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The Georgia House of Representatives passed legislation Tuesday that would significantly reform the state law governing hospital construction and medical services but stop short of repealing it entirely.

House Bill 1339, which passed 166-1 and now heads to the state Senate, includes changes to Georgia’s 45-year-old certificate of need (CON) law aimed at making health care more accessible and affordable, particularly in rural Georgia.

A state Senate study committee late last year recommended repealing the CON law as an obstacle to quality health care in Georgia. But on the House side, a committee formed by Speaker Jon Burns last year concluded reforming rather than repealing CON would offer a more realistic approach.

“We wanted to move forward in a measured way,” Rep. Butch Parrish, R-Swainsboro, who chaired the House Special Committee on Health Care and House Bill 1339’s chief sponsor, said on the House floor Tuesday. “We didn’t want to take giant leaps.”

Georgia’s CON law requires applicants wishing to build a new medical facility or provide a new health-care service to demonstrate to the state Department of Community Health that the facility or service is needed in that community.

Parrish’s bill includes provisions aimed at speeding up the state agency’s review of CON applications. The measure also removes spending thresholds governing hospital construction projects and increases the cap on the state’s tax credit supporting rural hospitals from $75 million a year to $100 million.

The legislation focuses special attention on mental health-care and obstetrics needs with new exemptions from the CON law for certain psychiatric and obstetrics services. Also, rural hospitals would be exempt from CON in some circumstances.

Although only one House lawmaker voted against the bill, several argued it doesn’t go far enough. Rep. Michelle Au, D-Johns Creek, said Georgia suffers from the second-highest uninsured rate in the nation, a problem that could be addressed if the state’s political leaders would agree to expand Medicaid coverage in Georgia through the Affordable Care Act (ACA).

Forty states, including many led by Republican governors and legislatures, have approved Medicaid expansion in the 12 years since the Congress passed the ACA. But Gov. Brian Kemp and Georgia’s GOP legislative leaders have balked at a full Medicaid expansion, citing the cost.

“We need to address our high uninsurance rate and close the coverage gap,” Au said Tuesday. “We know what we need to do. We’re just not brave enough to do it.”