Action Alert: Patients First Act falls short

Last week, state leaders introduced SB 106. Titled the Patients First Act, the legislation permits Georgia’s Governor to pursue two health care waivers that could make significant changes to health coverage for Georgia consumers. The legislation allows for an 1115 waiver to extend Medicaid coverage to some poor adults in Georgia but leaves out thousands who would be covered under a full Medicaid expansion. Additionally, the bill allows the Governor to make potentially seismic changes to private health insurance in Georgia through 1332 waivers with little accountability. While it is heartening that Georgia’s leaders see the need to create a pathway to coverage for more Georgians, this proposed legislation falls short for two reasons, both of which we’re asking you to take action on:

1. The proposed 1115 Medicaid waiver would cover fewer people at a higher cost than Medicaid expansion. It would leave out thousands of Georgians in need of coverage and leave the state accountable for a larger share of the medical costs for those who would be newly covered. Ask Governor Kemp and your state legislators to get the best deal for Georgia by covering all eligible Georgians. (Then plan to join us for Cover Georgia Day at the Capitol on February 28th!)

2. More than 480,000 Georgians rely on Georgia’s health insurance marketplace for health coverage, and many more are eligible. Changes made to private coverage through a 1332 waiver could benefit or harm these consumers, but the legislation, as written is too broad to determine its impact. Ask Governor Kemp and your state leaders to specify in the bill that any waiver will preserve critical consumer protections (like those that protect consumers with pre-existing conditions), maintain comprehensive, quality health coverage, support a stable marketplace through increased enrollment, and will not leave consumers on the hook for higher costs.

House passes step therapy bill

Step therapy legislation moves quickly through House

HB 63, a bill sponsored by Chairman of the House HHS Committee Representative Sharon Cooper, was passed by the House this week. HB 63 addresses step therapy, which is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the higher-cost treatment prescribed by a patient’s physician. This bill would require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. HB 63 will now go to the Senate for consideration.

GHF releases annual consumer health advocate’s guide

A Consumer Health Advocate’s Guide to the 2019 Legislative Session

GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. This annual booklet provides information on the legislative process, legislators, and committees, key agency officials, advocate contacts, and more. Experienced advocates and new volunteers will find their way around Georgia’s Capitol more easily with the information provided in this year’s guide. Download or pick up your copy today.

(Interested in a hard copy? Contact Michelle Conde.)

RSVP for Cover Georgia Day

Join Cover Georgia at the state capitol on February 28th!

Join us on Thursday, February 28th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of all Georgians. For the first time in Georgia, there is wide-spread agreement among Georgia’s legislators that something must be done to extend coverage to low-income Georgians across the state. Take advantage of this opportunity to ask your elected officials to close Georgia’s coverage gap now! RSVP today!

Can’t make it? Call or send an email to your state legislators asking them to put an insurance card in the pockets of all Georgians.

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, we have the tools you need to stay in touch with health policy under the Gold Dome.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide

Momentum builds to close Georgia’s coverage gap

The 2019 legislative session is now in full swing and the past few weeks have brought the introduction of two bills that would close Georgia’s coverage gap by expanding Medicaid.

HB 37: Expand Medicaid Now Act; enact and SB 36 are sponsored by Representative Bob Trammell and Senator Steve Henson respectively. Each bill expands Medicaid in Georgia as envisioned by the Affordable Care Act by increasing Medicaid eligibility for adults up to 138% of the federal poverty guidelines (FPL). This is equivalent to $17,236 annually for an individual and $29,435 for a family of three.

In addition, Governor Kemp has announced that his office will seek an 1115 Medicaid waiver. An 1115 waiver provides states with the ability to experiment with or tailor their Medicaid programs. Governor Kemp has not released details of the waiver, so its impact on consumers is uncertain. The waiver could close Georgia’s coverage gap, among other changes to Medicaid coverage. Legislation to allow Georgia’s Medicaid agency to seek an 1115 waiver is expected to be introduced soon by Senate Republicans.

