Senate passes modified certificate of need reform, setting up expanded rural Georgia health access

ATLANTA — Georgia Lt. Gov. Burt Jones announced a House effort to reform some Georgia healthcare regulations had passed the state senate, with modifications, setting up a bid to expand access to healthcare in rural parts of the state.

The legislation, House Bill 1339, is aimed at addressing changes to what’s known as a certificate of need for a hospital, or certain requirements that hospitals must meet in order to get approval for major capital expenditures and other health facility projects.

In Georgia, the Department of Community Health says CON is the official determination that new or expanded healthcare services or facilities are needed, in order to allow funding to go through for building or expanding hospitals and hospital access across the state.

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At the end of February, HB 1339 passed the Georgia House of Representatives nearly unanimously. Jones’ office announced Thursday that the Senate substitute had passed, meaning the House must review their changes before they approve it and send the bill to Gov. Brian Kemp to sign or veto.

“Thank you to the Georgia Senate for your bi-partisan support of my priority to increase access to medical care,” Jones said after the bill passed the state senate. “In Georgia, your zip code should not determine your access to quality healthcare; that includes areas like South Fulton and Cuthbert. The Senate passed a measure today that would ensure that every Georgian, regardless of where they live, would have an opportunity to access quality care in their community. I urge the House to take swift action on this measure.”

As previously reported by the Associated Press, Jones has urged reform and review of the state’s certificate of need rules, particularly loosening them, though at times this was out of step with the Georgia House.

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Wanting to go a step further, Georgia Democrats have instead pushed for a full expansion of Medicaid, citing what they said were concerning maternal health and mortality statistics, as Channel 2 Action News reported in February.

Georgia Senate Majority Leader Steve Gooch said in January that there was “an appetite there to make some changes to our certificate of need requirements that could include better access for all Georgians to health care facilities and services,” but not a full expansion of the federal healthcare program, nor an expansion of the Affordable Care Act in Georgia.

Rather than push ahead with an expansion plan, HB 1339 creates a new state commission to review the state of healthcare access in Georgia.

If the legislation passes, the Georgia General Assembly would create and fund the Comprehensive Health Coverage Commission, with the intention of reviewing opportunities to reimburse and/or fund Georgia healthcare providers for premium assistance programs, improve healthcare for Georgia’s low-income and uninsured populations, enhance the delivery and coordination of healthcare across state agencies and provide a report on these topics to the Georgia General Assembly by the end of 2024.

The bill also requires Georgia’s Department of Community Health to “review and update the state health plan at least every five years beginning no later than January 1, 2025, to ensure the plan meets the evolving needs of the state.”

Georgia’s State Office of Rural Health said there were only 28 small rural prospective payment system hospitals, and 85 rural health clinics in the state, as of fiscal year 2020. Since 2010, 10 hospitals in Georgia have closed, including the Wellstar Atlanta Medical Center in 2022. In 2021, KFF Health News reported Georgia had the third most closures in the U.S., behind just Texas and Tennessee.

The DCH has also reported 46,897 Georgians were removed from the state’s Medicaid and PeachCare for Kids programs in January, and federal lawmakers have pushed state officials to explain how they’re managing the programs in question.

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