Medicaid expansion? Nah. Get ready first for a fight over a Georgia ‘bed tax’

Senator President pro tem David Shafer, R-Buford, in a 2015 file photo. Bob Andres,

Credit: Jim Galloway

Credit: Jim Galloway

Senator President pro tem David Shafer, R-Buford, in a 2015 file photo. Bob Andres,

Georgia lawmakers are readying for an early debate over whether to extend a tax that would leave a gaping hole in the state Medicaid system's budget if they don't renew it.

Donald Trump’s election – and his vows to gut Obamacare – have sidelined talk about a Medicaid expansion under the imperiled Affordable Care Act. Most lawmakers talk of a wait-and-see approach toward health policy after Trump’s election.

But legislative leaders say there’s a consensus brewing to quickly take on a vote in next year's legislative session over a fee on hospitals, known as the “bed tax,” designed to leverage more federal Medicaid funding. That’s what happened in 2013, when Georgia lawmakers dispatched with the vote in the opening weeks of the session.

“The first issue we have to confront is the renewal of the hospital provider fee,” said David Shafer, the Senate president pro tem, at a Gwinnett Chamber of Commerce event on Friday. “It’s critical that it be renewed because we don’t have a plan to replace the loss. But it’s going to be a challenge getting everyone together.”

The 2013 vote averted a roughly $700 million hole in the state’s healthcare budget, and it passed despite being labeled by critics as an onerous tax hike. But the fallout from November, and the aftershocks of a frustrated electorate, could complicate next year's debate.

House Minority Leader Stacey Abrams, also speaking at the event, said reauthorizing the fee is also a top priority. Her caucus hasn’t taken a position, but she said she’s hopeful it can be voted upon quickly – and that it could fit in with a broader debate about healthcare policy and the plight of rural hospitals.

“I’m not going to use the M-E word – Medicaid expansion – but we have to have a conversation about what we’re going to do about rural healthcare,” said Abrams. “We cannot as a state entice jobs to come to Georgia if we can’t provide healthcare.”

Some other tidbits from the event:

- Shafer said there will be a push to give other counties – and possibly the state Legislature – more say in MARTA’s governance. He expressed confidence in both Atlanta Mayor Kasim Reed and MARTA head Keith Parker. But he said as the transit agency expands, its oversight needs to be “regional in scope.”

- The Gwinnett Republican also said he favors moving “crossover day” – the final day for a bill to move from one chamber to the other – earlier in the session. It’s now the 30th day in the 40-day session, but he said he wants to boost it to day 25.

- He made no mention of the contentious fight over the “religious liberty” bill during his comments and declined to discuss the matter after his remarks.