Friends,
If it’s not a busy week during session, I feel like I’m not doing my job right. Luckily, we always have plenty to do for the people of Georgia and the residents of the 50th House District, the swing district at the heart of the nation’s preeminent swing state.
From community advocacy on gun violence, to committee work on the state budget, learning about novel therapies for Alzheimer’s dementia, to meeting with the next generation of Georgia’s leaders, this week had it all.
Ready to catch up with what we’ve been working on? Then let’s go!
STARTING WORK ON THE BIG BUDGET
I first want to note again how honored I am to be chosen by the Speaker of the House to serve on the House Appropriations Committee this year. In particular, the chance to serve on the Health Appropriations subcommittee is a way I hope I can add value to the work we do for Georgia, and it’s truly a thrill to have this chance to serve.
This week we got our first stab at delineating the priorities and the limits of our state budget for Fiscal Year 2027, as we heard presentations from department heads and members of the public about what is most important to improve the health of Georgians.
The true value of being a member of the Appropriations Committee is being able to directly ask questions of state department and agency heads. Many of the questions I had this week related to HR 1, the so-called “One Big Beautiful Bill Act” passed by the U.S. Congress in July, and how the massive federal healthcare cuts imposed by the new law impact Georgia.
Two key questions I got to ask, and why they’re important:
Does HR 1 Give Georgia an Opportunity to Expand Medicaid?
(Via the Georgia Recorder, read full article here)
First, some background and basics.
Prior to the passage of HR 1, Georgia was the only state in the nation with a Medicaid work requirement. In order to impose this requirement via its Pathways to Coverage program, the state had to apply for a unique Medicaid waiver (implemented in July 2023) requiring eligible low-income, non-disabled adults ages 19–64 to document 80 hours per month of work, education, or community service to gain and maintain coverage.
Though Pathways to Coverage has disastrously underdelivered on its projected coverage estimates, this did not stop the Trump Administration from using it as a model for the new federal work requirements in HR 1, mandated to be enforced nationwide by January 1, 2027. This neatly dovetails into the fact that Georgia’s work requirement waiver is set to expire at the end of December 2026.
(Via GPBI in 2021, read full article here)
Though Georgia Republicans tout Pathways as a limited expansion of Medicaid, it is not a meaningful full Medicaid expansion under the ACA. Why? Because the maximum income threshold for eligibility under Pathways is 100% of the federal poverty level. This does not qualify the state for the enhanced federal matching funds that ACA Medicaid expansion envisions, which requires the state to allow people up to 138% of the FPL to enroll.
Remember, the goal of the ACA was to decrease the number of people in this country without health insurance. In exchange for raising the income ceiling of those who could qualify for Medicaid, under the law the federal government would chip in to cover at least 90% of the cost of full expansion, meaning for every $1 the state spends on Medicaid expansion, the federal government would kick in $9.
(Via KFF, read full article here)
Ironically, despite the restrictive and often punitive bent of federal health policy under the current administration, the federal work requirements imposed by HR 1 are actually slightly more lenient than the work requirements imposed by Georgia under Pathways. (For example, it allows parents/guardians/caretakers of children up to age 13 as an exemption to the work requirement, while Georgia’s cutoff is kids under the age of 6. It also exempts patients who are “medically frail,” though that term is not defined.) Therefore, while Georgia likely will no longer need a waiver to continue its work requirement program, it will need to amend the eligibility of its work requirement program in order to continue administering it.
This presents an opportunity for 2027.
When we go back in to amend Pathways’ eligibility requirements to comply with federal law, there is no reason we can’t also amend the income eligibility cutoff to 138% of the federal poverty level (up from the current 100%), thereby availing ourselves of the enhanced federal matching funds to pay for the expanded coverage. This is money we’ve been leaving on the table for years, and especially at a time when so much federal funding is being cut, we’d be foolish not to take it.
(Click here to watch full video)
Here I am asking Commissioner Dean Burke, the head of the Department of Community Health, about changing the income eligibility cutoff. I like and respect Dr. Burke, with whom I worked in the state Senate, and his is one of the hardest jobs in state government. In committee on Wednesday he indicated a change in income eligibility has been vocalized by the governor. To me, that is all the more reason to raise the volume on this discussion.
What Will Be The Impact of Provider Tax Restrictions?
Provider taxes are fees that states impose on healthcare facilities and providers to generate revenue that helps them receive federal Medicaid matching funds. This arrangement allows states to expand Medicaid coverage and increase reimbursement rates without relying completely on general tax revenue.
How does this work? When a state collects provider taxes, it counts that revenue as part of its Medicaid spending. The federal government then matches that spending based on the Federal Medical Assistance Percentage (FMAP), which varies by state. The FMAP generally ranges between 50% to 83%. It is calculated annually based on a state’s per capita income relative to the national average. Lower-income states receive a higher federal match. Georgia’s FMAP is anticipated to be 66.63% for FY 2027.
