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Part I: The search for answers
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Key Points
- Medicare prescription-drugs have skyrocketed 89% in Georgia from 2013 to 2019.
- Prices for common medications in Georgia have also ballooned during that time.
- Cost transparency is lacking even from state government as key prescription-drug players blame each other.
For Nicola Jackson, how to stretch her family’s tight budget often boils down to choosing between paying for the prescription drugs she needs to stave off head-splitting migraines or buying groceries. Medicare doesn’t cover all the costs for her medications to treat fibromyalgia, rheumatoid arthritis and nerve damage, leaving Jackson to scrape for dollars each month in her constant battle to afford prescription drugs.
“I know I still have a bill, but what am I going to do?” Jackson, a Cherokee County resident, said in a recent interview. “If it wasn’t for my faith, I tell you, sometimes it gets real tough.”
Jackson isn’t alone in her struggle to pay for prescription drugs in Georgia. Many residents are left to scratch and claw to cover out-of-pocket drug costs, all while having no clue as to why medication costs are on the rise. Georgia is among the highest-spending states in the U.S. when it comes to prescription drugs and out-of-pocket costs, according to national researchers:
- Georgia ranked 8th on overall medication spending in 2019 with nearly $14 billion in pharmacy retail sales, or roughly $1,300 per capita, an analysis by the nonprofit Kaiser Family Foundation shows.
- The state also ranked 4th in out-of-pocket drug spending at around $195 per person annually in 2018, the medication-assistance group NiceRx found.
- Gross costs for drugs under Medicare in Georgia soared from nearly $3 billion in 2013 to more than $5.6 billion in 2019, totaling more than the state’s share of current costs for Medicaid, according to State Affairs’ analysis of federal Centers for Medicare and Medicaid Services data.
(Credit: Brittney Phan for State Affairs)
While the numbers paint a clear picture of rising medication costs, the root causes for why drug prices have soared in recent years remain largely unknown, shielded behind certain carve-outs in state law and a complex system of behind-the-scenes price negotiations that many patient advocates blame for the rising costs. Even the full picture of how much Georgia spends on prescription drugs each year is incomplete, with one state agency failing to provide State Affairs with data on drug costs under Georgia’s Medicaid programs before this story was published.
Many key players in the medication distribution chain have pointed the finger at each other as the main driver behind rising costs, leading some advocates to declare that the whole system is rigged.
“Everybody’s hands are dirty,” said Barbara Adle, a retired nurse from DeKalb County who volunteers for a local senior-living advocacy group. “And the person who needs the drugs is the last person whose voice is heard.”
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Barbershop talks and hip-hop summits: Georgia Black legislators’ group has big plans to build coalitions, boost voter rolls
The nation’s largest gathering of Black lawmakers is slated to meet in Atlanta this summer to discuss ways to boost voter participation nationwide ahead of the upcoming fall elections.
The Aug. 2-4 conference theme is “Testing 1, 2, 3.” The meeting will be the precursor to a series of events the Georgia Legislative Black Caucus plans to hold heading into the November presidential election.
“Because we’re the largest Black caucus in the nation, we’re reaching out to all of the caucuses from across the nation,” Rep. Carl Gilliard, D-Savannah, chairman of the 74-member Georgia caucus, told State Affairs. “This is the first time that I think we’re doing a total reach-out to all of the Black caucuses. We share a lot of similarities. Whether it’s voter suppression in Georgia, the same laws are going to be tried in Tennessee and the same laws are going to be tried in Florida. We share a lot of commonalities.”
Next week, for instance, the Georgia caucus is scheduled to issue a statement supporting efforts to pass a hate crimes bill in South Carolina. The bill passed in the House but stalled in the Senate, Gilliard noted.
Over 700 Black legislators represent about 60 million Americans, according to the National Black Caucus of State Legislators. In addition to the Georgia caucus, Black caucuses exist in nearly three dozen states.
Shortly after the August convention, the Georgia Legislative Black Caucus will embark on a 14-city tour throughout Georgia to focus on “getting out the vote.”
“We’re not going to tell them who to vote for,” Gilliard said of voters. “But what is happening right now is no one is talking to the people. And if the election were held today, we all would be in trouble because no one is talking or meeting the people where they’re at.”
The tour is a continuation of various actions the Georgia Legislative Black Caucus has taken this year to align with other organizations of people of color on common causes.
In March, the caucus joined forces with the Asian American Pacific Islander and Hispanic caucuses for a tri-caucus town hall. It was the first time the three groups have aligned. The Black caucus also has “reached out to partner with the Hindus of North America population and the diaspora,” Gilliard said.
