Last week, a constituent thanked me for my regular updates because before he got them, he thought what happens at the Capitol seemed “secret.” What we do is open and public, but we still have to be on high alert for things that aren’t as transparent as they should be. Right now, we have to be especially vigilant on healthcare, which is the most important issue being considered this session. Two intertwined bills have been introduced that will shape healthcare delivery in Georgia for many years to come.

Our legislative process endows all legislators and the public the right to weigh in on important decisions about our state. Instead, Governor Kemp introduced SB106, which he calls “The Patients First Act.”  It would allow the Governor to pursue various Medicaid waivers without legislative approval. His bill would pay consultants $1 million to come up with new limited expansion “options” that will cover fewer people and might even cost more.

We don’t need to waste taxpayer money studying an already well-studied issue. The research shows that full-scale Medicaid expansion works to increase healthcare access, decrease insurance premiums, create jobs, and put people back to work.

Democrats filed bills in the House and Senate to fully expand Medicaid that we could pass tomorrow if we only had the political will. It’s not an exaggeration to say that lives are being lost every day we don’t expand Medicaid.

Meanwhile, another healthcare issue that has been flying under the radar is the Republican effort to eliminate the Certificate of Need (CON) program. This program currently requires that hospitals and healthcare systems prove they are needed before they can build facilities in new communities. CON prevents healthcare companies from “cherry picking” the most lucrative locations and markets, and CON results in a more balanced and equitable distribution of care.

Why get rid of it? Healthcare providers want to make more money. Plain and simple.

Republicans introduced bills in both the House (HB198) and Senate (SB74) to eliminate Georgia’s CON program. They argue that introducing more competition throughout the state will drive down healthcare costs and add more providers in rural Georgia.

But healthcare isn’t the same as other markets. We can’t shop around for health services based on price and healthcare prices shouldn’t be at the mercy of market fluctuations. Without a CON program, for-profit specialty, stand-alone medical centers can flood the market.

Having a heart attack? If you can pay for it, you will be able to go to a small specialty center. If you can’t afford it, you may not be able to find anywhere to go.

Need to choose a place to deliver your baby? Maybe you will have to choose between an hour or two drive if you don’t live in a community with a birthing hospital.

These issues already have cropped up in rural hospitals, which are closing at alarming rates, because they don’t have enough insured patients in their communities to cover their expenses.

The specialty medical centers also are not required to follow the same quality standards as hospitals, and they can charge more without patients knowing it, both of which can have a devastating impact on patients.

When was the last time you looked at your medical bill and could understand that the cost was “about right”? We don’t get to negotiate our medical bills now. A unregulated approach will only serve to encourage profit-driven providers to make their costs even less transparent. And that also means that they can price underinsured or uninsured populations out of their services without a second thought. No company competes for the uninsured.

What the new Health and Human Services Committee Chair Dr. Ben Watson ( R ) and other conservative lawmakers also won’t say is that some of them stand to benefit financially by allowing more specialty outpatient services to open.

These are intertwined issues — limiting Medicaid expansion and the elimination of CON regulations — and they will impact private-pay patients too.

Expanding Medicaid to some Georgians, but on a limited basis, will still leave plenty of unpaid medical bills that will ultimately translate to higher healthcare prices for all of us.

In addition, it would be irresponsible to eliminate the CON program without a system of universal healthcare in place.

What can you do? Be loud. Spread the word to inform others. Call and email the Lt. Governor (404) 656-5030 and your own representatives. We all need to hear from you so we can demonstrate that our constituents believe healthcare is a human right. Tell us your stories and struggles accessing care. Tell your lawmakers that you believe every Georgian deserves access to healthcare.

I’m fighting for you down at the Capitol. But as Georgia citizens, you and your voice play the most powerful role in our democracy. We all have to fight together. Our lives and our futures are at stake.