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The Staggering Cost of Prescription Drugs in Georgia
Credit: iStock
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.
Costs for prescription drugs have risen dramatically over the past decade in Georgia while people struggling to pay for medications have little idea as to why.
In recent years, Georgia residents and their insurers have spent more on prescription drugs and for out-of-pocket medication costs not covered by health plans than most states in the U.S., according to several studies. Georgia joined every other state in the country in witnessing a trend of both more people filling prescriptions under Medicare and steep cost increases for those drugs between 2013 and 2019, rounding out to an 89% hike in Georgia's drug costs during that time, according to federal data.
Medicare and other health plans cover most prescription-drug costs to keep them affordable, but many low-income Georgia residents and seniors on fixed incomes still struggle to make up the difference for what’s not covered – leaving many people to choose between paying for medications or buying groceries.
Meanwhile, the root causes for why drug prices have soared in recent years remains 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. The intricate causes for Georgia's rising medication costs have left many people in the lurch like Nicola Jackson, whose monthly battle to pay for her medications poses a constant challenge for her family's budget.
In this five-part story, State Affairs tells the stories of several Georgia residents like Jackson who struggle to afford their medications, as well as the forces at play that make tracking the rise in costs – and who exactly is to blame – a difficult task.
Costs for prescription drugs under Medicare in Georgia shot up between 2013 and 2019. (Credit: Brittney Phan for State Affairs)
OUR STORY
Part I: The Search for Answers
Georgia is among the highest spending states in the U.S. when it comes prescription drugs and out-of-pocket costs, according to national researchers.
Part II: A Window into Drug Costs
Seeing her monthly bills for prescription drugs on paper is bad enough for Nicola Jackson. Having to tell her husband about it makes the stress even worse.
Part III: Choosing Drugs over Groceries
While Medicare data hint at rising medication costs across the board in Georgia, research by NiceRx shows prices for many high-demand prescription drugs have also ballooned – including for several drugs that Jackson needs.
Part IV: Prescription-Drug Blame Game
Critics trace rising drug costs largely to intermediary companies called pharmacy benefit managers that have pointed the finger right back at drugmakers, pharmacies and other key players.
Part V: Lawmakers Push for Transparency
State regulations and a law firm's investigation into prescription drugs under Georgia's Medicaid programs have kept the focus on pharmacy benefit managers in recent years.
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Latest Stories
Republican-drawn congressional map passes Senate committee
State lawmakers are days away from a judge-imposed Dec. 8 deadline to create new electoral maps for the Georgia General Assembly and U.S. Congress, also known as redistricting.
Our senior investigative reporters, Tammy Joyner and Jill Jordan Sieder, have been giving special attention to the special legislative session at the Capitol. Joyner is following the Senate proceedings, while Sieder is following the House proceedings. They are your eyes and ears during the session, which means you will find a variety of stories and live updates on what’s happening inside and even outside of the Capitol.
We’d love to hear from you — our readers. If there’s something you would like us to report on during the special session or just have a question about what’s going on, shoot us an email at [email protected].
Here are some of the highlights of Monday’s session.
Quote(s) of the day:
“Don’t act in this body based on the way people treat you, act in this body because it’s right, it’s just, it’s wise. Do what’s right because it’s the right thing to do.”
— The Rev. George Dillard, pastor of Peachtree City Christian Church, speaking to the Georgia Senate.
“Isn’t it true that the only good thing that ever came from Alabama is I-20?”
— Majority Leader Sen. Steve Gooch, during the point of personal privilege portion of the Senate session in response to Sen. Shawn Still’s “roll tide” utterance in the well. (“Roll tide” is a University of Alabama phrase used to rally Crimson Tides fans.)
Biggest thing that happened today:
Gov. Brian Kemp, backed by House and Senate members, announced plans to introduce a bill in the upcoming legislative session to accelerate tax cuts for Georgia taxpayers, to the tune of an estimated savings to their individual income tax of $1.1 billion.
