Budget hearings dominated last week, as each Department appealed to the Joint Appropriations Committee for the budget increases they need. In the week two wrap up video, I dive into the budget, plus touch on plans to close the coverage gap (don’t call it Medicaid expansion!). Video at: https://youtu.be/DWVOmFGp8Cw
Links:
Medicaid in Georgia (fact sheet from the Kaiser Family Foundation)
Georgia Budget and Policy Institute’s budget overview
Video clip of Marissa Dodson from the Southern Center for Human Rights
Transcript:
Hello there.
This is my week two update from state policy land.
Technically the legislature was *not* in session last week — meaning the House and Senate didn’t complete any business from the floors of their respective chambers… They didn’t pass any bills, or make any speeches, or recognize any little league teams. We did not technically observe a single day of the 40 day long legislative session.
Instead, we had budget hearings.
They haven’t VOTED on these budgets yet, so everything is just a proposal at the moment.
I want to talk about a few interesting things from these budgets. But mostly I will leave it organizations like the Georgia Budget and Policy Institute to provide a good overall analysis of Kemp’s budget proposals. I’ll make sure to post a link.
Just to clarify: July 1st marks the beginning of a new budget cycle in this state. So, when legislators gather in January, they update the current budget — this is called the little budget or the amended fiscal year 2019 budget — and then pass a new budget for the upcoming fiscal year. This is called the big budget or the fiscal year 2020 budget.
The $3,000 pay raises for teachers and 2% pay increase for state employees that Kemp spoke about during his State of the State address is going to cost Georgia almost 630 Million Dollars.
Let me take a moment to go back to September of 2016, when then-Governor Nathan Deal proposed a whopping 20% pay increase for state law enforcement officers. This was about an $8,000 pay raise per person, however it was for a much, much smaller pool of workers, so it did cost less overall.
This announcement was made out of sync with the budget cycle, so I still want to to know why this group of state employees suddenly got such a sweet deal. If any state troopers out there want to share what was happening behind the scenes, I’d love to hear it.
Anyway, back to present day.
630 million dollars is less than 2.5% of the 2020 state budget.
Yes, less than 2 and a half percent.
And that’s only of the money the state kicks in.
The state budget for the upcoming 2020 fiscal year — which will start July 1st — is 27 and a half Billion Dollars.
We’ll get about the same amount from the federal government; possibly more if Georgia expands Medicaid.
A lot of the federal dollars Georgia will get are from policies and programs that guarantee the federal government will match what the state government puts in or provides some kind of guaranteed baseline for important expenditures like public education and healthcare. Transportation — that is bridges, roads, ports, etc — is another big area where our state relies on the federal government.
For context: Georgia’s budget — the part we pay for ourselves — is like a third of a Bill Gates. A little less, but about a third.
So that’s what the state is working with as it maps out where to prioritize spending.
I want to just touch on some other notable numbers:
The Department of Human Services is asking for not even a million and half dollars to add case workers to their elder abuse investigation and prevention program.
This is such a teeny tiny percent of the state budget, and the commissioner of DHS shared that this will have a big impact on the case worker to client ratio …although Georgia will still have case workers with a larger case load than is recommended. But, it’s a step in the right direction, as are the pay increases for state employees.
Kemp is also proposing a 4.2% increase in funds for adoption services, with an emphasis on children with high needs.
Some other random facts from the past week:
Georgia currently has about 8,000 people serving life sentences in our prisons.
Let me pause and repeat that: 8,000 people.
Criminal justice reform legislation passed under former Governor Nathan Deal is credited with substantially reducing the number of people incarcerated by the state.
But, according to data presented by the Department of Corrections, that number has been steadily rising since the beginning of 2016. We’re less than 1,500 people away from returning to pre — criminal justice reform numbers.
I want to take a moment to appreciate Marissa Dodson from the Southern Center for Human Rights. I was able to hear her speak at two different panels last week.
She talked about how the introduction of accountability courts — things like drugs courts — have diverted people away from being incarcerated and have reduced recidivism rates by almost 20% among folks that participate… but, she also explained there’s a need to intervene sooner.
Dodson spoke about the need to divert people before they even come into contact with the criminal justice system.
She said:
“We know that cages don’t work. We know that probation and community interventions are better. But what would even be a more compassionate and fiscally conservative approach would be to help folks access treatment in their community, without having to encounter a police officer, a prosecutor, or a judge.”
Kemp has spoken about continuing the criminal justice reform legacy of Nathan Deal. These next few years will show if we actually see increased investment in pre-arrest diversion programs and a decrease in the number of people this state locks up.
On the Healthcare front, you’ve likely heard there is going to be a bill proposed and perhaps even passed this legislative session to address the healthcare coverage gap.
These are mostly adults who do not qualify for subsidies under Obamacare — aka the Affordable Care Act — because they make too little money, but also do not qualify for Medicaid.
Medicaid is only for certain populations — like very, very, very low income parents; some folks with disabilities; pregnant people; and folks with breast or cervical cancer.
Kemp is proposing one million dollars to go towards investigating some kind of coverage gap solution — although he’s been very clear that it will not be medicaid expansion.
This is a bit of semantics and a bit not.
The state is going to pursue what’s called an 1115 Medicaid Waiver.
Actual, legit Medicaid Expansion would only cost the state 200 million dollars. That’s less than one percent of the state budget. The economic argument for Medicaid Expansion — including the positive impacts it would have on rural hospitals — has already been made.
But, state Republicans had to thumb their noses at Washington when Barack Obama was president… so they’ve backed themselves into a corner.
Going the waiver route not only allows Kemp and the party in power to message this as, “The Most Amazing State Healthcare Innovation Plan and For Realsies Not Medicaid Expansion….Act.” Or whatever the hell they want to call it.
It also means they can tweak the rules in ways that have plenty of healthcare advocates worried.
Lawmakers could use the 1115 Waiver to re-do the entire Medicaid system. This would be a heavy lift, politically speaking, so is not the most likely outcome. But it still is a possibility.
Alternately, the 1115 Waiver could be used just to expand very basic healthcare access to folks in the coverage gap right now. I’m going to post a link to a good break down of how these waivers work and what kinds of options they make possible.
Side note: the folks in the coverage gap only make up a fraction of the uninsured. There are over 1.1 million uninsured Georgians. Of this group, about 240,000 fall into the coverage gap according to the Kaiser Family Foundation.
The waiver method gives legislators a lot of leeway to add in extra provisions, like: Work requirements, Lifetime caps, or Lock out periods.
Some advocates are concerned about how meaningful the access to healthcare will be under an 1115 waiver program. For instance, the legislature could insert a complicated co-pay system, make cuts to prescription benefits, or otherwise make whatever this healthcare solution is hard to access or keep.
Once a policy has actually been introduced, different advocacy groups will be able to weigh in on the actual impacts they expect it to have. Until then, there is a very strong “wait and see” approach from advocates… coupled with plenty of closed door conversations with lawmakers to try and back folks away from the most harmful possibilities.
That’s all I have for you for the last week. I’ll be diving back into session today, so expect plenty of tweeting and regular updates during the week.
Until next time…
