Public Policy for the People: 11 March


public policy for the people LS

Volume 5, Issue 5 2019 Legislative Session March 11, 2019

Calls to Action: Educate the Senate on the importance of DD Waivers
and IPSE funding! See below for more information!

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Be in the Know: Rumblings Under the Gold Dome

Happy Legislative Day 29 Advocates!
With only 11 more legislative days to go, we are fast approaching the end of the 2019 Legislative Session here in Georgia. Indeed, the gavel will fall for the last time on April 2.
With that in mind, we need your help to make a splash in the coming week ahead. As you might recall, the House passed their version of the budget for FY 2020. While the House kept the Governor's recommendation for 125 new NOW and COMP waivers, they unfortunately did not add any additional waivers. With approximately 6,000 Georgians on the waiting list for a NOW or COMP waiver, we know 125 is simply not sufficient. Additionally, the House did not add any additional funding for Inclusive Post-Secondary Education.
What does this mean? It means that we need to shift our advocacy to the Senate Appropriation's Committee, specifically the Human Development and Public Health Subcommittee. We need your help to contact the following Senators:
When you contact them, please educate them on the importance of:
  1. Supporting the Governor’s recommendation for 125 NOW & COMP waivers, and adding an additional $17.8 million to DBHDD’s FY20 budget to fund 525 more NOW & COMP waivers.
  2. For Inclusive Post-Secondary Education, increasing legislative funding from the existing $500,000 to $1,000,000 in total within the Georgia Council on Developmental Disabilities Budget.
In other news, the movement for the in-state cultivation of Low THC Oil has found a home in HB 324, otherwise known as Georgia's Hope Act. It is important to note that the bill does not expand who can legally use Low THC Oil, rather it only allows for the production, cultivation, and dispensing of oil to previously approved individuals. HB 324 has passed the House. The related bill, HB 213, allows for the farming of hemp and has also passed the House. Both bills now are in the hands of the state Senate.
As for the rights of parents that are visually impaired, a bill that would help protect their rights, has passed the House. Known as HB 79, this bill is the culmination of efforts by the National Federation of the Blind, Georgia Affiliate.
Moving right along to voting, the House passed HB 316 last week, which would replace Georgia's current voting machines with a hybrid touchscreen-paper system. Sponsored by Representative Barry Fleming, the the bill was reported favorably by the Senate Committee on Ethics and now must wait to be scheduled for a chamber vote in the Senate. During public testimony, proponents of hand marked ballots testified to their concerns over an electronic system's ability to be validated. Some in favor of HB 316 spoke of the need for an electronic system to accommodate voters with disabilities. On a related note, SB 22, an attempt by Senator Donzella James to increase the privacy of individuals that vote absentee through mail by limiting identifying information on the mailing envelops did not make it past Crossover Day.
Next up is Georgia's Hate Crime Legislation, HB 426, which passed on Crossover Day. Sponsored by Representative Chuck Efstration, HB 426 increases penalties for anyone that commits a crime on the basis of race, color, religion, national origin, sexual orientation, gender, mental disability, or physical disability. Some of you might remember that Georgia's previous Hate Crime Law was ruled unconstitutional by the Georgia Supreme Court in 2004 due to being too vague. The bill now sits in the Senate.
Finally, we want to thank all of the advocates who braved the unpleasant weather to attend GCDD's 5 Advocacy Days this year. We truly could not have done it without you!
Don't forget, the House and Senate have a fairly comprehensive video recording system. It is easy to stream committee meetings, floor sessions, or even watch a recording of a past meeting.

Learn the LingoSubstitute Bill: This is an alternative version of a bill, meaning that changes have occurred within the bill since it was first introduced. While sometimes the changes are minor, they can also be very substantial. For instance, the original bill language might be replaced by entirely new language. The bill's author does not have to approve the changes. Such tactics allow a legislator whose bill did not make Crossover Day to still become law.

A Medicaid Update: A Guest Post

by Laura Colbert, Executive Director of Georgians for a Healthy Future

For the first time in Georgia, there is widespread and bipartisan agreement among Georgia’s Governor and legislative leaders about the pressing need to provide health insurance to more Georgians. To address Georgia’s rising uninsured rate, Governor Brian Kemp has put forth a bill, SB 106, that would allow the state to submit two kinds of health care waivers:
  1. A Medicaid 1115 waiver that could be used to extend coverage to more low-income Georgians, among other reforms; and
  2. A 1332 State Innovation waiver that would make changes to Georgia’s private health insurance marketplace.
(Waivers allow a state to set aside or “waive” certain requirements imposed by the federal government and try new models of providing health coverage and care. Of note, this is different than a NOW, COMP, ICWP, CCSP, or SOURCE Waiver.)
While the goal to extend affordable, quality coverage to more Georgians is admirable, the proposed legislation currently falls short by limiting the number of people who would benefit, increasing the likely costs to the state, and leaving to door open to an erosion of critical consumer protections. 
SB 106 limits a future 1115 Medicaid waiver to cover only adults making up to 100% of the federal poverty line (FPL) ($12,490 for an individual and $21,330 for a family of three per year). While this would cover more Georgians than are currently eligible for Medicaid, that cut-off leaves out an estimated 200,000 uninsured Georgia adults making just more than poverty-level wages (up to 138% FPL, $17,296 for an individual and $29,435 for a family of three).
The Affordable Care Act envisioned that these citizens living close to the poverty line, would be covered by Medicaid and the law provides states with an incentive in which states pay only 10% of the costs of the newly-eligible adults and the federal government picks up the rest. If Georgia’s leaders approve SB 106 in its current form and leave out the people close to the poverty line, our state will miss out on the ACA’s “enhanced match rate” and will likely end up paying more money to cover far fewer people. 
The second part of SB 106 allows Georgia to submit a 1332 State Innovation waiver, an option created by the ACA to allow states to test different approaches for providing primarily private health insurance to their residents. At the same time, the law established “guardrails,” which set specific parameters to protect citizens. Unfortunately, these guardrails (protections) have been greatly weakened in recent months leaving consumers at risk.[i]
So far, all eight states with approved 1332 waivers have carried out plans that benefit consumers—and Georgia could too. However, the broad language in SB 106 allows for proposals that could also create sizeable and risky changes that put Georgians at risk for harm. For example, Georgia might allow citizens to use their subsidies to purchase junk insurance plans. This would likely draw healthy consumers out of the ACA Marketplace to cheaper, low quality plans and thereby send insurance premiums into an upward spiral for consumers with pre-existing conditions in need of comprehensive coverage.
Georgia’s legislators could narrow the scope of an allowable 1332 waiver by specifying that the waiver must be used for a specific beneficial reason, like establishing a reinsurance system to lower insurance premiums, or by laying out a set of principles that the waiver must meet to ensure Georgia consumers are fully protected.
Georgia’s leaders have taken an encouraging step forward by putting forth a proposal that aims to increase access to care and address affordability concerns for Georgia families. A few small, meaningful changes to the bill would assure a path to affordable, quality health coverage for all Georgians.
[i] Tim Jost, The Commonwealth Fund, Using the 1332 State Waiver Program to Undermine the Affordable Care Act State by State,

Bills to Watch: Click here!

How does a bill become a law?

Other Days of Note:

  • Mar. 13 - The Arc Georgia Day at the Capitol!
  • Mar. 19 - Independent Living Day!

Tags: GCDD, Advocacy, public policy