Tell Governor Kemp and your legislators that you support putting a health insurance cards in the pockets of Georgians regardless of their income.

Consumer protection bills introduced

Surprise medical billing emerges as a prominent issue

Surprise out‑of‑network medical billing is once again emerging as a prominent issue within the Georgia General Assembly. A surprise medical bill can occur when a consumer encounters an out-of-network (OON) provider at an in-network facility or in other circumstances. Two pieces of legislation have been introduced to address surprise billing and each attempts to resolve the issue in its own way.

HB 84: Insurance; provide for consumer protections regarding health insurance
Rep. Richard Smith, Chair of the House Insurance Committee, introduced HB 84 to increase transparency related to possible surprise medical bills. This bill sets disclosure requirements for health care providers, insurers, and hospitals. The legislation requires that information on billing, reimbursement, and arbitration of services must be provided to the consumer at their request. The bill also allows for an arbitration process between the consumer and the health care provider, the specifics of which would be determined by Georgia’s Department of Insurance. This bill currently sits in the House Insurance Committee and is in House second readers.

SB 56: Consumer Coverage and Protection for Out-of-Network Medical Care Act
Senator Chuck Hufstetler, Chair of the Senate Finance Committee, introduced SB 56 to address surprise out-of-network billing. This legislation disallows surprise billing in emergency situations under insurance plans issued after July 1, 2019. The bill contains similar transparency provisions to HB 84. For consumers who receive elective medical care after which they receive a surprise bill greater than $1000, the legislation makes available a mediation process through the Department of Insurance. This bill was referred to the Senate Insurance and Labor Committee.

Legislative calendar set

Legislature plans to finish work by April 2nd

The schedule for the remainder of the legislative session has been set in HR 152. Crossover Day, the day that legislation must move from one chamber to the other in order to be considered in 2019, will fall on March 7th. The remaining sixteen legislative days will be broken up throughout March, culminating on Sine Die, the last day of the session, on April 2nd. The full calendar can be viewed here.

RSVP for Cover Georgia Day

Join us at the state Capitol on February 28th!

Join us on Thursday, February 28th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of low-income Georgians. This is the most important step that our elected officials can take to slow the growing opioid crisis, strengthen our state’s struggling rural health care system, and improve the health & finances of hardworking Georgia families. Take advantage of this opportunity to talk with your elected officials about closing Georgia’s coverage gap! RSVP today!

Can’t make it? Call or send an email to your state legislators asking them to put an insurance card in the pockets of all Georgians.

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, we have the tools you need to stay in touch with health policy under the Gold Dome.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation

Charlie Ellison is 87 years old and a long time resident of Dalton, Georgia. Charlie is one of over half a million seniors and people with disabilities in Georgia who depend on Medicaid and Medicare to live and function in their communities.

After suffering a fall while living alone in 2016, Charlie’s nervous system was damaged and he was no longer able to live independently. He attended physical therapy for ten months and lived at a nursing home in Dalton during this time which he paid for out of pocket.

Now that Charlie has Medicaid coverage, he is able to visit RossWoods Adult Day Services every day and enjoys engaging in activities with others his age. He is also able to live at home with his daughter and son-in-law who help take care of him, rather than in a nursing home where he had less independence and fewer activities to keep him healthy and active.

Before Charlie’s fall, he was already managing diabetes and high blood pressure, and had a pacemaker in his chest. Charlie’s Medicaid coverage picks up the costs of some of his medications that are not covered by Medicare, which ensures Charlie remains as healthy and independent as possible.

For 168,000 seniors like Charlie who typically rely on low, fixed incomes, Medicaid makes the difference and helps to pay the costs of their Medicare coverage, and for some, it provides additional health benefits not covered through Medicare. For others, Medicaid allows them to age with dignity in their communities by covering needed home and living adaptations like chair lifts, wheelchair ramps, or engaging day programs with trained staff.

Your story is powerful! Stories help to put a human face to health care issues in Georgia. When you share your story, you help others understand the issue, its impact on Georgia, and why it’s important.

