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Jim Galloway, Greg Bluestein and Daniel Malloy

Hints that Nathan Deal will back down-sizing of rural hospitals

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State Rep. Sharon Cooper provoked backlash - and revived debate - when she mused about closing rural hospitals.

State Rep. Sharon Cooper provoked backlash – and revived debate – when she mused about closing rural hospitals.

When state Rep. Sharon Cooper publicly mused in January about closing some rural hospitals because their communities are too small to support them, she may have unwittingly revived a discussion among state leaders about what to do with the facilities.

Gov. Nathan Deal is set to speak at a rural caucus meeting at 12:30 p.m. today on the topic of healthcare. His office won’t comment on what he’ll say, but a Department of Community Health meeting last week offers a hint.

Your daily jolt on politics from the AJC's Political insider blog
At the meeting, commissioner Clyde Reese said board members would soon be asked to approve a plan for a “step-down rural access for communities that have lost their hospitals.” That could clear the way for struggling hospitals, or even those that were recently shuttered, to more easily drop expensive offerings and scale back to limited services such as emergency care.

The fate of rural hospitals has been a recurring theme of the session, which lurches to a merciful ending on Thursday. Andy Miller of Georgia Health News reports that four rural hospitals were shut down over the last two years, and six others have been shuttered since 2000. Healthcare activists worry more could be shuttered because of Gov. Nathan Deal’s rejection of the Medicaid expansion under Obamacare, which he views as far too costly in the long run.

Cooper sparked debate in January when she said that some faltering rural hospitals with few patients need to close and rely on regional hubs for healthcare. She quickly walked back those comments after a backlash from rural lawmakers and healthcare advocates, but her comments underscored the ongoing struggle over rural healthcare.

Deal, who has offered a separate bailout of safety-net hospitals, is said to have been developing this down-sizing plan over the past year with Rep. Terry England, a rural Republican who chairs the House Appropriations Committee. It will likely only involve administrative changes – no legislation this late in the session – with the possibility of more legislative proposals in 2015.

***

Clearly, at least in election years, angry tea partyers count more than angry parents of kids with autism.

Late Tuesday, House members stripped language mandating insurance coverage for autism treatment out of HB 943 – a bill originally had to do with the regulation of chemotherapy drugs.

In its place went most of HB 707, the anti-Obamacare bill that prohibits local and state governments from using their resources to direct consumers to health care exchanges under the Affordable Care Act. Erased from the HB 707 language was the portion that prohibited the state insurance commissioner from enforcing ACA mandates – like the ban on using pre-existing conditions to deny claims.

State Rep. Ed Lindsey, R-Atlanta, a candidate in the race to replace U.S. Rep. Phil Gingrey, took the credit. From an email to supporters:

After the original HB 707 stalled in the Senate Rules Committee on Monday, I worked with fellow bill co-sponsors and other parties to salvage as much as possible of the bill. “

Supporters of the autism insurance bill point out that they still have hope. Another version of the bill is attached to HB 885, which would legalize medicinal marijuana.

***

The GOP-backed proposed constitutional amendment that would cap the state’s income tax at 6 percent only mustered the two-thirds majority it needed with the help of two unlikely allies: Democratic Reps. Tyrone Brooks and Hugh Floyd.

Needless to say, Democratic leaders were not happy.

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State Rep. Tyrone Brooks, D-Atlanta

“I can’t believe Rep. Tyrone Brooks and Rep. Hugh Floyd voted for SR 415. They have voted with Republicans, who have spent this entire session dismantling the very programs that we stand for,” said Democratic chair DuBose Porter. “Both have been there long enough to know what they were voting on. It appears that they have lost their dadgum minds.”

We don’t know what might have motivated Floyd, who is from Norcross. He’s running opposed this year, as is Brooks of Atlanta. But note that Brooks is a co-sponsor of HB 1080, the bill to permit a statue of Martin Luther King Jr. on the state Capitol grounds.

The vote on SR 415 was No. 811 of the session. Three votes later, HB 1080 came up for final passage. No public funds are to be used in raising the MLK statue. But the price may have been a ballot issue to drive Republican voters to the poll in November.

***

The most telling hint of the state’s plans for the soon-to-be-demolished Georgia Dome came in the letter from Frank Poe, the head of the Georgia World Congress Center, advocating for state funds to expand a parking deck near the new Falcons stadium.

