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DOUG HOLT: House debate focuses on ACA, medical marijuana

The Georgia General Assembly began last week at a fast pace, since Monday was what we call crossover day. Crossover day is the 30th day of our 40-day annual legislative session. More importantly, it is the last day that you can move a bill out of one chamber of the Legislature and still have the opportunity to try and move it in the other chamber. In the House, we considered 64 bills and resolutions during the week, with 52 of those being on crossover day itself. I’ll cover the three, by far, most interesting measures.

HB 707 seeks to assert Georgia’s state rights in the face of the federal Affordable Care Act (also known as the ACA or Obamacare). Under this bill, Georgia state policy would resist implementation of the ACA in several ways. First, it would more formally cement our opt-out of the ACA provisions calling for creation and operation of a health insurance exchange website. Second, it would bar any state or local government officer or employee, on government time or using government resources, from advocating for the expansion of Medicaid. Thirdly, it would prohibit any arm of the state or a local government from operating what are called “navigator” programs to encourage or assist people to enroll in the ACA. Finally, it would prohibit Georgia’s insurance commissioner from investigating, enforcing, or adjudicating health insurance provisions and claims arising from participation in the ACA. This last item is meant to forestall what is called “commandeering” of an arm of a state by the federal government. Needless to say, the bill saw a long debate, though one that was far more focused on support or opposition to the ACA than on the bill itself. The question of whether the state can resist in this fashion is a moot point, since such a division of powers is a key component of the dual federal/state sovereignty system enshrined in the U.S. Constitution. I’ve never been a fan of the ACA, so my support for the bill was a given. It passed by a very party line 115 to 59.

HB 885 is the medical marijuana bill that has received a lot of attention in the press. It seeks to reactivate Georgia’s program allowing research into medical uses of the plant, which has been on the books since the early 1980s. It would slightly expand the program by adding seizure disorders to its list of allowable illnesses for treatment. The author introduced the bill because recent research has indicated that an extract from the plant, called cannabidiol, can be effective in treating severe seizure disorders. That extract is actually not the chemical in marijuana that illegal users are interested in THC, and in fact is best produced by a variety of the plant that generates minimal amounts of THC. The author is specifically interested in making another option available for small children whose seizure disorders are so severe that they suffer dozens or even hundreds of seizures a day. Still, while this bill would begin the process of making the option available in Georgia, there are difficulties with federal regulation that will have to be resolved before any treatment can occur. In other words, this is not an immediate solution. Nonetheless, there was significant agreement among House members that a carefully controlled reactivation of the program should be pursued. I supported the bill, and it passed by 171 to 4.

HB 990 is another bill aimed at concerns created by the ACA. You may recall that, as originally passed by Congress, the ACA would have mandated expansion of Medicaid by the states. However, in its review of the act during 2012, the U.S. Supreme Court ruled that Congress did not have the power to do so. Thus, the choice was up to each state. In Georgia, under our current law, the decision to expand is in the hands of the governor. This is actually an odd situation, in that we have a major spending policy decision in the hands of the executive, rather than with the Legislature. Most other states have legislative control. For Georgia, expansion would carry a price tag of hundreds of millions of dollars per year, and would force major financial changes on the state — in other words, new taxes, serious cuts to existing programs, or more likely, both. These are decisions that should absolutely be legislative in nature. Thus HB 990 seeks to put our decision process more in line with that of other states, and would change the law to require explicit legislative approval for Medicaid expansion. This bill saw another debate like that on HB 707, and was passed by a similar 118 to 57, including my “yes.”

Contact Doug Holt by calling his office at 404-656-0152 or emailing Doug@DougHolt.org.