Weekly Legislative Update: Down to the wire, House passes budget bill, more tax cuts for the wealthy during recession, House budget analyses here

Healthcare and Health Insurance Policy

Hospital and Managed Care Fees

On Wednesday, April 14, the House of Representatives added language to House Bill 1055 to enact a 1.45 percent hospital provider fee to be deposited in the Indigent Care Trust Fund. This language was originally included in HB 307, which had previously passed both the House and Senate, albeit in different forms.

As negotiated with the hospitals and included in HB 1055, 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 included in the House version of the fiscal year 2011 budget that also passed the House on Wednesday, April 14.

Language originally added to the Senate version of HB 307 to allow hospitals to count their provider fee payments as "indigent care" for the purposes of meeting state Certificate of Need requirements was also added to HB 1055.

The amended version of HB 1055 that passed the House on Wednesday contains several other provisions that are discussed in further detail in the previous section.

For more information about the hospital provider fee 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. Also, read the Medicaid fact sheet that examines the Medicaid funding gap the provider fee seeks to address.

Health Insurance Regulation

Several bills dealing with insurance regulation, as well as the oversight and regulation of Georgia's Medicaid program, are alive in the 2010 legislative session.

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. This bill has been assigned to the House Committee on Insurance.

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. This bill was favorably reported from the Senate Committee on Insurance and Labor on Tuesday, April 13.

The Senate 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. This bill has been assigned to the House Committee on Health and Human Services.

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. This bill has been assigned to the Senate Committee on Health and Human Services.

Bills Related to National Health Reform

In the final week before Crossover Day, both the House and Senate considered several bills seeking to prevent the implementation of health insurance reforms passed on the national level. Two bills that passed the Senate and that are now in the House include:

SB 399, which 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. This bill has been assigned to the House Committee on Governmental Affairs.

SB 317, which 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. This bill has been favorably reported from the House Committee on Health and Human Services.

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.