Georgia Senate to revisit certificate of need law

ATLANTA – The state Senate was where the action was in the General Assembly this year either to reform or repeal Georgia’s decades-old certificate of need law (CON) governing hospitals and health-care services.

Heading into the summer, there’s every indication Republican senators will continue aggressively pursuing their push to overhaul CON or scrap it entirely. A newly created Senate study committee of senators, health-care executives and an insurance industry representative will begin meeting June 13 to look for ways to at least reform the law.

The Senate Study Committee on Certificate of Need Reform is poised to start its work earlier than most legislative study committees, which typically don’t start meeting until well into the summer.

“It definitely shows the importance of the issue, especially to the Senate,” said Chris Denson, director of policy and research for the Georgia Public Policy Foundation, a think tank that advocates free-market approaches to public-policy issues.

Georgia’s CON law requires applicants wishing to build a new medical facility or provide a new health-care service to demonstrate to the state Department of Community Health that the facility or service is needed in that community.

The General Assembly passed the law in 1979 to comply with a federal mandate aimed at reducing health-care costs by avoiding duplication, only to see Congress repeal the federal statute in 1986. By 1990, 11 states – including California and Texas – had done away with their state CON laws.

This year’s push to reform or abolish CON in Georgia came primarily through two bills introduced by Senate Republicans. Senate Bill 99 called for exempting most rural hospitals from the law, while Senate Bill 162 would have repealed CON entirely except for long-term care facilities.

South Carolina lawmakers abolished the Palmetto State’s CON law this year, also with the exception of long-term care facilities.

Senate Bill 99 passed the Senate 42-13, including the votes of nine Democrats, but died in the Georgia House of Representatives. The repeal bill cleared the Senate Regulated Industries and Utilities Committee but failed to reach the Senate floor for a vote.

Denson’s group favors repealing CON. He and Matthew Mitchell, a researcher at West Virginia University, released a report in April that points to barriers to health-care access CON laws impose and questions the argument that getting rid of the law would result in a wave of hospital closures.

“The fears of the widespread closure of safety net hospitals is overblown,” Denson said. “There’s no correlation between CON laws and rural hospital closures.”

Monty Veazey, president and CEO of the Georgia Alliance of Community Hospitals, said making it easier to build new hospitals and ambulatory-surgery centers by abolishing the CON law would not improve access to health care in rural communities as supporters of repeal argue.

“These hospitals are not going to be built in rural areas,” Veazey said. “They’re going to be built in zip codes where the money is. … It’s all about the money.”

The Senate study committee is dominated by Republicans – including Sens. Greg Dolezal of Cumming, who will chair the panel; Kay Kirkpatrick of Marietta; Matt Brass of Newnan; Bill Cowsert of Athens; and Ben Watson of Savannah. Democrats on the committee includes Sens. Freddie Powell Sims of Dawson and Ed Harbison of Columbus.

Non-legislators on the panel include Jack Hughston Memorial Hospital CEO Mark Baker to represent for-profit health systems, Memorial Health Meadows Hospital CEO Matt Hasbrouck to represent rural hospitals, Christine Macewen of Piedmont Health Care to represent nonprofit health systems, Georgia Association of Health Plans CEO Jesse Weathington to represent the insurance industry, and independent physician Dr. Stephen Wertheim.

Meanwhile, the House also is expected to weigh in on CON this summer and fall.

House lawmakers voted on the last day of this year’s legislative session to create a study committee on CON. Its members have yet to be appointed.

Georgia senators vote in favor of debt limit deal

ATLANTA – Both of Georgia’s U.S. senators put aside their concerns over how the debt limit agreement reached by President Joe Biden and House Speaker Kevin McCarthy would affect spending on federal programs to vote for the deal.

Democrats Jon Ossoff and Raphael Warnock joined 61 of their colleagues from both sides of the aisle Thursday night to give the legislation final passage. Thirty-six senators opposed the agreement, including five Democrats.

The U.S. House of Representatives passed the bill on Wednesday, with Georgia’s House delegation voting 10-4 in favor of the deal. Six of the Peach State’s nine House Republicans supported the legislation, as did four of the five Democrats.

The legislation will raise the nation’s debt limit for the next two years in exchange for spending caps pushed by congressional Republicans. GOP lawmakers who voted against the bill argued the spending cuts didn’t go far enough, while Democratic opponents maintained the reductions were too steep.

‚ÄúToday, the Congress acted to prevent a catastrophic default, which would have plunged the U.S. and global economies into recession and severely damaged families and businesses in Georgia, across the country, and around the world,” Ossoff said after Thursday night’s vote.

“It’s shameful that partisan actors and their political brinksmanship needlessly pushed us toward a potential default in the first place, using poor people as pawns,” Warnock added. “I’m glad that cooler heads prevailed and crafted a bipartisan bill that will allow us to pay our bills and avoid a default, while also preserving important investments that help hardworking Georgia families and keep our economy strong.”

Congressional passage of the debt limit deal heads off a June 5 deadline for the nation to start making good on its debts or go into default for the first time in U.S. history.

ATL board OKs contract for planning Top End transit

ATLANTA – The board of Atlanta’s regional transit agency gave the go-ahead Thursday to a contract with an engineering consultant to design the addition of mass transit to the Top End of Interstate 285.

CDM Smith of Sandy Springs will incorporate high-capacity bus-rapid transit (BRT) service into a project that will add two barrier-separated toll lanes in each direction along 35 miles of I-285 from its interchange with I-20 west of Atlanta all the way around to the I-285/I-20 interchange east of the city. The project is aimed at providing more reliable trip times for all vehicles, including BRT buses.

