Looking ahead to the 2018 legislative session, two key dynamics will drive much of the activity. First, it will be Gov. Nathan Deal’s last session to move major policy issues forward as he finishes his second term in office. The Deal team is adept at maneuvering the legislative process, so anticipate significant efforts around his key priorities of education reform, economic development and criminal justice reform.

Second, the session will progress in the shadow of the May primary for all statewide offices, including the races for governor and lieutenant governor. Because many of the candidates also will be actively serving in the legislature, it is a safe bet that issues appealing to the primary electorate (particularly the Republican primary electorate) will be front and center.

Following are some of the key issues expected to see debate next year:

Budget

The state continues to perform well economically, and this continues to result in a generally stable budget situation. The legislature likely would be considering significant forward movement on spending in new priority issues, were it not for two factors. The first is a growing gap between pension funding and pension obligations for state employees and teachers. The second factor is growth in medical costs for the state employee health plan that continue to significantly exceed member contributions. Combined, these mandatory spend items will consume much of the available new funding on the cash side of the ledger. Due to the state’s strong credit position, expect to see another substantial bond package to fund a range of infrastructure priorities. Economic growth also will positively impact the availability of funding for state transportation needs since that money is largely earmarked for transportation purposes only.

Medicaid Reform

Incrementalism will be the word of the day when the legislature starts to look at changes to the Medicaid program. The state Senate finished a round of hearings on this topic around the state, and heard a great deal about the need to increase provider payments, implement new telehealth technologies and consider limited waiver-driven expansion programs to cover specific needs, such as opioid addiction and mental health. Additionally, the state is now embarking on replacement of its Medicaid Management Information System with a new modular approach, which will reshape the way the Medicaid program is technically delivered to providers and members. Because of the interplay with the Centers for Medicare and Medicaid Services on any changes — and the lack of global progress in the health reform discussion in Washington — the outlook for specific policy changes coming out of this discussion remains unclear.

Certificate of Need

This session likely will feature more discussion of Georgia’s Certificate of Need program than has occurred in recent years. Continued challenges with operating smaller rural hospitals have opened a debate about whether these laws are preventing restructuring of small hospitals and creation of urgent and emergency care facilities that can provide immediate care at a lower total cost. Additionally, the competitive Atlanta hospital operating environment may have some large organizations considering changes to enable expansion for their physician groups. Several other CON issues have been brewing for some time and will get legislative attention. Given the general opposition of most Georgia hospitals to any change, this will be another hard-fought issue in 2018.

Mass Transit

In the wake of Atlanta’s new sales tax to fund transit expansion, several other metro Atlanta jurisdictions are considering similar changes to remain economically competitive and reduce traffic congestion. These jurisdictions include DeKalb County, Fulton County and Gwinnett County. At the same time, legislators continue to examine broader governance models for transit in the metro Atlanta region. Whether any of these jurisdictions are successful will depend largely on whether they built strong legislative support around their proposals prior to the legislative session.

Sanctuary Cities

As the national fight around local compliance with U.S. Immigration and Customs Enforcement detainers heats up in Georgia, expect immigration-related legislation around this issue to emerge quickly in 2018. Given the intensity of this issue with Republican primary voters, the odds are relatively high that a bill will pass.

Rural Broadband

Speaker David Ralston put a great deal of personal effort into leading a task force looking at issues that need addressing to keep rural Georgia economically competitive. Rural broadband access is front and center in this debate. On the more controversial side, some proposed letting electric co-ops enter the broadband business. Also discussed were proposals to reduce regulatory burdens for installation and lower the sales tax on broadband equipment. While policy details are still taking shape, the odds of a major package dealing with this issue moving next year are very high.

Religious Freedom

This session almost certainly will feature debate on legislative proposals pitting the business community against social conservatives. The most prominent candidate is an effort to codify the federal Religious Freedom Restoration Act, which many businesses, activist groups and motion picture companies have identified as catastrophic from a business growth and community branding standpoint. Other permutations of this general issue have been debated as well, including new regulations around faith-based organizations that receive public funding to provide adoption and foster care services. Gov. Deal opposes any moves in this direction, which will make enactment of such legislation unlikely, at least in the 2018 session. Regardless, it will be a major point of debate.

Tax Policy

A Senate study committee spent time in the off-season examining the tax credits and deductions that are on the books in Georgia. While the Senate cannot start tax bills, the general is that there is a pretty strong appetite to implement some kind of regular sunset and/or review process for these programs. It is unclear at this point whether the House would be inclined to move in this direction. Additionally, there continues to be concern about Georgia’s recently revamped auto tax program and its impact on the leasing business. Finally, expect that debate around taxation of emerging industries, from online software and books, to retails sales and rideshares, will continue as new economic ideas collide with old tax laws.

Gun Policy

Legislative conservatives are clamoring to vote on “Constitutional Carry” legislation, which essentially negates the requirement to get a permit before carrying a firearm in public. The actual parameters are not yet available, but in a primary election year, there’s no ruling out movement on another piece of firearms legislation.

Balance Billing

The two-year-old fight among insurers, patient advocates, hospitals and physicians around billing for surprise out-of-network services will certainly continue for a third year. All parties involved agree the practice should be curtailed, but there is little agreement on how to do so. Generally, the debate revolves around what standard to use as the floor for out-of-network charges when the patient has no opportunity to consent to them in advance.

Destination Gaming

The discussion about gaming in Georgia will certainly continue next year. In general, the success of these efforts will depend on whether there is a new program or existing fiscal need that is compelling enough to get lawmakers who are concerned about the political implications of this issue to want to put it in front of voters. While primary election pressures make this a challenge, existing fund sources cannot meet the needs around rural healthcare, opioid addiction and other priorities, so many legislators will continue to look at gaming as a potential solution.

Energy Policy

As Georgia moves forward with a nuclear power expansion, some level of legislative attention will focus on the topic. However, the debate around financing is largely assigned to the Public Service Commission, so major legislative movement in the area is unlikely. A related issue concerns disposal of coal ash residuals from other states in Georgia landfills. Federal constitutional limitations outline what Georgia can do on this issue, but that will not deter concerned legislators from seeking a path forward.