M to expand the maternal health pilot program in rural communities.
    • $150,000 to add one case manager position to help pregnant women (and those who have recently delivered) who have tested positive for congenital syphilis and/or HIV connect to testing and treatment resources.


Hearing brings together business, health, & community leaders to call for Medicaid expansion

On January 10th, Medicaid expansion was in the air around the Georgia Capitol! At the Georgia Chamber of Commerce’s Eggs & Issues breakfast, House Speaker Jon Burns confirmed that his chamber is gathering facts and information about Medicaid expansion, including a “private option” like Arkansas has done. 

Several hours later, Rep. Michelle Au led a hearing about the same issue. The hearing attracted so much interest that there was standing room only in the hearing room. Among those who spoke were health care experts, hospital representatives. and many others. Thank you to those who came and supported with your comments and those who filled the hallways showing that Medicaid expansion is the best choice for Georgia. 

“Through taking my father to his appointments, I am able to see the Medicaid system, but I am unable to access it (because) my employment title as my father’s caretaker doesn’t qualify me for Medicaid,” saida woman who moved to Warner Robins to be a caretaker for her aging father. Because of the time required to take him to different health appointments and to carry out other caregiver duties, taking care of her father is her full time role. However, she is unable to enroll in Medicaid (or any insurance) in Georgia because of the stringent work requirements imposed by the Pathways program and because our state leaders have not yet fully expanded Medicaid.

Among those present, many reported that the Pathways program isn’t inclusive enough and doesn’t take into account the current conditions or work situations of many Georgians. GHF stands with those that expressed that full Medicaid expansion is the best avenue for Georgia. 

Advocate with us at the Capitol!

Check out these advocacy events: 

Each week during the legislative session, we’ll highlight legislative advocacy days hosted by partner groups. These are great opportunities for you to participate in the lawmaking process by meeting your legislators and speaking up about important health issues. Upcoming:

If you have an upcoming advocacy event that you’d like included, please contact Alex McDoniel at amcdoniel@healthyfuturega.org

GHF has you covered!

Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, here are tools to help you stay in touch with health policy under the Gold Dome.

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