The Senate Reapportionment & Redistricting Committee approved by a vote of 7-4 the “Proposed Congressional Districts of Georgia” map that was released Friday afternoon. The committee also approved the House’s Republican drawn maps by a vote of 7-4.
Interesting observation inside the Capitol:
The 33rd Christmas Tree Lighting ceremony featuring the Atlanta Boy Choir and the Atlanta Boy Choir Alumni Choir. The 25-foot red cedar tree was donated by the Roy family of Ringgold.
Happening while lawmakers are in session:
Lots of school children touring the Capitol, including the Marietta Center for Advanced Academics.
What’s for lunch?
Visitors to the Capitol — and there were many on Monday due to the Christmas Tree Lighting ceremony — were treated to complimentary red and green sprinkle Christmas cookies and bottles of water.
If any senators missed lunch, they had a giant bag of Georgia peanuts waiting for them on their chamber desk for the afternoon session, compliments of Sen. Russ Goodman, R-Cogdell.
— Tammy Joyner
Quote(s) of the day:
“There is no way to create a brand new district or two new districts and not make changes to other districts that surround it. … Creating a new district is like dropping a rock on a still pond, and the ripples go out.”
– Rep. Rob Leverett, R-Elberton, House redistricting committee chair, responding to a question from Rep. Sandra Scott, D-Rex, about why the Senate map was “changed drastically.”
“The one thing we’re missing is the thousands and thousands of lives that have been lost on all fronts, Jewish and Palestinian … This resolution needs to be a call for peace, a call that condemns the terror but also the unilateral killing of civilians on all sides.”
– Rep. Spencer Frye, D-Athens, on HR 4EX, condemning Hamas terrorism and expressing support for the Jewish people, which passed after an hour of debate on the House floor.
Biggest thing that happened today
The House Reapportionment and Redistricting Committee voted 9-4 to approve the Senate redistricting plan passed by the Senate last week. Earlier, the committee released its proposed electoral map for the U.S. House in Congress. Public comment on the map will occur tomorrow, and can be made online here.
Interesting observation inside the Capitol:
After the Atlanta Boys Choir performed, Lane Howard spoke on behalf of Clark’s Christmas Kids and her husband, radio and tv personality Clark Howard, who she said was being prepped for heart surgery. This year the charity is collecting gifts for about 12,000 Georgia children in foster care, both online and at Walmart stores across the state.
Gov. Brian Kemp said he was not surprised that Howard’s heart needed a bit of repair, “since he works that heart hard” in his effort to bring joy to foster children.
Happening while lawmakers are in session:
Among the groups of school kids visiting today were students from the Wesleyan School in Peachtree Corners, who proposed a series of new laws to their district representative, Rep. Scott Hilton, while gathered in the balcony of the House. Many of their proposals would allow children to drive before age 16.
What’s for lunch?
Tables with bags of holiday snack mixes of Chex cereal, pretzels, nuts and M&Ms were available to Capitol visitors.
— Jill Jordan Sieder
[email protected]
In case you missed it, here’s what you need to know about the special legislative session.
In case you missed it, here’s what you need to know about the special legislative session.
- What is a special session of the Georgia Legislature, and why is it happening?
- Legislators schedule special assembly to address redistricting, but will they make headway?
- Say what? Terms you may hear during the special session
Subscribe to State Affairs so you will have unlimited access to all of our stories.
We’d love to hear from you. If there’s something you would like us to report on during the special session or just have a question about what’s going on, shoot us an email at [email protected].
Despite opposition, both chambers pass their proposed redistricting maps
It’s crunch time for state lawmakers tasked with meeting a Dec. 8 deadline for creating new electoral maps for the Georgia General Assembly and U.S. Congress, also known as redistricting.
Our senior investigative reporters, Tammy Joyner and Jill Jordan Sieder, were covering the special legislative session at the Capitol this week. Joyner is following the Senate proceedings, while Sieder is following the House proceedings. They will be your eyes and ears during the eight-day session, which means you will find a variety of stories and live updates on what’s happening inside and even outside of the Capitol. The special session will resume on Monday. And so will we.