“What we’re trying to do is form a coalition to get to as many diverse groups of people as we can,” he said.
Gilliard said the lack of individual and collective involvement in communities he’s seeing concerns him. It’s a far cry from four years ago.
In 2020, the deaths of Ahmaud Arbery, an unarmed Black man murdered while jogging in Glynn County, and Breonna Taylor, a Black woman killed by Louisville, Kentucky police serving a no-knock warrant for drug suspicion, led to more than 450 protests nationwide and on three continents.
That same year, former Georgia gubernatorial candidate Stacey Abrams led an effort to increase the voter rolls for the 2020 presidential election. Fair Fight and the New Georgia Projects, two groups Abrams founded, registered more than 800,000 new voters.
That level of community and political engagement has since subsided, Gilliard said.
“People don’t know what’s going on,” Gilliard said. “No one is really talking to the people. You’ve got a presidential election. I’m talking about on both [political] sides. There are rallies and different events being held, but nobody has gone to the barbershop. No one has gone to the community centers or the neighborhoods. We’re going to be empowering those communities by going and taking those townhall meetings right where they’re at, not in a big municipality but in community centers and neighborhoods.”
The caucus also plans to hold a hip-hop summit to reach young people, many of whom are skeptical of both political parties.
“They’re forming their own opinions,” Gilliard said. “They’re saying, ‘Forget about Trump. We need to hear something different.’ That’s just their perception. That’s why I’m really quietly championing the young candidates behind the scenes who are running right now because we need young leaders.
“We have to get as many people together, but we also have to get them ready to work.”
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Special prosecutor to decide if Lt. Gov. Jones should face criminal charges in 2020 election-meddling case
Lt. Gov. Burt Jones will face scrutiny over whether he should be criminally charged for alleged meddling in the 2020 presidential election in Georgia.
The Prosecuting Attorneys’ Council of Georgia said Thursday it has assigned Executive Director Pete Skandalakis as the special prosecutor to handle the case because Fulton County District Attorney Fani Willis is barred from investigating Jones. The council is a nonpartisan state advocacy agency for district attorneys.
In July 2022, Superior Court Judge Robert McBurney blocked Willis from investigating Jones because her actions were an “actual and untenable” conflict of interest. At the time, Willis had hosted a campaign fundraiser for Jones’ Democratic rival, Charlie Bailey, and donated to his campaign when both men were running for lieutenant governor. Willis is currently involved in an election interference case she brought against former President Donald Trump and 18 others.
McBurney’s ruling left it up to the council to decide whether Jones should be criminally charged.
“I’m happy to see this process move forward and look forward to the opportunity to get this charade behind me,” Jones said in a statement issued Thursday. “Fani Willis has made a mockery of this legal process, as she tends to do. I look forward to a quick resolution and moving forward with the business of the state of Georgia.”
The council cited state bar rules in its news release and said there would be no further comments.
Skandalakis’ appointment marks another step in the ongoing political odyssey for Jones and other lawmakers over charges that they served as “false” electors to help Trump overturn the 2020 presidential election in Georgia.
Jones is one of 16 alleged “false” electors in Georgia who gathered at the state capitol on Dec. 14, 2020, to cast ballots for Trump and then sent their false certification of his victory to the National Archives and the governor’s office.
Jones has denied any wrongdoing, saying he and other electors were acting on the advice of lawyers to preserve Trump’s chances in Georgia in case the former president won a court challenge that was pending at the time. Jones was a state senator during the 2020 election.
Trump’s campaign enlisted an alternate slate of electors in 2020 in a number of swing states where Trump was defeated, as part of an effort to circumvent the outcome of the voting, The New York Times reported Thursday.
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Georgia taxpayers get a tax credit for helping young adults leaving foster care
The Gist
Georgia lawmakers in 2022 laid the groundwork to help young adults leaving the foster care system get a good start in life while giving taxpayers another tax relief option.
At that time, the Georgia General Assembly passed House Bill 424, also known as the Fostering Success Act. This law created the Qualified Foster Child Donation Credit program. It’s a tax credit plan that allows taxpayers to redirect their state income tax dollars to qualified organizations providing support services to young adults transitioning out of foster care.
Capped at $20 million a year, the money is used to help young adults ages 18 to 25 once they leave foster care.
What’s Happening
The tax credit took effect in 2023. The number of qualified organizations participating in the program has nearly doubled to 39 this year from 20 last year.
A bill to increase the cap on the tax credit to $30 million a year failed during this year’s legislative session because the House and Senate couldn’t agree on whether to expand the annual cap. It remains at $20 million a year.
As of March 28, $153,000 of the $20 million fund has been approved for the 2024 tax year. Roughly $19.8 million remains.
