Editor's note: This article has been revised to reflect the following clarification, which appears in the Jan. 30 print edition: An article that appeared on the front page Jan. 13 indicated that Rep. Jan Tankersley, R-Brooklet, did not appear in a 2010 voting record for the state hospital provider fee, commonly known as the "hospital bed tax." The reason she did not appear was because she did not begin her tenure as a state legislator until 2011.

Look for health care and education to be the dominant focal points during this year’s legislative session, which begins Monday in Atlanta.
Those are two of the most challenging – and costly – areas in the state’s budget. And within those two areas, it is health care that figures to have the most heated discussions.
That’s the consensus of the Bulloch County legislative delegation — Sen. Jack Hill, R-Reidsville, and Reps. Butch Parrish, R-Swainsboro; Jon G. Burns, R-Newington; and Jan Tankersley, R-Brooklet — in interviews with the Statesboro Herald leading up to the 2013 session.
One of the most contentious areas figures to be the hospital provider fee, more commonly known as the “hospital bed tax,” in which all Georgia hospitals pay a percentage of their revenues toward the state’s Medicaid program. It allows federal matching dollars to further support Medicaid –  a program jointly funded by the federal government and states that provides health-care benefits for some low-income individuals and families.
The fee, passed in 2010, will expire in June without legislation. Advocates say it is needed or else some smaller, rural hospitals might be forced to close with the loss in revenue. Opponents say it’s another onerous tax that ought to be eliminated. In 2010, Burns and Parrish voted for the measure and Hill did not vote. Tankersley didn't begin her tenure as a state legislator until 2011.
“This is an effort that helps even the playing field where all hospitals participate,” Burns said. “We might lose some hospitals in rural settings if we don’t provide this funding.”
That fee also ties in to the discussion over Medicaid overall in Georgia. The program, along with PeachCare for Kids, faces a $374 million shortfall in the current fiscal year and nearly $400 million in fiscal 2014, according to The Atlanta Journal-Constitution.
Shortfalls of that magnitude have far-reaching implications. To close the gap, other state programs must be cut or eliminated entirely, which leads to even more contentious debate.
“The one biggest piece of need in our state budget process is Medicaid,” said Hill, who is the chairman of the Senate Appropriations Committee. “It’s bigger than any other – bigger than growth in education, the payments we’re putting into (state employees’) retirement funds.”
The financial clouds are not quite as dark for education, though educators are quick to point out that because of continuing austerity cuts since 2003, the state has underfunded public education by $1.1 billion a year since then.
Two bright spots with regard to education come courtesy of increased Georgia Lottery revenue. Gov. Nathan Deal has said his proposed budget will include a 3 percent increase in HOPE Scholarship funding and the restoration of 10 days into the Georgia Prekindergarten program, which would bring it back to its original 180-day academic year.
Legislators generally are signaling support for those increases. Both programs were cut in 2011, when state projections showed that the HOPE Scholarship was not sustainable as it was structured then, when it guaranteed a full-tuition scholarship to any four-year public college in the state for any Georgia high school graduate who had a grade-point average of 3.0 or higher. The full-tuition bar was raised to a GPA of 3.7 or higher and SAT score of 1200 or higher and renamed the Zell Miller Scholarship, after the governor who established the HOPE Scholarship. Students with a cumulative GPA of 3.0 or higher were given 90 percent of the 2011 tuition rates, regardless of what tuition rose to in subsequent years. Pre-K was cut to 160 days in 2011 and 10 days were restored last year.
Ethics reform, in particular limits on contributions to lawmakers by lobbyists, also is expected to be acted on. It has support in high places, as House Speaker David Ralston, R-Blue Ridge, has endorsed it. Hill also indicated his support.
All Bulloch County delegation members also said they will keep a close eye on developments concerning the Ogeechee River, which has been a major issue locally since a fish kill that saw 38,000 fish die downriver of King America Finishing, a Dover-based textiles plant. Many environmentalists and river advocates blame the plant, but the company and state Environmental Protection Division have cited other possible causes, such as the prolonged drought and higher temperatures in recent years causing environmental stress.
Jason Wermers may be reached at (912) 489-9431.