The legislative session is barely a few weeks old, but what promised to be the dominant issue is already on its way to Gov. Nathan Deal’s desk.
The House of Representatives on Friday gave final passage to Deal’s compromise plan that lets the state avoid losing $450 million in federal health care support without legislators having to vote explicitly on whether to extend an existing tax on the hospital industry.
Under Senate Bill 24, which Deal may sign in the coming weeks, a board of the governor’s appointees will decide what assessment hospitals will pay to help fund Medicaid rather than pay a tax set explicitly by the General Assembly.
Capitol players and citizens alike could be forgiven if they think the new the new plan is just a “tax” by another name.
The issue is the so-called “bed tax,” which is actually a 1.45 percent tax on Georgia hospitals’ net patient revenue. Created in 2010 to shore up the Medicaid insurance program, the tax yields about $230 million that is used as state match money to grab another $450 million or so in federal money. All of it is routed back into payments to providers who treat Medicaid recipients.
But that tax expires at the end of the current fiscal year, threatening to blow an even bigger hole than already exists in the $8 billion-plus Medicaid program.
Lawmakers didn’t want to inflict that kind of pain on Georgia hospitals, physicians and patients. However, many legislators — particularly Republicans — also didn’t want to hand potential opponents any leverage. The fear was all the more acute since anti-government activists and national GOP powerbroker Grover Norquist urged Georgia’s elected officials to abandon the tax.
So, Deal came to the rescue with his compromise and lawmakers say they didn’t pass any sort of tax. It’s a “provider fee.” And — they note — it’s the same kind of arrangement that Georgia nursing homes have used for years, ponying up a little of their own money and parlaying that into a federal bounty that’s plowed back into nursing home coffers.
Whatever you call it, the quick vote is a victory for Deal.
ODDS AND ENDS:
House Speaker David Ralston unveiled his proposed overhaul of lobbying rules this week. And to some surprise, the immediate flashpoint had nothing to do with whether to set a cap on lobbyist spending on elected officials or impose an outright ban. The question was how widely to define lobbyist.
Many unpaid activists, including several tea party organizers, bristled at Ralston’s initial draft, which would have included such individuals on the list of lobbyists who have to register, pay a fee and disclose their spending. Ralston and legislative leaders say they have no intention of putting a financial barrier in front of people who describe themselves as “citizen lobbyists.”
A shooting at an Atlanta middle school prompted several Democrats from the metro area to ratchet up their calls for tighter background checks and new limits on military-style weapons and high-capacity clips. But Republican majority leaders say the incident, in which one teenager injured another, will not make the General Assembly willing to tighten rules for gun access and possession.
“We are your landlords. How dare you put a sign that says ‘closed’ on the people’s house.” — Atlanta tea party activist Debbie Dooley on the idea of requiring lobbyists, including unpaid citizens, to pay a fee.
The House and Senate will resume their floor sessions next week. With the biggest piece of the Medicaid financing puzzle solved, the focus will now shift to the rest of the state spending plan, which still includes a Medicaid shortfall of several hundred million dollars.