Visitors to the Georgia State Capitol were delighted by the rhythm and artistry of a lion dance in the South Wing on Wednesday as the Asian American Pacific Islander Legislative Caucus hosted its second annual Lunar New Year celebration. The cultural exhibition marked the beginning of the Year of the Snake, which the most paranoid lawmakers and lobbyists may think is every year under the Gold Dome. But as for us, we’re “all about shedding that bad energy” and looking for a positive year ahead.
But, first, some reports of the day’s committee actions in this #GoldDomeReport.
In this Report:
- Committee Notes
- New Legislation
- What’s Next
Committee Notes
House Ways and Means Committee
The House Committee on Ways and Means, chaired by Representative Shaw Blackmon (R-Kathleen), met Wednesday morning for its first meeting of the biennium in which its rules were adopted and new members welcomed. The committee took up one piece of legislation.
- HB 92, authored and presented by Chairman Blackmon, amends the homestead floating exemption that was passed last year (HB 581) and grants a statewide homestead exemption that limits the increases in the taxable value of homes to no more than the inflation rate that occurred over the prior year. Local governments may opt out, and the current deadline to do so is March 1, 2025. This bill extends the deadline to May 1. The committee unanimously recommended the bill DO PASS and be sent to the Rules Committee.
Senate Insurance and Labor Committee
The Senate Insurance and Labor Committee, chaired by Senator Larry Walker, III (R-Perry), met for its first meeting on Wednesday and heard one measure:
- SB 5, authored by Senator Kay Kirkpatrick (R-Marietta), amends Title 33 to require health insurers to implement and maintain a program that allows for the selective application of reductions in prior authorization requirements under certain circumstances. Specifically, the bill requires health insurers to have what are known as “gold card” programs that reduce prior authorization requirements for providers that meet certain performance metrics. The bill requires implementation of these programs by July 1, 2026.
Senator Kirkpatrick presented the bill to the committee, noting that she worked with the Insurance Commissioner and the insurance industry to perfect the bill. Jesse Weathington of the Georgia Association of Health Plans expressed appreciation to Senator Kirkpatrick for working with insurers on the bill language, noting they have no issues. Senator Randy Robertson (R-Cataula) asked how many insurers in Georgia don’t have gold card programs, to which Weathington said he was not sure but that no insurer had expressed concern about complying within the bill’s required timeline. The committee recommended the bill DO PASS and be sent to the Rules Committee.
Senate Health and Human Services Committee
Chairman Ben Watson (R-Savannah) and the Health and Human Services Committee convened this afternoon. Chairman Watson introduced new members to his Committee Senators Bill Cowsert who is ex officio (R-Athens), Sally Harrell (D-Atlanta), Randal Mangham (D-Stone Mountain), Nikki Merritt (D-Snellville), and Larry Walker III (R-Perry). The committee adopted its rules for the new session; there were no changes from last year’s rules.
Chairman Watson made some opening remarks, outlining that Medicaid 101 was requested by the Lt. Governor’s Office. He noted that Senator Blake Tillery (R-Vidalia) carried the legislation creating Governor Kemp’s waiver programs (the 1115 and 1332) to the federal ACA legislation. The “Access” program is a private insurance effort covering individuals between 100-138% of the federal poverty level (FPL) and there are 806,000 plus individuals who are covered by private insurance of the state’s uninsured population. Pathways is a program designed to help individuals who are moving out of poverty (recently Arkansas passed its effort like Pathways). Pathways was approved by the earlier Trump Administration but was then rolled back by the Biden Administration and the state went to court in Brunswick where the State won. Note, that South Carolina also has announced a Pathways effort. Under Pathways, there are around 5,000 individuals enrolled according to Chairman Watson - much of this was after the redeterminations were made by Medicaid after the Public Health Emergency ended (during the Emergency, there was a suspension of Medicaid enrollment on an annual basis). Foster care children and their parents are being proposed to be covered by Pathways. There are work requirements under the program (e.g. 20 hours of work or community service, enrollment in technical college, enrollment in college or university, or serving as a caregiver).