Your health care story is valuable because the reader may be your neighbor, friend, someone in your congregation, or your legislator. It may inspire others to share their stories or to become advocates. It is an opportunity for individuals who receive Medicaid or fall into the coverage gap, their family members, their physicians and concerned Georgia citizens to show that there are real people with real needs who will be impacted by the health policy decisions made by Congress and Georgia’s state leaders.

Share your story here! Read and share our latest storybook here!

General Assembly meets for joint budget hearings

Last week the Georgia General Assembly met for the joint budget hearings during which Senate and House legislators heard from agency leaders and Governor Brian Kemp about the proposed current and upcoming state budgets. This year’s budgetary considerations consist of requested changes to the current FY 2019 state budget which will run through June 30th and proposals for the FY 2020 general state budget, which will begin on July 1st.

The House will now craft the budget requests into legislation and continue its funding considerations. Both chambers reconvened yesterday, January 28th, for the fifth day of legislative session.

2019 joint session budget hearings

Budget requests presented to the General Assembly

Last week, the General Assembly heard from department commissioners and other leaders regarding their budget requests for the amended FY 2019 budget (sometimes called the “little budget”) and the upcoming FY 2020 budget (called the “big budget”). Here we highlight some of the primary asks made by the state agencies that most impact consumer health. For more detailed budget analysis, please see the Georgia Budget and Policy Institute’s Overview of Georgia’s 2020 Fiscal Year Budget document.

Department of Community Health 

The Department of Community Health (DCH) oversees Medicaid, PeachCare, and other state health care programs. Commissioner Berry requested an increase of $71 million in the amended FY 2019 budget to include $33.7 million for growth in Medicaid expense and $18.7 million for the Indigent Care Trust Fund, which draws down additional federal money for Disproportionate Share Hospital payments.

Commissioner Berry’s most significant request in the FY 2020 budget was an increase of $92 million to offset a reduction in the federal cost-sharing payments for Medicaid and PeachCare for Kids. Georgia’s Federal Medical Assistance Percentage (FMAP) rate will drop from 67.62% to 67.30% for Medicaid and from 100% to 88.61% for PeachCare for Kids, prompting the funding request.

Department of Behavioral Health and Developmental Disabilities 

The Department of Behavioral Health and Developmental Disabilities (DBHDD) provides treatment, support services, and assistance to Georgians with disabilities, behavioral health challenges, and substance use disorders. Commissioner Fitzgerald’s request for the little budget mirrored the Governor’s recommendations to add $8.4 million for the Georgia Apex Program to provide support counselors for mental health services in high schools.

Commissioner Fitzgerald requested that the big budget include an increase of $78.6 million for the Department. The additional funds would be partially compromised of an additional $10.2 million for behavioral health crisis beds, $2.5 million for supported housing, and 125 new slots for NOW and COMP waivers to reduce the current waiting list.

Department of Human Services

The Department of Human Services (DHS) delivers a wide range of human services designed to promote self-sufficiency, safety and well-being for all Georgians. Commissioner Crittenden requested that the big budget include $849,951 to increase funds for 50 additional Medicaid eligibility caseworkers.

The Department of Public Health did not present during the joint budget hearings last week and the Department of Insurance did not have any budgetary requests that were specifically health related. We will include summaries from both departments as we learn more.

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, we have the tools you need to stay in touch with health policy under the Gold Dome.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• Look out for the 2019 Consumer Health Advocates Guide coming soon!

Georgians for a Healthy Future’s ninth annual Health Care Unscrambled breakfast built on previous years’ successes with another standing room-only crowd.

This year’s program began with a personal story from consumer Lori Murdock, who bravely shared her experience struggling to manage a chronic disease without health insurance because she was caught in Georgia’s coverage gap. Lori’s experience illustrates the pressing need to provide health insurance to all Georgians regardless of income.