We’d love to hear from you — our readers. If there’s something you would like us to report on during the special session or just have a question about what’s going on, shoot us an email at [email protected].
Here are some of the highlights of Friday’s session.
In and about the Senate
Quote(s) of the day:
“In the maps being drawn by the Republican majority, 80% of the Black voters on the map who are being redistricted come from outside these new growth areas where there are large and growing Black populations. And yet the court specifically identified disenfranchisement areas within the order. Eighty percent of Black voters are being shuffled around. This is like the Republicans’ mother scolded them and said, ‘Clean your room.’ And instead of doing that, they hung up a couple of shirts and left all of the dirty underwear all over the floor.”
— Sen. Elena Parent, D-Atlanta, said of the proposed map change
“It hurts my feelings. I get defensive because I feel like I’m essentially being called a racist for supporting a map that is compliant with racial numbers the judge wants.”
— Sen. Bill Cowsert, R-Athens, who gave an eloquent history of redistricting in Georgia
Biggest thing that happened today:
The Congressional map proposed by the state Senate for the U.S. House was quietly released Friday afternoon to little fanfare after both chambers’ sessions had adjourned. Next week’s session will clearly focus on that map.
Meanwhile, after more than four hours of debate, the Senate passed Senate Bill 1 EX by a vote of 32-23. The bill is the proposed revised district map, which drew lots of opposition from voting rights groups and Democrats who say the map still dilutes Black voting power and violates Section 2 of the Voting Rights Act.
Lots of partisan volleying back and forth. Democrats accused the Senate Committee on Reapportionment and Redistricting of not allowing enough time for people to speak about the map. Republicans held firm that the map meets U.S. District Judge Steve Jones’ order.
After the Senate map’s passage, the Senate Redistricting Committee met briefly to hear public comment on House Bill 1 EX — the House’s proposed district map, which also passed the House on Friday. No action was taken.
Interesting observation inside the Capitol:
A group of children, babies in strollers and their parents with South Cobb Homeschool filed through the Capitol.
Happening while lawmakers are in session:
A group of health care professionals greeted lawmakers and visitors as they entered the Capitol with signs urging safe storage of firearms. They handed out information that noted 4.6 million children live in homes with at least one loaded, unlocked firearm. They mentioned HB 161, hoping that bill will see some movement when the Legislature reconvenes on Jan. 8.
What’s for lunch?
There was no official break for lunch. Some senators worked through lunch, grabbing snacks from the nearby mini cafe off the side of the chamber.
— Tammy Joyner
In and about the House
Quote(s) of the day:
“This map is an undemocratic, un-American, blatant exercise of partisan gerrymandering that harms the freedom of Georgians to elect their candidates of choice … Unfortunately it seems that we are repeating the mistakes of our dark past under Republican control of the Georgia Legislature.”
— Minority Whip Sam Park, D-Lawrenceville, on the proposed state House map
“I had to take a test to vote … I understand why voting matters … and as an attorney, I understand that when a judge tells you to do something in an order, you comply. He said to create five majority-Black districts — not opportunity districts or coalition districts or crossover districts. Chairman [Rob] Leverett’s map complies with everything the judge required.”
— Rep. Soo Hong, R-Lawrenceville, Gov. Kemp’s floor leader
Biggest thing that happened today:
The state House voted 101 to 78 along party lines to pass the proposed House electoral map crafted by Republican leadership, over the intense objections of Democrats, who said the map violates the Voting Rights Act by breaking up two minority opportunity districts and unnecessarily eliminating or vastly changing Democratic districts.
Minority Leader James Beverly, D-Macon, said the GOP maps “failed to remedy the wrong directed toward our African-American electorate that was disenfranchised” by the maps enacted by the Republican-controlled Legislature in 2021. He was also frustrated by the earlier decision of House redistricting committee chair Rob Leverett, R-Elberton, to bar a Democratic amendment that would have presented an alternate map for the committee to consider. The amended plan would have decoupled six incumbent Democrats and two incumbent Republicans who were paired in the same districts in the GOP plan.