“Medicaid 101” Presentations
- Georgia Access - John King, Commissioner of Insurance: Commissioner King outlined the reasons around Access which is the private market and was created by the Patient First Act of 2019. It launched as a state-based exchange on November 1, 2024 allowing more individuals to be covered (he noted that the Boys and Girls Club in Albany had been an excellent partner in providing answers and getting individuals signed up). The program is also to improve consumer enrollment experiences with “no wrong door.” Finally, Access is to strengthen competition in the market (by insurers) allowing more choices, particularly in rural areas. The open enrollment period was a huge success. Georgia is the largest state-based exchange behind California. He noted that there are 225,000 consumers who enrolled and are brand new, never having insurance. 95% of those are eligible for financial assistance. Insurance agents have been key to the success. Approximately 70% have signed up for coverage through entities such as webBroker. Finally, King stated that carriers have doubled and there are no counties now in Georgia without a single carrier. He fielded a few questions. Senator Ed Setzler (R-Acworth) inquired about the policies — those have met or exceeded those on healthcare.gov. Senator Nan Orrock (D-Atlanta) asked about dollars expended on Pathways. Commissioner King noted that there were fees generated by the marketplace and the costs have not been a burden on the taxpayers. It also allowed creation of a high-risk pool. Most enrollees are fully subsidized with their premiums. The premiums have been lowered in rural areas by 17-20% with more companies competing. Senator Sonya Halpern (D-) asked about the federal subsidies which are scheduled to end. DOI is preparing for the elimination of these but there are many unknowns.
- Georgia Pathways - Grant Thomas, Department of Community Health: Thomas provided an update on the Pathways effort which was created by the Patients First Act of 2019. He noted that there were two waivers as Chairman Watson explained — 1115 waiver which was done June 30, 2020 and the 1332 waiver which was made December 31, 2021 which contained the reinsurance program. Georgia has essentially four plans where it covers individuals: Medicaid, Pathways, Access, and the State Health Benefit Plan. 1.5 million are eligible for Access; 810,000 are between 100-138% FPL. He noted that Georgia’s unemployment rate is low — around 3.7%. The number one reason for denial to Access is for being over the income threshold. He mentioned the qualifying activities (work requirements as enumerated by Watson). He also shared some uninsured information (based on 2017 data and 2023 data which is the most recently available information). Of those in the 19-64 age range, there are 246,000 eligible (this number is down from the point the waiver was written which was 408,000). Georgia’s total uninsured population is 1.2 million and there are 900,000 individuals who are qualified for insurance programs but have not signed up. Under the program, premiums are capped at 8.5%. Currently, the Department of Community Health is prioritizing marketing of the Pathways program and noted that 1.4 million have visited the website. Thomas stated that the enrollment numbers (actually higher than what Senator Watson shared) were 6,514 and a total of 9,160 individuals have been served. He stated that the “churn” of the number was because of individuals reaching/exceeding the income threshold and moving to Access. He fielded a few questions from members. Senator Merritt inquired about the costs of the program and he noted that all programs have costs (approval by CMS, Biden delay for start up, etc.). He further mentioned that many move to Access where they pay providers higher reimbursement (over Medicaid payments) and individuals have a broader network of providers to select from. Senator Orrock asked for the presentation, which had been mailed to Chairman Watson. She asked about the 40 other states that have done Medicaid expansion and the costs for providing coverage — Thomas noted that the state was not paying for the 816,000 and that reimbursement rates were better for providers as well as the networks’ adequacy were better. Further he stated that only 64% of the physicians in Georgia accept Medicaid. Chairman Watson mentioned that federal changes, such as possibly the percentage allowed for FMAP, might change — Georgia now only pays about a third of the Medicaid dollars.
- Insights on Medicaid in Georgia - Cindy Zeldin, Georgia Health Initiative: Zeldin presented an overview called the Insight on Medicaid in Georgia. There are 2.3 million on Medicaid in the state and nearly half of all births are covered by Medicaid. The state’s nursing home residents also enjoy Medicaid payments with approximately 3 of 4 patients covered by the Aged Blind and Disabled program in Medicaid. Zeldin noted that Georgia’s Medicaid enrollment peaked during the COVID pandemic (Public Health Emergency) with 2.8 million Georgians enrolled; those numbers have decreased since redetermination was conducted. The majority of enrollees in Medicaid are children. The more populous a county the higher number of Medicaid enrollees. She accented some of the benefits covered by Medicaid, including EPSDT services for children. Georgia’s program has most licensed provider types enrolled but each must go through a credentialing process. 63% of Georgia’s primary care physicians are enrolled in Medicaid. She also shared some information on utilization (spending) noting in part the drivers are inpatient care, pharmacy, pharmacy, and behavioral health services. Medicaid managed care began in 2006 and now there are new contracts being sought for those to implement in mid-2026. Georgia Families (the CMO-covered program) has 75% of Medicaid’s enrollees (or approximately 1.7 million). Georgia receives about $9.3 billion in federal funds for its program.
SB 6, by Senator Kay Kirkpatrick (R-Marietta), was scheduled to be heard. However, Chairman Watson held the legislation for next week.
New Legislation
The following new legislation of interest has been introduced in the House:
The following new legislation of interest has been introduced in the Senate:
