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Legislative Update: Steep budget cuts and significant health bills close 2020 session

Sine Die

Georgia’s 2020 legislative session comes to a close

Friday, June 26, marked the final day of the 2020 Georgia legislative session. This year’s Sine Die (the last day of the legislative session) came after a months-long suspension due to safety concerns over COVID-19. The final two-week legislative sprint brought the approval of a number of bills that will benefit consumers if approved by the Governor. Unfortunately, this progress comes against a backdrop of steep budget cuts that will put many Georgians at risk, especially those who are most marginalized.

Below you will find an overview of the approved state budget, summaries of notable health-related legislation, and short status reports on other health bills. GHF’s legislative tracker is updated so you can check on the health bills you were watching this session.


General Assembly passes FY2021 state budget

Legislators’ primary responsibility upon returning to the state capitol this month was to finish and pass the FY 2021 state budget, which goes into effect this Wednesday, July 1. On Thursday, the Georgia House and Senate passed a state budget that includes $2.2 billion in budget cuts for the FY 2021 budget. Although cuts were reduced from 14% to 10%, the approved budget curtails funds to many critical health care programs and social services. Notable changes to this year’s budget include:

  • Department of Behavioral Health and Developmental Disabilities: $91 million cut
    • One-third of the cuts ($29 million) comes from adult developmental disability services 
    • Another third ($29.9 million) comes from child and adult mental health services
  • Department of Community Health: Increase of $178 million
    • Increase in funds due to a higher projected growth for Medicaid
    • $19.7 million added to provide six-months of Medicaid coverage for new mothers (see below for more info.)
  • Department of Public Health: $8.2 million cut
    • Funding restored for grants to local health departments
    • No reduction in funding for maternal mortality review board

The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. Voice’s for Georgia’s Children also has a relatively easy-to-read version of the budget changes here.


Our priorities

General Assembly passes four bills to reform PBM practices in Georgia 

This year’s Georgia General Assembly took a keen interest in pharmacy benefit managers (commonly called PBMs). PBMs are companies that manage prescription drug benefits for health insurance companies. In order to secure lower prices on medications, PBMs have adopted practices that are seen as burdensome by pharmacies, restrictive and hard-to-navigate by consumers, and opaque by elected officials. The following four PBM bills were passed last week in an effort to increase patient access to and decrease costs of medications:

  • HB 918, sponsored by Rep. Sharon Cooper, limits the practices of PBMs as they audit pharmacies so that pharmacies can more easily meet audit requests. The bill gives the benefit of the doubt to pharmacies when small or innocuous mistakes are discovered.
  • HB 946, sponsored by Rep. Matt Knight, and SB 313 by Senator Dean Burke are companion bills with the same legislative language. Both bills would require that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. The bills also increase fines on PBMs when they “steer” consumers to specific pharmacies and disallows PBMs from building drug formularies (lists of covered medicines) in a way that discriminates against people with prescription drug needs.
  • HB 991, sponsored by Rep. Matt Hatchet, establishes an oversight committee which will oversee the contracts and subcontracts under the State Health Benefit Plan (covers state employees and their families), Medicaid, and PeachCare for Kids. This legislation aims to increase transparency around the pharmacy benefit managers contracted by these plans. The oversight committee is made of nine members, one of whom must be a consumer covered by one of the state health plans.

Bill to increase taxes and raise the age of purchase for vaping products passes

Multiple pieces of legislation were introduced this year that would change the way Georgia regulates tobacco, vaping devices and other nicotine products. Ultimately, only SB 375, sponsored by Senator Jeff Mullins, saw final passage. The bill will establish a 7% tax on vaping products and would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age. This increase in the so-called “age of purchase” brings state law in line with federal law.


Legislation to establish an All Payer Claims Database passed

SB 482, sponsored by Senator Dean Burke, builds on Georgia’s new surprise billing legislation (HB 888). HB 888 authorizes Georgia’s Department of Insurance to establish an all payer claims database (APCD) that will inform the surprise billing payment resolution process. APCDs can be a powerful tool that can also help policymakers, stakeholders, and advocates develop better understandings of health care costs, use of services, population trends, and disparities.

SB 482 goes farther than HB 888 by setting up an advisory body to assist in the creation of the APCD and establishing the purposes of the APCD, among other provisions. The advisory body does not currently include consumer representation. 

The creation of Georgia’s APCD is subject to appropriations. It was not funded in the FY2021 budget but state leaders have expressed optimism about funding it in future state budgets and attracting private funds to help support its development.


Surprise billing legislation awaits Governor’s signature

The Surprise Billing Consumer Protection Act (House Bill 888), was recently passed by the General Assembly and now heads to Governor Kemp’s desk for his signature.

This bill will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers. After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how legislation will work and what consumers may expect.