Leverett said he could not find a way to comply with the court order to create five majority-Black districts without creating some incumbent pairings, noting, “we did not inflict political casualty solely on the opposing party — we took some damage ourselves.”
Interesting observation inside the Capitol:
Facility staff put the finishing touches on holiday decorations inside the Capitol, including putting the star on the giant Christmas tree in the rotunda, which will be decorated with much fanfare on Monday.
Happening while lawmakers are in session:
The Christmas decorating wasn’t limited to inside the corridors of the Statehouse. Facility staff were also sprucing up the outside with Christmas cheer, too.
What’s for lunch?
Some House members enjoyed pizza, and this intrepid reporter had what is certain to be her first — and last — Hot Pocket.
— Jill Jordan Sieder
In case you missed it, here’s what you need to know about the special legislative session.
Subscribe to State Affairs so you will have unlimited access to all of our stories.
We’d love to hear from you. If there’s something you would like us to report on during the special session or just have a question about what’s going on, shoot us an email at [email protected].
On the ground: Day 2 of the Georgia special legislative session
It’s crunch time for state lawmakers tasked with meeting a Dec. 8 deadline for creating new electoral maps for the Georgia General Assembly and U.S. Congress, also known as redistricting.
Our senior investigative reporters, Tammy Joyner and Jill Jordan Sieder, are at the state Capitol for the special legislative session. Joyner is following the Senate proceedings, while Sieder is following the House proceedings. They will be your eyes and ears during the eight-day session, which means you will find a variety of stories and live updates on what’s happening inside and even outside of the Capitol.
We’d love to hear from you — our readers. If there’s something you would like us to report on during the special session or just have a question about what’s going on, shoot us an email at [email protected].
Here are some of the highlights of Thursday’s session.
Quote(s) of the day:
“Don’t take life for granted.”
— Sen. Rick Williams receives a standing ovation from his peers after conveying his ordeal getting medical help in his rural community following a Nov. 3 heart attack.
“Do the right thing here, people, it’s not that hard.”
— Community organizer Michelle Sanchez
Biggest thing that happened today:
After some heated exchange, the Senate Reapportionment & Redistricting Committee approved its proposed map, rejecting the Democrats’ plan. The 7-5 vote fell along racial and party lines, with the committee’s five Black members voting in favor of the Democratic-drawn map. Sen. Gloria Butler, who presented the Democratic plan to the committee, expressed concern about the way the process was handled regarding the two maps. The map now goes to the Senate floor.
“Yesterday [when the Republican plan was presented], the committee didn’t ask questions. Today, the committee members got to ask questions. All of the public did not get an opportunity to express themselves but they did yesterday. So in my view, that’s two processes. We need to be consistent,” said Butler.
Interesting observation inside the Capitol:
Senators arrived for the afternoon session to find two books wrapped in a bow at their chamber desk. One book was photos of the lawmakers during the 2023 session. The other book was “Unlimited” by Benny Tate. The books are an early holiday gift from Lt. Gov. Burt Jones, president of the Senate. Tate is senior pastor of Rock Springs Church in Milner, where Jones attends services.
Happening while lawmakers are in session:
Unlike Wednesday’s opening session when community activists, school children and other visitors swelled the hallways of the Capitol, Thursday’s special legislative session was rather low-key.
What’s for lunch?
Senators had a catered lunch of chicken and steak fajitas from On the Border.
— Tammy Joyner
Quote(s) of the day:
“The truth of the matter is that we have delivered a map that we’re sure complies with the judge’s order. Y’all have not. There is a remedy. If we were to look at the area south and west of Atlanta, there’s one representative that you’re trying to save, but that one representative that you save is going to cost us all in the end. If you accept our map, then one representative may be eliminated. That’s the will of the voters. If you don’t accept our map and the judge has to do a special master, then every last one of us, 180 of us, are in jeopardy. Y’all have some big decisions to make.”
— House Minority Leader James Beverly
Biggest thing that happened today:
In the House Reapportionment and Redistricting Committee meeting, Republican members rejected an alternate House district plan proposed by Democrats and the committee voted 9 – 5 along partisan lines to approve the Republican chair’s plan already submitted.
