The fate of the Affordable Care Act may be uncertain as President-elect Donald Trump prepares to take over with a Republican-controlled Congress, but don’t expect Georgia lawmakers to wait for Washington’s lead in 2017.
At least that was the message Georgia Senate President Pro Tem David Shafer and House of Representatives Minority Leader Stacey Abrams shared during the Gwinnett Chamber’s Legislative Update Luncheon on Friday.
They offered a bipartisan view of what to expect in the upcoming legislative session during the luncheon at the Infinite Energy Forum. Regardless of what Congress does with healthcare next year, they said, Georgia has its own healthcare issues to deal with.
Namely, how to keep rural hospitals across the state afloat. That means hospital provider fees, also known as the “bed tax,” will be a major issue as those fees are set to expire next summer.
“We are going to have to reauthorize, in some fashion, the hospital provider fee,” Abrams said. “What that looks like, the shape it takes, the amount is still to be determined.
“While our caucus has not yet taken a position, I think we all understand people get sick whether they have money or not and we have to, as a state, provide a healthy workforce so our investment in health care cannot diminish.”
The General Assembly is a little over a month away from beginning its 2017 session, and once that begins, legislators will spend 40 days (not counting time off for committee work) trying to work out the state’s issues.
The hospital provider fees is one of the issues Shafer, a Republican from Duluth, and Abrams, a Democrat from Atlanta, agreed will be key topics in the 2017 legislative session.
Shafer said the state enacted the fees about eight years ago, and they allow Georgia to allocate nearly $1 billion of its budget to make sure rural hospitals don’t fail. The fees themselves generate about $300 million in revenue, but the Senate leader said that money allows the state to get another $500 to $600 million in federal matching funds for the hospitals.
“It’s critical that it be renewed because we don’t have a plan to replace the $1 billion loss of revenue that we’d have if the fee wasn’t renewed,” Shafer said.
With Republicans in Washington expected to work on a repeal of the Affordable Care Act, the issue of Medicaid expansion, which seemed likely to be a major issue in Georgia next year, may now be put on the back burner.
Until lawmakers in Washington decide what to do with healthcare that is.
Under President Barack Obama, the federal government has promised to pay 90 percent of the Medicaid expansion costs. With their being a good chance of Congress repealing Obama’s signature healthcare law and Trump signing off on it, thee is uncertainty about what will happen beyond next spring.
“Now that we have a new president who probably won’t renew the promise to pay the 90 percent forever, we need to pause and see what sort of policy changes will come out of Washington before we begin committing to things,” Shafer said.
Legislators expected to look at education
Healthcare is hardly the only issue that legislators will face next year, however, according to Shafer and Abrams.
Rising tuition costs and an overhaul of the aging K-12 funding formula for public schools are also expected to be key issues next year, they said. They agreed the public school funding formula, which is an issue Gov. Nathan Deal has had studied with an eye on overhauling, needs to be revised to help fund low-income and rural schools.
How tuition issues could be solved, however, remains to be seen.
Abrams said one idea is to use revenue from casino gambling to pay for higher education. That plan would be similar to the use of lottery dollars for education, although voters would first have to approve a constitutional amendment to legalize casino gambling.
“For us (in the House Democratic Caucus), the conversation has to be on gap funding,” Abrams said. “In the state of Georgia, there are 13,000 students who are academically eligible who dropped out of school in 2013 and 2014 because of a lack of $5,000 or less.
“We have a need-based aid gap of $660 million in the state of Georgia in our higher ed system. In 2015, only $28.8 million was available. That gap is dangerous.”
Shafer said college tuition has increased so much in Georgia that it is driving other education-related issues dealing with student loans and being able to fund the H.O.P.E. scholarships.
“At the core of the student loan problem, at the core of the H.O.P.E. scholarship problem is the cost of higher education, and I think we’ve got to address that in a thoughtful and reasonable way,” he said.
Shafer said changes to the funding formula for higher education could be one way to approach the issue.
“Other states, as I’ve look at this issue, have made changes to their higher education funding formula that reward colleges based on things like what percentage of the students graduate,” he said.
Mass transit may also come up
There are some other issues that could come up in the session. Shafer said one issue that should be looked at is mass transit as traffic in metro Atlanta, and particularly in Gwinnett, continues to worsen.
Gwinnett was included in MARTA’s footprint under the MARTA Act of 1965, but Gwinnett voters have repeatedly voted down referendums to pay a tax to participate in the transit system.
“I believe that mass transit plays a role in solving our transportation problems, but I think we’ve got to be smart about it and thoughtful,” Shafer said.
He said after the luncheon that he expects a mass transit solution will take several years to accomplish though. Part of an effort to address the issue may mean some sort of overhaul of MARTA’s governance system.
“As we move forward on mass transit, which I’m generally supportive of, we’ve got to make some governance changes to MARTA as an agency that is regional in scope,” Shafer said. “And we’ve got to make sure the legislators and the people who will ultimately approach this tax have a clear understanding of how this money will be spent.”