After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how the legislation will work and what consumers may expect.


Postpartum Medicaid coverage bill passed and funded

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth, up from the current 60-day limit. The General Assembly approved the legislation and funding ($19.7 million) last week. HB 1114 now heads to Governor Kemp’s desk for his signature.

In order for this change to take effect, the Georgia Department of Community Health will need approval from federal health officials.


Sine Die recap

HB 792: Amended FY 2020 Budget | SIGNED BY GOVERNOR HB 792 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2020. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on March 17th.


HB 793: FY 2020 Budget | SIGNED BY GOVERNOR HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. The budget includes several steep cuts to behavioral health and other health care programs. 


HB 719:  Effort to modernize HIV laws | DID NOT PASS HB 719, sponsored by Rep. Deborah Silcox, would modernize Georgia’s HIV-related laws and make progress towards decriminalizing HIV. Current Georgia law deems it a felony for people living with HIV to have sex or donate blood without disclosing their status, or for spitting at or using bodily fluids on a law enforcement officer. Under HB 719 only the act of having sex without disclosing a person’s HIV status would remain illegal.


HB 789: Creation of a surprise bill rating system | PASSED HB 789, sponsored by Rep. Mark Newton, would create a surprise bill rating system based upon the number of certain physician specialty groups contracted with a hospital within a health insurer’s network. 


HB 842: Gracie’s Law – organ transplant discrimination | DID NOT PASS HB 842, sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities.


HB 987: Protection of elderly persons | PASSED HB 987, sponsored by Rep. Sharon Cooper, would increase training requirements for staff members in elderly care facilities and raises the number of staff who would have to be on site at any given time to watch over residents. It would also increase fines for violations or if a facility causes a resident’s death.


SB 303: Georgia Right to Shop Act | PASSED SB 303, sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee, would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information. 


SB 352: Online provider directories | DID NOT PASS SB 352, sponsored by Senator Burke, would allow consumers to see providers at in-network rates for their entire plan year, if the provider is listed as in-network at the time a person enrolls in their health plan. The providers included in a consumer’s insurance plan network changes regularly throughout the year and this bill would assure that the provider network advertised at the time of enrollment is the provider network they are able to access all year long.


SB 408: Family Care Act Sunset Removal | PASSED SB 408, sponsored by Senator Brian Strickland, would extend the sunset on the Family Care Act to July 1, 2023. The Family Care Act allows employees to use sick time to care for ill family members. 


GHF has you covered

Stay up-to-date with the legislative session and COVID-19
 

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.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.


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Legislative Update: House passes little budget & Senate to vote on surprise billing today

Legislative Update: Week 6

Legislative session has resumed

After more than a week-long break to consider the state budget, the Georgia General Assembly resumed its normal schedule last week. The House of Representatives approved the amended FY20 budget on Wednesday and continues its consideration of the FY2021 budget. Even as the budget takes center stage, health-related legislation is beginning to make progress in both the House and Senate. 

Today marks Day 17 (out of 40) of this year’s legislative session.


Senate vote expected today on surprise billing legislation

Senate committee approves legislation, House committee will reconsider surprise billing bill

Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. Last Tuesday the House Special Committee on Access to Quality Health Care heard testimony from insurers, advocates, and medical providers about the House legislation, HB 888. While the bill was narrowly passed by the committee that day, the House Rules committee has since sent the bill back (or “recommitted”) to the committee for further consideration.

The companion bill, SB 359, was approved on Wednesday by the Senate Health and Human Services committee. The Senate bill, sponsored by Sen. Chuck Hufstetler, includes changes that better protect consumers from receiving surprise bills from hospitals after emergency situations. (The bill already included physicians in emergency situations.) The Senate is expected to vote on SB 359 this morning, and if approved, the bill will move to the House for its consideration.


Amended FY20 budget passed by House

House makes sizeable changes to Gov. Kemp’s proposed budget

The House of Representatives voted on Wednesday to approve the amended FY2020 state budget, which ends June 30th of this year. The version passed by the House erases many of Governor Kemp’s proposed cuts including funding reduction to the Georgia Poison Center, Mercer and Morehouse Schools of Medicine and the Rural Health Systems Innovation Center at Mercer. Cuts to local county health departments across the state were reduced from $6.3 million to $3.7 million. 

The Department of Behavioral Health and Developmental Disabilities (DBHDD) saw $9 million in cuts restored in the areas of intensive family support services, adult crisis stabilization beds, behavioral health core services, and other areas. DBHDD will still see a net loss of $25.7 million under this budget, but that cut is down from $34.4 million.

You can see the changes made by the House in the FY20 Track Sheet. The Senate will now take up this year’s amended budget and the House will turn its attention to the FY2021 budget which takes effect July 1, 2020.