House Minority Leader James Beverly, D-Macon, and civil rights attorney Bryan Sells presented the Democrats’ proposed plan. Sells said it cures a problem in the Republicans’ plan, which “unravels or dismantles two protected coalition districts” with majority minority voters, which he said would likely cause a federal judge to find the plan in violation of the Voting Rights Act.
Rep. Mary Margaret Oliver, D-Decatur, who has served in the Legislature for 25 years, told the redistricting committee she was shocked to learn her House District 82 in Dekalb County has been redrawn in a way that tears apart a growing coalition district of diverse minority communities. She called the changes a “glaring violation” of voting rights law that Judge Jones is likely to take issue with, and offered to help GOP lawmakers to remedy the plan.
Interesting observation inside the Capitol:
During their morning session House members watched a 120-second time-lapse video of the renovation work performed inside the Capitol over the summer and fall, which included painting virtually all the walls, columns and balconies in the building. After watching the blur of scaffolding, ladders and workers transform several spaces, members applauded all of the workers responsible for the transformation.
Happening while lawmakers are in session:
There was nothing of note happening outside the Capitol today.
What’s for lunch?
Members of the House Agriculture & Consumer Affairs Committee enjoyed Jersey Mike subs today, including roast beef, turkey, Italian and club sandwiches.
— Jill Jordan Sieder
Our stories explaining what’s behind the special legislative session:
- What is a special session of the Georgia Legislature, and why is it happening?
- Legislators schedule special assembly to address redistricting, but will they make headway?
- Say what? Terms you may hear during the special session
Subscribe to State Affairs so you will have unlimited access to all of our stories.
Georgia lawmakers push for repeal of law determining where medical facilities are built
A study committee of Georgia senators took a decisive step Tuesday toward ending a longstanding and contentious law that regulates how and where new medical facilities are located in the state.
The committee’s decision centers on the 44-year-old Certificate of Need law. It was created to control health care costs and cut down on duplication of services and unnecessary expansions. It determines when, where and if hospitals need to be built. Opponents have said the law prevents competition and enables big hospitals to have a monopoly, often shutting out small and private medical outlets.
On Tuesday, the Senate Study Committee on Certificate of Need Reform effectively said the law needs to be repealed. The committee approved, in a 6-2 vote, nine recommendations.
“Based upon the testimony, research presented, and information received, the Study Committee on Certificate of Need Reform has found that the problem Georgia’s CON law was intended to combat no longer exists,” the report said.
However, the head of the Georgia Alliance of Community Hospitals said Tuesday that repealing the law would be a bad idea.
“It would have a devastating financial impact on hospitals and the quality and access to health care,” Monty Veazey, the alliance’s chief executive, told State Affairs.
Veazey said he has not seen the recommendations yet but his organization has sent its own set of recommendations to the senate and house study committees.
“We believe that the certificate of need really does need some modernization and we look forward to working with the committee to work through those recommendations and see if we can reach a compromise position during the upcoming legislative session,” Veazey said. “We still want to see what the House committee recommends before moving forward.”
Here’s what the senate study committee recommends, according to a draft:
- Repeal CON requirements for obstetrics services, neonatal intensive care, birth centers and all services related to maternal and neonatal care across Georgia.
- End requirements for hospital-based CON on Jan. 1, 2025.
- Reform CON laws to eliminate CON review for new and expanded inpatient psychiatric services and beds that serve Medicaid patients and the uninsured.
- Repeal all cost expenditure triggers for CON.
- All medical and surgery specialties should be considered a single specialty, including cardiology and general surgery.
- Multi-specialty centers should be allowed, particularly in rural areas.
- Remove CON for hospital bed expansion.
- Revise freestanding emergency department requirements such that they must be within 35 miles of an affiliated hospital.
- Remove CON for research centers.
The committee will present its recommendations to the Georgia General Assembly when it reconvenes in January.
Have questions? Contact Tammy Joyner on X @lvjoyner or at [email protected].
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