Georgia lawmakers launch into the 2020 General Assembly on Monday, Jan. 13. In speaking with The Times, Hall County lawmakers gave a long list of topics that may come up during the 40-day session, with budget cuts possibly highlighting action. 

We’ve whittled down the list to a few issues worth watching.

Health care

Rep. Lee Hawkins, R-Gainesville, said “the cost of drugs has just skyrocketed,” an issue he hopes to address by regulating pharmacy benefit managers who contract with insurance companies to handle their prescription drug plans.

“They make deals with the drug manufacturers with rebates, with employer groups. We’ve uncovered quite a bit of shenanigans going on,” Hawkins said. “Patients are being charged enormous amounts for a drug that doesn’t cost near what they’re having to pay. That money is being backpedaled to the PBM companies.”

Patients should be able to benefit from rebates on prescriptions, just like a consumer may be able to get a rebate on a car they buy, he said.

“If there’s a rebate going on with the drug, the patient needs to get the rebate,” Hawkins said. “They bought the insurance, they’re the ones that the medicine is for, they need it and they should not be left out in the cold paying large sums of money.”

Legislation could outline an arbitration process for addressing the issue, Hawkins said.

Rep. Emory Dunahoo, R-Gillsville, outlined some other health care issues that he thinks will come up. He sees the mortality rate of mothers at childbirth, rural health care, mental health care and Medicaid expansion as possible issues in the legislature.

Gov. Brian Kemp has submitted waiver requests to the federal government addressing health insurance access and Medicaid changes.

Kemp is proposing that uninsured adults in Georgia who make no more than the federal poverty level would qualify for Medicaid assistance if they spent at least 80 hours a month working, volunteering, training or studying. They would also have to pay monthly premiums.

Public hearings held late in 2019 by Lt. Gov. Geoff Duncan’s Task Force on Healthcare Access and Cost may produce “meaningful legislation,” Duncan told The Times.

The group looked at price transparency, data and technology use, and employer opportunities in aiming to “pinpoint improvements that can be made to tackle the cost and access burdens to health care across Georgia,” Duncan said.

One key issue is “balance billing” or “surprise billing,” when patients get a bill from a provider who turns out to be out of network with their insurance company — such as one who performed part of a procedure at a hospital.

“If you go to have a medical procedure done, you have no idea how much that’s going to cost until you get home and wait a few weeks to go to the mailbox,” Duncan said.

Hawkins said he also hopes to address surprise billing.

“We have too many patients out there who hear six or nine months after treatment that they owe a pretty large amount of money,” he said. “... They’re paying for the insurance, and they’re not getting taken care of.”

Mental health issues also need to be examined, especially in light of the closure of regional hospitals in recent years, Hawkins said.

“You can’t fill a hospital up with the mentally ill and then have nowhere to move them,” Hawkins said. “A lot of these folks, especially young folks … are sitting in jail cells. I’m really sensitive to that.”

Housing

House Bill 302, which would prohibit local governments from adopting or enforcing regulations on building design elements on single-family homes or duplexes, never passed during last year’s legislative session.

But the issue could return this year. Sen. John Wilkinson, R-Toccoa, who introduced the Senate version, said extra restrictions on building standards drive up housing prices.

“There were counties in Georgia where people who had been building nice, $300,000 homes, after they were told they couldn’t put their home on a concrete pad foundation, they were told they had to have a crawl space and what kind of exterior materials they were allowed to use and those kinds of things,” Wilkinson said. “It was increasing the cost from $300,000 to $500,000. … School teachers and firefighters and police officers can’t go to the bank and get a half a million dollar loan. To me, it’s an affordable housing issue.”

Those who write the International Building Code are knowledgeable about building standards, Wilkinson said, and other entities such as homeowners associations can set the standards for their areas.

“If you meet the building code and the zoning regulations and the homeowners association regulations, the cities and counties should not make it more restrictive,” Wilkinson said. “... If you set the minimum housing standard so you can’t buy a house unless it’s $500,000, you’re going to exclude a lot of people.”

Several local governments, including Flowery Branch, Oakwood and Lula, opposed the bill last year.

Rep. Matt Dubnik, R-Gainesville, said that after some of the negative reaction to the bill, legislators will likely move on to other topics this year.

“I’m just not sure that that’s the type of issue there’s going to be much of an appetite for in this type of legislative session,” he said.

Business

Dubnik, R-Gainesville, said he hopes legislators can make Georgia more business-friendly by reaching out to small business owners and prospective business owners.

“I think we need to continue to make it easier on small businesses. We need to cut regulation and red tape,” Dubnik said. “At the end of the day, if somebody has an idea and they want to go start a business. ... how can we help?”

Small business outreach has also been a priority for Kemp, who has established the Georgians First Commission, a group of business owners studying possible reform.

Dubnik said that while Georgia has been able to attract many large companies, small businesses, particularly in technology, are also needed.

“Lt. Gov. (Geoff) Duncan has said he has this vision for us to be the Silicon Valley of the east and really the leader of technology. Let’s bring in the tech industry more than we have and continue to grow the top-size businesses, the large businesses, and that will create jobs and support small and mid-size businesses,” Dubnik said. 

Gambling, sports betting

The key gambling components are casinos, horse racing and sports betting, and “I think we’ll see any number of bills related to those this year,” Rep. Timothy Barr, R-Lawrenceville, said.

Georgians already participate in sports betting, “even though the state doesn’t sanction it,” Barr said. “It’s very easy to do that online.”

Legislation pushing a constitutional amendment expanding gambling in the state — requiring voter approval — isn’t new to Georgia, rising and falling every session.

Lake Lanier was part of the conversation in 2011, when a Savannah lawmaker sought to allow video casinos in areas that already draw tourists, with proceeds helping the state’s then-struggling Hope scholarship.

“The current bill that has been floated has several different regions in the state … in a bidding process to get a casino,” Barr said.

Dunahoo said he believes the fate of such legislation is “going to depend on what the speaker (David Ralston) allows on this.”

The issue would move forward if Ralston “gets behind it and says he’s going to let the House and Senate fight this out — which he should — and let committees present why they feel they should have it.”

Ultimately, legislators may call for a statewide referendum on whether to allow gambling and horse racing.

“I’m not for that, so I don’t support it,” Dunahoo said.

Foster care/adoption

Last year’s “Heartbeat Bill” may have a sequel — though likely not nearly as controversial.

“There’s quite a few of us who have said that now that we have protected life, we need to make it easier for folks to adopt ... so it’s not as expensive,” Barr said.

Kemp signed legislation last year banning abortions once a fetal heartbeat can be detected. That can be as early as six weeks, before many women know they're pregnant. In October, a federal judge temporarily blocked the law from taking effect Jan. 1.

“A lot of folks, even in my church, go overseas (to adopt) because it’s cheaper and the process is simpler,” Barr said. “We need to work on that in Georgia.”

The process may involve looking at foster parenting, which can serve as a doorway to adoptions.

“They are definitely connected,” Barr said. “I have had multiple conversations looking at ways to bring down possible barriers to becoming foster parents. Those may not be specifically pieces of legislation but perhaps rule changes. All the options are on the table.”

Compiled by staff writers Jeff Gill and Megan Reed.