(Via KFF, click here to read full article)
Federal law establishes a “safe harbor” threshold for provider taxes at 6% of net patient revenue. States can impose provider taxes up to this limit without triggering additional federal scrutiny or requirements. This provision ensures states maintain reasonable tax levels while preventing them from exploiting the system.
For many states like Georgia, these taxes have become indispensable. They fund broadening Medicaid coverage, support safety net hospitals serving uninsured populations, and maintain adequate reimbursement rates that encourage provider participation in Medicaid. Without these taxes, states would need to cut services, reduce eligibility, or find alternative sources of revenue.
(Via the Commonwealth Fund, read full article here)
When the “One Big Beautiful Bill Act” was signed into law, a key section of this bill focused on provider tax reform. The law freezes all existing provider taxes, meaning states cannot enact new provider taxes or increase current rates. It also lowers the safe harbor cap for many states. Specifically:
- No New or Higher Taxes: States may not adopt any new provider tax or raise an existing one beyond current levels. Provider taxes are frozen at 2025 levels.
- Safe Harbor Reduction (Expansion States): For states that expanded Medicaid under the ACA, the safe harbor limit will drop from 6% to 3.5% of net patient revenue. This reduction happens in steps, starting in FY 2028 with a 0.5% drop each year until it reaches 3.5%.
- New Tax Threshold: Any new provider tax imposed after enactment effectively has a 0% hold-harmless cap, meaning it cannot be guaranteed back to providers.
For better or worse, as a non-Medicaid expansion state Georgia’s provider taxes are already considered to be among the lowest in the nation (at about 3.5%), but they cover about 12% of the state’s Medicaid funding. Removing the ability for our state to adjust our provider tax takes away an important tool for filling holes in the state’s health care budget during economic downturns and limits our ability to adapt to changes in the healthcare landscape.
It’s also clear that the lack of detail from the federal Center for Medicare and Medicaid Services (CMS) on how these and other changes will be executed make it difficult for the state to plan ahead, or indeed to know what funding shortfalls we should anticipate as we craft the budget for 2027. Here I discuss these issues with DCH Commissioner Dr. Burke.
(Click here to watch full video)
It’s a challenge to appropriate funds for 2027 when we don’t quite know yet what we may need to cover. Stay tuned.
SAVE ACT PASSES OUT OF THE U.S. HOUSE
(Via NBC News, click here to read full article)
On Wednesday, the U.S. House of Representatives passed the SAVE America Act in a 218-213 vote. The bill is a high-priority Trump-backed initiative aimed at restructuring how elections are conducted, mandating that voters provide proof of citizenship via a narrow list of evidentiary documents when registering to vote.
Republicans, having received their talking points, insist that the SAVE Act is simply a “voter ID bill.” (Georgia, it should be noted, already requires photo ID when voting either in person or absentee.) But that’s not what this bill is at heart. It’s not a “voter ID bill,” it’s a “show me your papers” voter suppression bill.
To be clear: it’s important that only eligible voters cast ballots in our elections. However, it’s equally important that eligible voters aren’t prevented from voting because of onerous and ultimately unnecessary paperwork, or the cost and time it takes to meet these stringent requirements.
A breakdown of how the SAVE Act would catastrophically impact voter registration (via Non-Profit Vote):
(Via the Bipartisan Policy Center, click here to read full article)
The SAVE Act would require all voters to provide documentary proof of citizenship – a passport or birth certificate (with a photo ID) in most cases – anytime they register or update their registration.
A REAL ID like a Georgia driver’s license would not be acceptable (it is only proof of lawful residence, not citizenship), nor would military IDs without accompanying documentation like a birth certificate. In addition, the bill contemplates that proof of citizenship be presented in person, with no clear allowance for online submission or mailing copies.
According to research from the Brennan Center for Justice, over 21 million voting-eligible citizens do not have ready access to documentary proof of citizenship such as a passport or birth certificate.
The SAVE Act makes no allowance for proof of citizenship to be submitted online. This would render the online voter registration systems (like the one we have in Georgia) currently running in 42 states useless, forcing election officials to revert to more far more costly and labor-intensive in-person registration. It would also end the ability of third parties to organize voter registration drives.
(Via Center for American Progress, click here to read full article)
Approximately 146 million American citizens do not possess a valid passport. (For context, 153 million Americans voted in the 2024 presidential general election.) Ironically, given that this bill is being pushed by Republicans, high rates of passport ownership are overwhelmingly concentrated in blue states, while low rates are concentrated in red states.
Voters with higher incomes and more education are far more likely to have a passport. People with household incomes over $100K are three times as likely to have a current passport as those with incomes below $50,000. Residents of northeast and west coast states are more likely to have passports than others.