Following Lori was our bipartisan legislative panel. This year’s legislative panelists were:

• Senator Kay Kirkpatrick
• Representative Debbie Buckner
• Representative Lee Hawkins

Each panelist provided updates on emerging health care trends impacting Georgia and took questions from the audience about what health issues are likely to be taken up in the 2019 legislative session. Topics included Medicaid expansion, surprise out of network medical billing, access to mental health,  network adequacy, Certificate of Need reform, social determinants of health, rural health care access, federal health care reform, and affordability of health care. All three panelists shared an optimistic vision for health care in this years legislative session.

This year’s key note speaker was Dr. David Blumenthal, President of the Commonwealth Fund. Dr. Blumenthal brought a wealth of knowledge and insight to our conversation about how innovations in health care and coverage can help us achieve better health outcomes for all Georgians. He led the discussion by comparing Georgia’s health outcomes to those of our neighboring states, and then provided an agenda for improvement. He emphasized that Georgia is unlikely to overcome poor health outcomes unless state leadership improves insurance coverage, as demonstrated by the Commonwealth Fund’s own research on Medicaid expansion’s impacts on population health. Dr. Blumenthal also shared the importance of investments in the social determinants of health for improving health outcomes and ultimately saving money. Dr. Blumenthal’s presentation can be accessed here and the Georgia scorecard from the Commonwealth Fund can be found here.

To see photos, review materials, and get more information about this year’s Health Care Unscrambled event, please visit the event page.

For more event pictures visit our Facebook photo album. 

Medicaid provides health care coverage to almost two million Georgians, including 1.3 million children across the state and 500,000 seniors and people with disabilities. It’s comprehensive coverage provides needed health care services that would otherwise be unaffordable to low-income Georgia families and individuals in communities across the state. Because Medicaid is so fundamental to Georgians and Georgia’s health care system, GHF is highlighting it in two new resources!

The Medicaid Matters to Georgia storybook shares the real health care stories of Georgia children and families. Georgians from across the state share the important role that Medicaid plays in their lives. Hear directly from Sherry, Travis, Oliver, and others about their experiences. Oppositely, Mary, Susie, and other uninsured Georgians share how Medicaid coverage could improve their lives if state policy makers closed Georgia’s coverage gap.

Our new Medicaid Matters for Georgia fact sheet is updated with what you need know about Medicaid. This one-page fact sheet outlines who is eligible for Medicaid in Georgia, what health services and supports are covered, and why Medicaid is a good investment for Georgia.

GHF’s new resources bring attention to the difference Medicaid makes in the lives of Georgians every day and the potential it has to serve those who are currently uninsured. We hope these new resources help policymakers, advocates, and consumers from across the state better understand the importance of ensuring all Georgians have access to quality, affordable healthcare. We invite you to read and share both with your friends, colleagues, and partners.

Georgians for a Healthy Future is partnering with community groups across the state to host Georgia Voices for Medicaid events. If you are interested in learning more about Georgia’s Medicaid program, who it covers, how it benefits the state, and how you can be a strong health care advocate, you should attend! Check out our events page to see if we have any Georgia Voices for Medicaid events happening near you or contact Alyssa Green at agreen@healthyfuturega.org if you would like to schedule one in your community.

The race to be Georgia’s Insurance Commissioner is one of the most overlooked statewide races on the ballot this November, despite the position’s impact on the health and finances of almost all Georgians.

Georgia’s Office of Insurance and Safety Fire Commissioner (commonly referred to as the Department of Insurance or DOI) is headed by Georgia’s Insurance Commissioner. The Department oversees health, auto, long-term care, and other insurance products that can be regulated by the state. For Georgians who have individual or small-group insurance (about 2.6 million Georgians), the Insurance Commissioner has a direct impact on their insurance rates, their ability to access needed health services, and the extent to which their coverage is transparent and fair.

Georgia’s Insurance Commissioner is a constitutional officer in Georgia and is elected by Georgia voters for a four-year term. The Commissioner and the Department are tasked with regulating insurance companies and licensing insurance agents operating in Georgia and overseeing state fire safety initiatives, in addition to other non-health-related duties.