The $6.7 million planning and design contract – not to exceed $7.5 million – was put together by a consortium including Fulton, Cobb, Gwinnett and DeKalb counties, eight cities along the route, the Atlanta-Region Transit Link Authority (ATL), the Georgia Department of Transportation, and MARTA.

“This is a very significant effort and a truly regional approach,” Cain Williamson, the ATL’s chief planning officer, told ATL board members before Thursday’s vote.

“It’s a historic demonstration of partnership in the region,” added Georgia Commissioner of Transportation Russell McMurry. “It’s a holistic look at transportation.”

The contract with CDM Smith, which the MARTA board already has approved, will run for two years with two one-year extension options.

The scope of the consultant’s work will include exploring location options for BRT stations, conceptual station designs and station area planning, environmental impact, cost estimates, and an analysis of potential funding sources.

Debt limit bill draws bipartisan support, opposition from Georgia lawmakers

ATLANTA – Georgia’s U.S. House delegation did not split along the usual party lines over controversial legislation raising the federal debt limit.

Ten House members from Georgia – including six of the delegation’s 10 Republicans – voted Wednesday night in favor of an agreement hammered out by President Joe Biden and GOP House Speaker Kevin McCarthy to increase the debt limit for an additional two years in exchange for cuts in federal spending.

On the other hand, Democratic Rep. Nikema Williams of Atlanta bucked House Democratic leadership and the White House by voting against the bill, joining three Georgia Republicans in voting “no.”

The House vote came as the nation faced a deadline of June 5 for raising the debt limit to avoid the U.S. government going into default for the first time in the nation’s history, an event economists warned would trigger a recession.

To reach a deal with McCarthy, Biden agreed to keep non-defense spending relatively flat during the next fiscal year and increase it by just 1% in fiscal 2025.

“House Republicans held the American people hostage so they could inflict cruel cuts,” Williams said following the vote. “I could not vote for an agreement that puts my constituents on the chopping block.”

But Democratic Reps. Hank Johnson of Stone Mountain, Sanford Bishop of Albany, David Scott of Atlanta, and Lucy McBath of Marietta voted for the deal.

“I congratulate [the president] for a shrewdly negotiated debt ceiling bill that protects our economy, protects against MAGA hostage taking for two years, and protects Americans from cruel MAGA social safety net cuts,” Johnson said.

On the other side of the aisle, Rep. Marjorie Taylor Greene, R-Rome, went against many of her conservative Republican colleagues and sided with McCarthy in voting for the bill.

“I agree with my conservative friends on some of the flaws in the FRA (Fiscal Responsibility Act), and I’ve never wanted to raise the debt ceiling on debt that I never voted to create,” she said. “But I came to Washington to make changes, and this bill actually provides a tool that gives us a chance to make those fiscal changes.”

Georgia Republicans joining Greene in voting for the legislation included Reps. Austin Scott of Tifton, Buddy Carter of Savannah, Barry Loudermilk of Cassville, Rick Allen of Augusta, and Drew Ferguson of West Point.

Republicans Andrew Clyde of Athens, Mike Collins of Jackson, and Rich McCormick of Suwanee voted against the legislation.

“At best, the ‘Fiscal Responsibility Act’ … is a modest attempt to address the skyrocketing national debt Congress has ignored for far too long,” McCormick said. “Republicans had the ability to tackle this problem years ago when we had the White House and commanding majorities in Congress.”

The bill, which cleared the House 314-117, now moves to the U.S. Senate for a vote later this week.

Georgia Supreme Court rejects licensing for lactation care

The Nathan Deal Judicial Center in downtown Atlanta (Photo by Beau Evans)

ATLANTA – A state law requiring lactation care providers to obtain a license is unconstitutional, the Georgia Supreme Court ruled unanimously Wednesday.

The case goes back to 2016, when the General Assembly passed legislation requiring a state license to offer lactation care and limiting licenses to businesses that obtain a privately issued certification as an International Board Certified Lactation Consultant (IBCLC).

Certified lactation consultant Mary Jackson of Fulton County and a nonprofit organization known as Reaching Our Sisters Everywhere sued the Georgia secretary of state’s office, claiming the law violated their rights to due process and equal protection because it would require them to cease practicing their chosen profession.

The suit also maintained the law lacked any substantive connection to public health or safety and that there was no evidence to show non-IBCLC lactation care providers had ever harmed the public.

In Wednesday’s ruling, Chief Justice Michael Boggs reversed the trial court’s decision, which had been in favor of the state, and found in favor of the plaintiffs.

“Not every burden on the ability to pursue a lawful occupation will be unconstitutional,” Boggs wrote. “Sometimes, a regulation will be ‘rational’ in the sense that it is reasonably necessary. … But if the challenger can establish that a regulation imposing restrictions on a lawful occupation does not advance the articulated public purpose by means that are reasonably necessary for that purpose, then the regulation cannot stand.”

While Secretary of State Brad Raffensperger technically lost the case as the head of the agency that was sued, he praised the ruling Wednesday. Raffensperger said he voted against the 2016 legislation while serving as a Republican member of the Georgia House of Representatives.

Raffensperger argued that prohibiting consultants from providing lactation care without going through the process of obtaining a license may actually cause “a greater risk of harm because the majority of lactation consultant providers would no longer be able to provide care.”

Raffensperger recently formed a commission to undertake a comprehensive review of the professions that require a license in Georgia and whether licensing is necessary for that line of work.