A proposal to ease health care regulations in Georgia passed the Senate Thursday with some bipartisan support, but Democrats say they will withhold support next time unless the bill includes a full Medicaid expansion.
Republicans in the Republican-controlled chamber may not need to send the bill to Democrats. measurement But the final form of the bill will be worked out in conference committees, and there were already signs of unease among Republican lawmakers.
State Sen. Billy Hickman, R-Stateboro, said he voted in favor of the bill because it would set aside more state funding for the local hospital tax credit program. The cap will go from $75 million to $100 million.
But Hickman said he is concerned about proposed changes that would make it easier for some outpatient surgery centers to open, which hospital representatives oppose.
“I've prayed about this bill more than probably any other bill in my four years here. I've prayed about this more than the horse racing bill,” Hickman said.
During the debate, which lasted more than an hour, Senate Democrats repeatedly called for complete expansion of Medicaid. The proposal would instead create a committee focused on comprehensive health care that would meet after lawmakers return later this year.
Sen. Jason Estevez, D-Atlanta, argued that changing the state's certificate-of-need rules alone is not enough to improve access to health care in Georgia.
“I vote 'no' today as a call to action,” Estevez said. “While I agree with the principles of this bill, I also strongly believe that we need to expand Medicaid now. By demonstrating our desire to expand Medicaid with a simple vote in this chamber, we will You can take control in this chamber.
“We don't have to wait for the House of Representatives. We don't have to wait for the governor's statement that he wants to advance health care in this great state,” he said.
The bill's sponsor, Sen. Bill Cowsert (R-Athens), said supporting the bill would keep the debate about Medicaid expansion alive, but perhaps not just this year.
“We'll set up a committee to look at it,” Cowsert said. “And we'll keep talking until we find a solution. He can't get everything he wants on one bill.”
The decades-old certificate of need rule was designed to contain costs by limiting the number of medical services allowed in a region. But the regulations have long been a source of debate under Gold Dome, with critics saying the restrictions are unhelpful and allowing hospitals to take advantage of vulnerable businesses from independent centers that deprive them of more profitable services. They claim to protect the hospital.
This year's proposal would maintain the program but loosen some rules, such as opening psychiatric and substance abuse inpatient facilities, rural hospitals if certain conditions are met, and freestanding birth centers. Expansion becomes easier.
The bill passed the Senate by a vote of 43-11 on Thursday and will now return to the House for consideration. An earlier version passed the House last month by a vote of 166-1. BIt is expected to be referred to a conference committee made up of members of both chambers that will meet to speed up a deal.
Stone Mountain Democratic Minority Leader Gloria Butler and other Senate Democrats said Thursday after the vote that they would not support the bill again if it returns from the House this session without a full Medicaid expansion.
“If Medicaid expansion passes, I think Democrats will support certificate of need reform, just like we saw in North Carolina last year,” Butler said at a press conference Thursday afternoon. “Let me be clear: CON and Medicaid expansion must go together.”
North Carolina is recent southern states Last year, lawmakers sought to expand Medicaid by tying it to changes to state hospital business regulations. And Medicaid expansion is now being debated in Mississippi.
Georgia is one of 10 states that have not expanded Medicaid under the Affordable Care Act. Approximately 500,000 people will be insured, and state coffers will benefit from federal incentives.
Instead, Georgia partially expanded Medicaid through a program called Georgia Pathways to Coverage. The program requires participants to complete 80 hours of work, school, or other qualifying activities each month to earn and maintain coverage. She had fewer than 3,000 people sign up in her first six months.
this year's session It started with a chat He also mentioned Medicaid after Republican leaders expressed openness to discussing an Arkansas-style model that would use federal funds to buy private insurance for low-income people.
But House leaders seem to be suggesting that this is not the year for Georgia to change policy. proposed countermeasures Last month, it asked for a commission instead. In early February, the state sued the federal government over delays in implementing the Georgia Pathway, which began in July.
But Kemp dismissed the idea that he questioned Medicaid expansion negotiations at this meeting.
The governor told reporters Tuesday that he had “never thought of discussing that.” “It was primarily a legislative priority of the House to get this out into the world and discuss it.”
Since first taking office in 2019, Kemp has focused on health insurance waivers, including setting up what Kemp calls “a limited expansion of Medicaid in a conservative manner.” Said to be included.
But advocacy groups remain hopeful that the full expansion could occur during this session.
“We urge legislators to take action before this session ends and improve health care now, rather than looking ahead,” Natalie Crawford, executive director of Georgia First, said in a statement Thursday. We urge them to close the gaps in the insurance system.”