Because the Insurance Commissioner is primarily responsible for overseeing private health insurance in Georgia, they are key to how the Affordable Care Act and its consumer protections are implemented in the state. For example, the ACA requires that insurance companies justify any premium rate increases of more than 10% through a process called “rate review”. The Commissioner and Department staff determine how strong and transparent to make Georgia’s rate review process, and in doing so, determine how accountable insurers must be as they ask consumers for more dollars out of their household budgets.

The Commissioner and DOI are also responsible for ensuring that health plans do not design their benefits so that they discriminate against certain types of consumers. For example, if a health plan only covers one type of HIV medication and only at the highest cost-sharing level of the plan, the Commissioner could instruct his department to examine whether the plan’s design constitutes discrimination against people living with HIV. Similarly, health plans are required to cover mental health and substance use treatment services at the same level as they cover physical health services. If the Commissioner is lax in overseeing the enforcement of these laws, consumers could be financially blocked from receiving the health services that they need.

The Commissioner and his office also license insurance agents selling health insurance plans and other consumer products, as well as Georgia’s health insurance navigators. The position of “navigator” was created and funded through the Affordable Care Act in order to provide free, local, unbiased assistance for consumer enrolling into health coverage through the Marketplace. Currently, Georgia’s navigators have to meet unnecessarily burdensome licensing requirements and pay a large fee in order to be licensed by the state, something that Georgia’s next Insurance Commissioner has the power to address.

The Department of Insurance is further charged with protecting Georgia citizens from insurance fraud, mediating disputes between consumers and insurance companies, and assisting consumers with questions. The Georgia Department of Insurance has historically been under-resourced and, as a result, has struggled to carry out these tasks in a robust way. Georgia’s next Commissioner will be integral in advocating for the budget and resources needed to assist and support Georgia consumers across all insurance products.

Georgia’s next Insurance Commissioner 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 blogs in the series:

• Eight questions for health care voters to ask Georgia candidates
• Governor blog
• General Assembly Blog

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

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:

• Eight questions for health care voters to ask Georgia candidates
• A consumer health advocates guide to the 2018 elections: Georgia’s Governor

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

Pricilla Epps is a 54-year-old former security guard who lives in Blakely, GA, a rural community in the southwest region of the state.

Two days after having a sudden stroke, Priscilla lost her job because she was unable to work her scheduled shifts as she recovered that week. Priscilla’s health insurance was provided by her employer, so she lost her health insurance coverage when she lost her job, leaving her on the hook for all of the hospital costs that accumulated as she received care for her stroke. After a two-day stay, Priscilla was told she would have to leave the hospital due to her inability to pay for the costs of in-patient care.

Experiencing dizziness, difficult walking, discomfort in her limbs, and frequent forgetfulness, Priscilla went to see Dr. Kinsell, the only available physician in Clay County, where she still receives the limited follow-up care she can afford. She is still unable to go back to work or live on her own, so Priscilla has been living with her daughter for the time being.

Like Priscilla, 360,000 low-income Georgians, many of whom are uninsured, live in small towns and rural areas across the state. These areas have the most at stake in the debate over whether or not to close the health care coverage gap. According to a new report from Georgetown University’s Center for Children and Families and the University of North Carolina’s Rural Health Project, Medicaid expansions in other states have cut the uninsured rate in rural areas by half, while Georgia has seen a much smaller decline from 43 percent to 38 percent among the same population.

For rural Georgia residents like Priscilla, health coverage would open doors to the physicians and services that they need to stay employed or get back to work. For rural communities like Blakely, more residents with health coverage could make the difference between keeping or losing the few remaining primary care physicians in the area.

Your story is powerful! Stories help to put a human face to health care issues in Georgia. When you share your story, you help others understand the issue, its impact on Georgia, and why it’s important.

Your health care story is valuable because the reader may be your neighbor, friend, someone in your congregation, or your legislator. It may inspire others to share their stories or to become advocates. It is an opportunity for individuals who receive Medicaid or fall into the coverage gap, their family members, their physicians and concerned Georgia citizens to show that there are real people with real needs who will be impacted by the health policy decisions made by Congress and Georgia’s state leaders.

Share your story here!

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.