Poe said the parking deck would “provide parking for potential future development of a convention center hotel on our campus.” We’re told that such a hotel is envisioned for the state-owned site of the Dome. How it will be financed is another story.

State authorities could consider public-private partnerships to get it built. Or they could go it alone and build it with public funds. And that would likely lead to another round of controversial legislation on using public-backed bonds to build a new facility on the campus grounds.

***

Now, about that $17 million for a Falcons parking deck – which popped up on Tuesday as the House and Senate gave final passage to the state budget. Opponents of the Falcons stadium are suggesting that Gov. Nathan Deal erase the parking deck with a line item veto. From Debbie Dooley of Atlanta Tea Party Patriots:

“Surely during an election year, he knows better than to allow such a huge boost to a private interest with state dollars when 75% of Georgians oppose public financing of the Falcons new stadium. Will he really give his opponents that much firepower?”

A likely answer: Not a problem, if his two GOP opponents are still polling under 10 percent.

***

How closely are Democrat Jason Carter’s voting patterns being watched as the session winds down? Consider this: Moments after Carter missed a vote on a piece of legislation that would authorize the sale of Board of Regents debt to the private sector, several Republicans sent us word that he had left the chamber.

The measure passed overwhelmingly and Carter’s camp said he had no issue with the legislation and that he was in the hall talking to constituents. They later produced documents from the Senate clerk’s office signifying his “yes” vote, just as they did in February when he later declared a “no” vote on a controversial vote in February to create new DeKalb cities after slipping out of the chamber.

But we have confirmed with David Cook, the secretary of the Senate, that such after-the-fact assertions in no way alter the recorded outcome of votes in that chamber. Or in the House, for that matter.

We’ve run into this issue before. Click here to refresh your memory.

***

The Moral Monday, er, Tuesday protest in the Gold Dome caught the attention of the New York Times. Here’s the Gray Lady’s assessment of the movement in Georgia, North Carolina and South Carolina:

“The movements are rare stirrings of impassioned, liberal political action in a region where conservative control of government is as solid as cold grits and Democrats are struggling for survival more than influence.

“The question raised by all three groups, which have echoes in at least four other states, is whether they can become more than an outlet for protests by liberal activists who feel shut out of state politics.”

***

National Journal’s Josh Kraushaar writes that national tea party groups are playing it more cautious in this year’s elections, and the lack of outside intervention in Georgia – so far – is evidence of this:

Republicans fear that weak, too-conservative candidates in these races could cost them valuable seats—with control of the Senate at stake. With the exception of FreedomWorks’ backing of physician Greg Brannon in North Carolina, most conservative groups have remained on the sidelines in these crucial contests.

But that could change if the Georgia and North Carolina races head into runoffs, or if the Iowa nominating fight heads to a convention (if no one wins 35 percent or more of the vote in a primary). For now there’s an uncomfortable GOP détente—with neither side tipping the scales yet.

If outside conservative groups endorse like-minded candidates like Rep. Paul Broun of Georgia, Iowa talk-show host Sam Clovis, and Brannon in these primaries, expect a heated ideological battle to break out over the future of the party. But if they pull their punches, it’s a sign that even tea-party sympathizers recognize their influence has peaked.

***
The Federal Election Commission has dismissed a two-year-old ethics complaint against Rep. Paul Broun for not properly disclosing the source of loans to his campaign.

The watchdog group Citizens for Responsibility and Ethics in Washington, which was started by Democrats but has gone after members from both parties, filed a complaint against the Broun campaign in 2012 for paying Broun interest on self-loans to his campaign from 2007. The Broun campaign later disclosed that the money actually came from a home equity loan, and the interest reimbursements went to the bank — not to enrich Broun himself.

The Broun campaign corrected its old, erroneous campaign finance reports in 2012, and the violations happened outside the FEC’s five-year statute of limitations, the FEC wrote in a decision this month. It also found that “Paul Broun has no personal liability for the reporting violations.”

CREW remained indignant about the matter in a press release this morning from executive director Melanie Sloan:

“A real enforcement agency would take its duties seriously, meting out severe penalties for the Broun campaign’s deliberate violations of campaign finance law. Rep. Broun deliberately concealed the source of the loans and the FEC let him off scot-free. Given Rep. Broun’s track record, the FEC should be reviewing his Senate campaign reports with a fine-tooth comb.”

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