Vaping and organ transplant bills move forward

Bills to raise the age of purchase for tobacco & nicotine products approved by Senate committee

Multiple pieces of legislation were introduced this year that would change the way Georgia regulates tobacco, vaping devices and other nicotine products. SB 298, sponsored by Sen. Renee Unterman, would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age, among other things. The Senate Regulated Industries and Utilities committee approved SB 298 last week. The bill must now be passed by the Senate Rules committee in order to receive a vote by the full Senate. (For an overview of the bill, please read our Jan. 21st legislative update.)


Gracie’s Law passed by House Insurance committee

Gracie’s Law (HB 842), which would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities, was approved by the House Insurance committee last week. Sponsored by Rep. Rick Williams, the bill is supported by The Arc of Georgia, the Georgia Council on Developmental Disabilities, and other disability advocacy organizations. The bill is expected to receive a vote by the full House of Representatives this week. (For more on this bill, please read our earlier legislative update.)


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.


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Legislative Update: Surprise billing, vaping, & Georgia’s budget

Legislative Update: Week 1

The 2020 legislative session has begun

Last week, the Georgia General Assembly convened for the first time in 2020. The first four days of the 2020 legislative session were mostly taken up with committee appointments, Governor Kemp’s second State of the State address, and other annual traditions including GHF’s own Health Care Unscrambled

This week will be dedicated primarily to budget hearings for the current (FY 2020 Amended) and next year’s (FY 2021) state budgets. The General Assembly will reconvene next Monday, January 27th for the fifth day of legislative session. 


Efforts to address surprise billing gain early momentum

The issue of surprise out-of-network medical billing (sometimes called “surprise billing” or “balance billing”) is already getting a lot of attention early in the 2020 session. At Health Care Unscrambled, Senate Health & Human Services Chairman Ben Watson said, “If we do not pass balanced billing or surprised billing this year, I don’t think it will be a successful session.” Governor Kemp added his support during his State of the State address, saying “Working with patients, providers, and the private sector, we’ll craft a legislative remedy to reduce surprise medical billing. We will demand transparency, embrace empathy, and insist on fairness.” 

GHF and our partners at Georgia Watch have long advocated for a legislative solution that protects Georgia consumers from payment battles between insurers and providers. We are grateful for the support of Governor Kemp, Lieutenant Governor Duncan, and legislative leaders on this important issue. We look forward to working with all parties to ensure that Georgia consumers are no longer stuck with surprise bills when they go to the doctor.


Governor outlines priorities in annual address

Governor Kemp submits his budget recommendations

On Thursday, Governor Kemp addressed the General Assembly in his second annual State of the State address and, per tradition, used the opportunity to introduce his proposed budget. Governor Kemp also laid out his priorities for his second year in office, including education, foster care, and public safety.

The amended budget (an update to the current state budget) includes a 4% cut to cut state spending through the end of the state fiscal year (June 30, 2020).

The Governor’s recommended FY 2021 budget, which will begin on July 1, 2020, includes a 6% cut to state spending. Despite the cut, a $89.6 million increase in the Medicaid budget is proposed to address growing enrollment. The House will now take up and consider the two budgets before passing them to the Senate later in the session.


Action Alert!

Act now, submit your comment today!

Before the legislative session began, Gov. Kemp filed paperwork with health officials in the federal government to move forward with their plans to change Medicaid and private insurance in Georgia. Now those health officials must ask for your input, beginning with the Medicaid plan! 
 

Gov. Kemp’s Medicaid plan will leave thousands of low-income Georgians with no meaningful pathway to coverage. We need you to step up AGAIN and become a health care hero by telling health officials what you think of the Medicaid plan! The deadline for comment is Friday, February 7th. Visit CoverGA.org to comment today! 

Did you submit a comment in November? Please submit a comment again so federal officials can hear directly from you.


Early legislation introduced

Legislation to restrict vaping

SB 298 would raise the minimum age to purchase vaping products from the current age of 18 to 21. It would also set tougher penalties for selling tobacco, nicotine and vaping products to minors and would require schools to include information about the harms of vaping and smoking in their health education curricula. The legislation is sponsored by Senator Renee Unterman. Similar legislation is expected to be introduced in the House in the coming weeks. The bill has been referred to the Senate Regulated Industries and Utilities Committee.


The legislative calendar begins to take shape

The General Assembly set its calendar for the first fourteen days of the 2020 legislative session in HR 879. After this week’s budget hearings, the session will pick up again according to the following schedule:

January 27: Day 5

January 28: Day 6

January 29: Day 7

February 30: Day 8

February 31: Day 9

February 3: Day 10

February 4: Day 11

February 5: Day 12

February 6: Day 13

February 10: Day 14


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.


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