Rep. Terry Rogers (R-Clarkesville) enters the House Chamber with Gov. Kemp (far right, in red tie) before the governor’s State of the State speech on Jan. 16, 2020. (Photo: Georgia Recorder)
Gov. Brian Kemp pushed for a legislative remedy for the problem of surprise medical billing in his Thursday address to Georgia lawmakers.
Kemp, a Republican, also touted his waiver proposals, passed last year by the General Assembly, as solutions to lower health care costs and add a pathway for uninsured Georgians to access medical services.
The governor said he would establish a professorship for Parkinson’s disease research at the University of Georgia, in honor of recently retired U.S. Sen. Johnny Isakson. The Marietta Republican, who has the disease and stepped down early because of its effects, attended Kemp’s State of the State address at the Georgia Capitol.
In his speech, Kemp did not mention the state budget cuts that are looming over the General Assembly session, which began this week. Those reductions are expected to hit some health programs, notably at the Department of Behavioral Health and Developmental Disabilities.
The governor did address surprise billing. It has been an annual tug-of-war issue at the state Capitol, pitting reform proposals favored by physicians against those supported by insurers.
Consumers sometimes get unforeseen bills after they have medical procedures or visit ERs at hospitals in their insurance network. These bills come from non-network doctors involved in their care, such as ER physicians, anesthesiologists and radiologists, among others. Such surprise bills can amount to hundreds or even thousands of dollars, and consumers often feel misled and blindsided when they arrive.
“We have hardworking Georgians who by no fault of their own are on the brink of bankruptcy because there’s no transparency in health care billing,’’ Kemp said. “Families are living on a prayer because the system is rigged against them.’’
“Working with patients, providers and the private sector, we’ll craft legislative remedies to reduce surprise medical billing.’’
A newly introduced Senate bill would set up a system whereby a non-network medical provider would be paid by an insurer based on that health plan’s average contracted prices. The goal would be to remove the patient from the payment equation, said state Sen. Ben Watson (R-Savannah), chairman of the Senate Health and Human Services Committee.
Under this legislation, if the insurer and the doctor could not agree on a price, they would submit their payment proposals to an arbitrator, who would pick one of the amounts to resolve the matter.
Democratic Sen. Steve Henson of Stone Mountain, the chamber’s minority leader, said Thursday that solving the surprise billing issue “is a priority for all of us.’’
Democrats criticize waiver plan
The Kemp waiver plans, which have been sent to the feds for approval, include adding uninsured Georgians to Medicaid provided they meet new eligibility requirements. The other proposal involves changes to the health insurance exchange for individual and family coverage.
These ideas “shake up the status quo and put patients first, ahead of the special interests,’’ Kemp told the lawmakers.
Democrats have argued that expanding Medicaid under the Affordable Care Act — sometimes called full expansion or standard expansion — would cover many more Georgians for about the same cost. Full expansion gets 90 percent funding from the federal government, while the Kemp plan is expected to get just a 70 percent federal match.
A group of Democratic senators, responding to the Kemp address, called for full expansion, though it has been rejected as too costly by Kemp, his predecessor Nathan Deal and GOP legislators who control the General Assembly.
Sen. Harold Jones (D-Augusta) noted that Georgia lags behind other states on many health measures. “The answer was full Medicaid expansion,’’ he said.
Kemp focused a substantial part of his State of the State address on the service of Isakson, both in the state Legislature and then in Congress.
“Right now, over 20,000 Georgians are living with Parkinson’s disease – with new patients diagnosed every single day,’’ Kemp said. “While treatable, Parkinson’s disease has no cure. I don’t know about you all, but I want to change that.’’
“Through this partnership, we will use technology and innovation to break new ground. With the grit and resolve of Johnny Isakson, we will move one step closer to a cure.’’
