Healthcare and Health Insurance Policy
Hospital and Managed Care Fees
During the week leading up to the 30th day, Crossover Day, lawmakers reached an agreement to achieve support from hospitals for the passage of a 1.45 percent hospital provider fee as contained in
House Bill 307. The revenue from the fee will be directed to the state's Indigent Care Trust Fund.
As negotiated with the hospitals, the fee will sunset after three years (at the end of FY 2013) and will be used to fund base operations as well as provider reimbursement rate increases in Georgia's Medicaid program. These rate increases are expected to be included in the House of Representatives version of the fiscal year 2011 budget that is expected in the coming week.
Additional details on the expected revenue generated by the hospital fee in HB 307 likely will be available when the House releases its proposed budget for FY 2011. Based on testimony during the Appropriations Committee hearing on the bill, the version of HB 307 that passed through the committee would have generated net revenue of approximately $175 million to fill a hole in the state's Medicaid budget; however, the amendment that removes private ambulatory surgery centers from the tax is expected to lower the revenue estimate by approximately $6 million (based on figures from the House floor debate on the bill).
The House did not act on HB 299, which would have generated revenue by removing the sales tax exemption for non-profit hospitals. This proposal was introduced as part of Governor Perdue's revised budget proposal on March 11th; however, passing the hospital provider fee ended the consideration of this proposal.
For more information about the hospital provider fee in general and about the governor's original budget proposal that included this fee,
read Senior Healthcare Analyst Timothy Sweeney's
analysis and
testimony before a House subcommittee examining the proposal.
Health Insurance Regulation Both the House and Senate passed several bills dealing with insurance regulation, as well as the oversight and regulation of Georgia's Medicaid program.
Both chambers passed bills to allow private companies to sell individual health insurance products that are primarily regulated by other states. The Senate version --
Senate Bill 407 -- was amended to ensure that products sold in Georgia under these provisions must still contain almost all of the coverage mandates required of products currently sold in Georgia.
The House version of the bill --
HB 1184 -- does not include these provisions. Under the provisions of HB 1184, out-of-state insurers would be exempted from state laws governing required benefits and consumer protections.
The Senate has also passed
SB 443, which creates a legislative oversight committee to review and evaluate the Care Management Organizations (CMO) that currently operate a portion of Georgia's Medicaid program.
The House passed
HB 1407, which requires a single Medicaid administrator for dental services and carves out the administrative contract from beneath the CMOs that operate the bulk of the Medicaid program.
The Senate failed to act on the following bills:
SB 330 would have eliminated the ability of insurance companies licensed in Georgia to impose lifetime or annual caps on benefits for patients. In addition, the bill would limit the ability of insurers to rescind existing policies or deny services in the case of misstatements or omissions on insurance applications. Finally, the bill would allow dependent children to remain on their parent's health insurance policy through the age of 25, even if the dependent is not a full-time student.
(These provisions were included in the health insurance reforms passed at the federal level, and all except eliminating annual benefit caps will take full effect in the coming year. Eliminating the annual benefit cap will phase in at the national level.)
SB 331 would have allowed small employers with 2 - 50 employees to pool with other small employers to purchase group health insurance policies, and would require all health insurers in Georgia to offer plans -- often called Association Health Plans -- designed for these arrangements. This bill did not make it out of committee.
Bills Related to National Health Reform In the final week before Crossover Day, both the House and Senate passed bills seeking to prevent the implementation of health insurance reforms passed on the national level. For example:
SB 399 seeks to prevent any state agency or department from implementing any portion of the federal health insurance reform legislation without explicit state legislation authorizing the implementation activities.
SB 317 would make it a state law that Georgians could not be compelled to "participate in any health care system," and that the purchase or sale of health insurance products and/or direct healthcare services could not be prohibited.
In addition, several resolutions introduced in the House and Senate to place constitutional amendments on the ballot for the November election failed to achieve the two-thirds votes needed to pass. In particular, SR 794 and HR 1086 also sought to establish that Georgians could not be compelled by the new federal legislation to obtain health insurance.
Although these bills are aimed at provisions in the national health insurance reform legislation enacted by the U.S. Congress that assess penalties for individuals who do not obtain health insurance (with exceptions related to affordability) through the federal income tax system, it is unclear as to whether these bills enable Georgians to escape the federal rules if they are enacted.