“With this being the second year of the tax credit, this tax credit opportunity is still relatively new and unknown,” Heidi Carr, executive director of Fostering Success Act Inc., told State Affairs. “It takes a while to get the awareness around it up.”
Carr’s group is one of the qualified organizations participating in the tax credit program. The nonprofit is not connected to the government program.
Georgia taxpayers get a dollar credit for every dollar they donate to a qualified organization, up to a certain amount. Here’s how it works:
- An individual or business applies through the Georgia Department of Revenue to qualify for the tax credit. The taxpayer specifies how much to donate and which organization will get the donation.
- Once approved, the taxpayer makes a payment directly to the organization.
- When the organization receives the payment, it sends the taxpayer the documents required when filing their state tax return so they can get their tax credit. The organization also notifies the state of the transaction.
Why It Matters
Each year, more than 700 young adults leave the foster care system in Georgia. They are some of the most underserved and overlooked people in the foster care system. Many never return to their biological families or get adopted. Once they leave the system, they often have little to no guidance as they enter college or the workforce.
The fostering success funds will help those young people with education, housing, counseling, medical care and transportation services.
Money generated from the tax credit has enabled Connections Homes to help 20 young people so far this year, Founder and Chief Executive Officer Pam Parish told State Affairs.
The Alpharetta-based nonprofit’s main goal is matching young people who have left or are leaving foster care with mentoring families. However, the $20,000 received through the tax credit program allows the organization to do much more, Parish said.
In one instance, they helped a young mother of two in her early 20s who is attending college and dealing with cancer. The organization paid the former foster care youth’s rent and car note and was able to “do the things that we could worry about and let her worry about getting better and staying in school,” Parish said.
Without the money generated through the Fostering Success Act’s tax credit program, such help would have been a “funding struggle,” Parish added.
“Our main program is our mentorship, which is immensely helpful to our kids,” she said. “But really to get into these practical needs and [having] funding available to do that is really helpful for our organization but most importantly for these kids.”
The organization has helped some 350 foster youth in its 10-year existence, Parish said. She and her husband have eight daughters, seven of them adopted. Five became part of the family after the age of 18 due to various circumstances, including surviving trafficking, homelessness and aging out of foster care, she said.
Similarly, Wellroot Family Services has been able to help foster youth pursuing college degrees.
“The Fostering Success Tax Credit bolsters the housing and wraparound services we provide for those youth pursuing postsecondary education and has enabled us to provide scholarships to former foster youth,” Wellroot CEO Allison Ashe said. “Because of the tax credit and the generosity of donors, we were able to provide additional funds to some of the youth pursuing college degrees to use for books and other academic supplies.”
What’s Next?
It’s not too late to participate in the 2024 tax credit program. To qualify, taxpayers must get the state’s approval and make their payments within 60 days of being approved or by Dec. 31, whichever comes first.
Between January 1 and June 30, the following yearly contribution limits are based on the taxpayer’s filing status:
- Single individual or head of household: Up to $2,500
- Married filing jointly: Up to $5,000
- Individual owner of an S corporation, member of an LLC or partner in a partnership: Up to $5,000
- C corporation, trust, or pass-through entity electing to pay tax at entity level: Up to 10% of Georgia income tax liability
Learn more about the Fostering Success Tax Credit here. As with any tax matter, consult your tax adviser. You can find a list of certified foster child support organizations on the Department of Revenue website.
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Special election runoff for House seat in Columbus may be dress rehearsal for general election
ATLANTA — Two Georgia Republicans who virtually tied in a special election held Tuesday to fill the Columbus-area seat of the late state Rep. Richard Smith, will now compete in a May 7 runoff.
Sean Knox, who heads a pest control company, won only 12 more votes than Carmen Rice, a corporate administrator who’s the former chair of the Muscogee County Republican Party. Each received about 42% of 2,455 votes, finishing far ahead of Republican Donald Moeller, a dentist and oral surgeon; and independent Robert Mallard, a real estate broker. Neither Knox nor Rice earned a majority of votes to avoid a runoff.
The winner of the runoff will represent Smith’s House District 139, which covers parts of Muscogee and Harris counties, through the rest of this year and until Jan. 13. Smith died Jan. 30.
Knox and Rice also are vying to represent the Columbus district for a full two-year term beginning in January 2025, for which they’ll have to compete again with Moeller, who qualified for the May 21 primary. The Republican who emerges victorious in that race will compete with Mallard in the general election in November, along with Democrat Carl Sprayberry, a chef from Muscogee who has no primary challenger.
So, who are the two GOP front-runners hoping to replace Smith, who served in the House for nearly 20 years, rising to the powerful position of Rules Committee chair, and used his clout to bring back considerable resources to his home district?