People could be barred from voting because of birth certificate name mismatches if they took their spouse’s name or changed their name for other reasons. Of note, about 84% of married women in this country have changed their surname, therefore as many as an estimated 69 million American married women do not have a birth certificate with their legal name on it.
(Via The 19th, click here to read full article)
The requirement for citizenship documentation to be delivered in person to an elections office will be a barrier to those with limited access to transportation, voters with disabilities and seniors who cannot easily get to an election office, as well as rural voters. Frequent movers will also be faced with the added burden of providing these documents in person every time they move. Many people simply won’t bother and become unregistered, non-voters.
Even if the documents could be submitted online, over 21 million otherwise eligible American voters don’t have these proof of citizenship documents readily available. In the end, millions of eligible American citizens–in particular, lower-income individuals, younger first-time voters, and new citizen voters–without access to the required documents or can’t get to a government office in person would be unable to vote, all to prevent an exceedingly small number of non-citizens, a few dozen perhaps, from voting.
(Via Fox News, click here to read full article)
Luckily the bill will face a high hurdle in the U.S. Senate, where it must clear a 60 vote threshold. Please continue to watch the progress of this bill, and recognize that it is part of a larger push from the Trump administration to suppress the vote in advance of the 2026 election.
THE GEORGIA DIAGNOSIS
Available on Apple, Spotify, or YouTube
Team Au is in pre-production for Season 2 of our podcast THE GEORGIA DIAGNOSIS, and we want to hear from you!
Whose stories do you want to hear, and what fascinating voices would you love to have included? Fill out our podcast survey here. Thank you for listening to and sharing our first season, and for helping us make Season 2 even better!
Catch up on Season 1 of THE GEORGIA DIAGNOSIS on Apple, Spotify, or YouTube.
TEAM AU IN ACTION
Moms Demand Action Day at the Capitol
(Click here to watch full video)
An honor joining Moms Demand Action during their Day of Action at the Georgia State Capitol. At their press conference I had a chance to make some remarks, and noted that while the culture around the issue of gun safety was slowly changing even under the Gold Dome, our conservative majority party simply won’t act until it’s clear that their voters will no longer tolerate inaction.
“We are all here to do hard things. If it was easy, anyone could do it.
But if you don’t have the balls to do the hard things, the right things, the transformative things, then maybe you should consider whether you need to be here at all.
And if you can’t figure that out for yourselves, maybe we can figure it out for you.”
Thank you to Moms Demand and all our gun safety advocates for continuing to be in the fight. We’re making progress. Keep going.
The Ron Show
A pleasure to join Ron Roberts on his eponymous “The Ron Show” this week as we discussed the latest goings on under the Gold Dome, podcasting as a way of talking to voters, and squaring election year theatrics with the real work we’ve been entrusted to do by those we represent.
This latest episodes now live on Georgia NOW, hope you give it a listen!
Asian Student Alliance at the Capitol
Loved meeting with these highly motivated young people with Students 4 Students and the Asian Student Alliance during their Day at the Capitol this week!
These students had some wonderful policy ideas relating to health education around high caffeine drinks, youth vaping, support for student entrepreneurs, and arts education. It’s heartening to see how engaged our youngest Georgians are, bravo all!
FCCLA Leadership Team from Apalachee High School
Loved seeing our friend Sasha Contreras and her FCCLA leadership team from Apalachee High School during their visit to the Capitol this week!
These students are the future of this state. I can’t wait to see what they’ll do next.
House District 50 Pages at the Capitol
It’s always a pleasure hosting students from HD 50 at the Capitol as part of the House Page Program! This week we had two fellows, including Aditi, a junior at Johns Creek High School.
Our office is already fully subscribed for pages for the year, but we always welcome students and their families to the Capitol! Please do not hesitate to reach out to our office if you would like to visit, are interested in a tour, or just want to stop by and say hi!
UPCOMING EVENTS
Please join the Legislative Asian American Pacific Islander Caucus for our third annual Lunar New Year at the Capitol as we welcome the community to The People’s House and ring in the Year of the Horse!
Tuesday, February 17, 2026
Georgia State Capitol, South Steps
Lion Dance starts 12PM
Buffet lunch to follow, open to all!
A huge thank you to the Chinese Business Association of Atlanta for helping to sponsor the lunch, provided courtesy of HD 50’s own YiFan Restaurant & Event Center!
And don’t forget to access Team Au’s Gold Dome Visitor Guide, which has information about location, security, parking, and all you need to know to get the most out of your trip!
* * *
It has never been more important to pay attention to the work of state legislatures. Thank you as ever for your support so that we can keep doing this most important work together.
As always, please do not hesitate to reach out to our office should you need any assistance, or if you have any concerns you’d like me to address on your behalf.
It is my honor to be your voice in the Georgia House of Representatives.
In service,