Knox, a third-generation leader of his family’s Columbus-based pest control company, has campaigned on his business acumen and deep community connections. A Columbus native, he has served on the boards of a Boys & Girls Club in Columbus, the Columbus Convention and Trade Center, and the Georgia Chamber of Commerce.
His campaign website indicates he supports job creation, economic growth and low taxes. During the special election campaign, Knox told local reporters that he, like Smith, is for small government.
“Richard was passionate about limited government but smart government and how government can help the state and the community that it serves, and Columbus benefited from his leadership,” Knox told WVTM-TV. “I will just do the best I can to continue that legacy.”
Rice, an administrative director with a background in food franchising, was the first woman elected as Republican Party chair in Muscogee County last year. She hosted former President Donald Trump and U.S. Rep. Marjorie Taylor Greene, the conservative firebrand who represents District 14 in northwest Georgia, as headliners at the state GOP convention in Columbus last June.
A self-described America First candidate, Rice is running on a platform that includes supporting public safety and law enforcement, education (including school choice and more funding for teachers), stricter border control, transportation and economic growth. Part of that economic growth includes the proposed $5 billion Interstate 14 project that would run from Texas through Georgia, with a leg stretching from Columbus to Augusta. The state transportation department so far has dismissed the project as too expensive.
“As a former foster parent, I am committed to furthering foster and adoption care reform, ensuring the well-being of vulnerable members of our community,” Rice stated on her campaign website. She’s also for “efficient, effective and limited” government.
Rice is an avid supporter of Trump and his second presidential campaign, and has echoed his claims of political persecution related to the several criminal cases and civil suits he’s faced over the past two years.
Moeller, a part-time oral surgeon and the third Republican candidate in both District 139 elections, received 6% of the vote in Tuesday’s special election. If elected to the Statehouse, he vowed to focus on “the Georgia budget” and constituents’ health care and educational needs. “We’re losing our nurses and teachers,” he said.
Also a proponent of the America First agenda, Moeller said he values free markets, lower taxes, eliminating burdensome regulations that stifle economic growth, border control that protects national security and economic interests, and defending gun rights.
Noting he served in the military for 10 years and “attended two wars,” he’s also sensitive to the needs of veterans, including those with post-traumatic stress disorder. A former college professor in health sciences, Moeller said he has engaged in “research in neuroscience and bioengineering to stop PTSD.”
The independent candidate Mallard, who got nearly 10% of the vote on Tuesday, is an Army veteran who served multiple tours in Iraq and works as a real estate broker. He and his wife, also an Army vet, run a nonprofit that engages youth, seniors and veterans in beekeeping and other therapeutic services to promote self-sufficiency.
Mallard wants to add more high-paying trades and technical certifications to the education system and develop programs for young adults emphasizing business and entrepreneurship “that opens their eyes to what’s possible, how things work and how they can build or support the economic engines that will keep putting food on their table and raising their standard of living.”
He supports gun rights, school choice, more resources for law enforcement and first responders, and secure borders, and says he’ll “work across the aisle” to find ways to address rising addiction rates among youth.
Democrat Sprayberry lost to then-incumbent Republican Smith in the 2020 general election for the same House seat, earning 36% of the vote. In 2022, he ran for the Columbus City Council and won 5% of the vote in a five-person race for an at-large seat.
The 31-year-old chef has an expired campaign website, but his recent posts on X emphasize his strong support of President Joe Biden’s economic policies, reproductive choice, gun control and government-subsidized health insurance. He’d also like the government to regulate social media sites such as TikTok and Facebook, which he said are engaging in “child exploitation.”
On March 3, Sprayberry posted a thread on X that said:
“My platform is basically the same as in 2020, with an emphasis on healthcare access, addressing rising insurance rates in the state, funding for mental health workers, working on addressing increased homelessness throughout the state, continuing efforts to lower crime rates, oversight on how federal infrastructure funds are being spent, and additionally, I would like to introduce an amendment to the state constitution to require any statewide office holder (governor, lt. gov, SoS, etc.) to step down before they could run for a federal office.”
The special election runoff for House District 139 will be May 7. The winner will serve until Jan. 13.
The 2024 election primary for all 236 General Assembly seats and other state offices will be held May 21.The general election, which includes state and federal races, including the presidential election, will happen Nov. 5.
The 2024 legislative session ended March 29, but lawmakers will continue to convene for committee meetings, interact with constituents and gather to strategize with political allies in the Legislature throughout the rest of the year.
Have questions or comments? Contact Jill Jordan Sieder on X @journalistajill or at [email protected]
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