The Peach Pulse: May 2016

HEALTH CARE UPDATES

healthequityAn Important Step Towards Health Equity

On May 13, the U.S. Department of Health and Human Services (HHS) issued a final rule implementing Section 1557 of the ACA, an important milestone in the movement towards health equity. Section 1557 prohibits discrimination based on race, color, national origin, sex, age, or disability in all health programs and activities that receive federal financial assistance through HHS, are administered through HHS, or are established under Title 1 of the ACA. Notably, Section 1557 marks the first time that sex discrimination in health care is prohibited and clarifies that gender identity and sex stereotyping are included in this definition. For more check out this blog post.


networkadequacyYield for Consumers: Insurance Mergers in Georgia

The Georgia Department of Insurance will hold hearings this summer on proposed health insurance company mergers that, if approved as requested, could limit choice and increase costs for Georgia health care consumers. Georgia regulators have the opportunity through these hearings to assess the merits of these mergers and to place conditions on them that can mitigate negative outcomes for consumers, but advocacy is needed to accomplish this. Read on for more about mergers, how GHF plans to engage in the hearing process on behalf of Georgia health care consumers, and how you can weigh in.


share_OE4#Enrollment365

The weather is heating up and the official start of summer is just around the corner, but here at GHF we’re already looking ahead to one of the hallmarks of fall: open enrollment! Earlier this spring, new renewal policies and consumer shopping tools were announced and health insurance plans released their initial rate filings, giving us early insights into what we might expect in the upcoming open enrollment period: November 1, 2016 – January 31, 2017. But while we’re busy preparing for OE4, we also know that health insurance enrollment happens year-round. Read on for more about new rules for special enrollment periods, rate filings, and how to stay up to date on all things enrollment.


THE IMPACT OF THE CONSUMER VOICE

Does a strong consumer voice make a difference in health policy outcomes? At GHF, consumer engagement is woven into each of our initiatives to bring the needs and voices of Georgia health care consumers into the public policy process. Over the past two years, one of our top priorities has been maximizing health insurance enrollment and ensuring that once enrolled, consumers can access the care they need. Our work in this area, along with that of similar efforts in seventeen states, was recently evaluated by Mathematica. The evaluation focused on the activities and outcomes of the eighteen Consumer Voices for Coverage projects funded by the Robert Wood Johnson Foundation. Learn more about the evaluation findings here.


COVER GEORGIA UPDATES

Spring SummitCover Georgia Spring Summit 

This month, members of the Cover Georgia Coalition met for a half-day meeting to discuss what advocates can do to make sure that Georgia closes its coverage gap in 2017. If your organization is interested in joining the coalition, reach out to Laura Colbert. If you are an individual advocate who’d like to join the movement here are three ways you can get involved:

  1. Share an infographic on social media about the coverage gap
  2. Sign the petition to close the coverage gap

Join the Georgia Health Action Network to receive updates on progress and prompts to reach out to legislators, engage on social media, and other quick actions


UPCOMING EVENTS

Final book cover-1A Conversation with Author Mike King

The Warren City Club
July 19, 2016
6:30 – 8:30 PM

Health care advocates and friends – please join GHF for a book signing and conversation with Atlanta journalist Mike King, author of A Spirit of Charity: Restoring the Bond Between America and Its Public Hospitals. His new book explores the role of public hospitals in our health system, weaving Georgia’s history – and the history of Grady – into this national story. You can read more about his book here. We look forward to an evening of lively conversation about the role of safety net hospitals here in Georgia and throughout America. We will provide a light dinner and there will be a cash bar. This is a free event. RSVP here.


CHIA 2015 AwardsConsumer Health Impact Awards 

Please join us for our second annual Consumer Health Impact Awards! This event shines a spotlight on advocates, community leaders, and state policymakers working to improve health in Georgia through service and advocacy. RSVP for the event here.

We will be announcing 2016 awardees in the coming weeks – look out for that announcement!


IN THE NEWS

Some rates in Georgia insurance exchange could soar in 2017
Andy Miller, Georgia Health News

Ruling against Obamacare a win for GOP, but impact for Georgia on hold
Tamar Hallerman, The Atlanta Journal-Constitution


The Peach Pulse: April 2016

GHF IN THE COMMUNITY

PWP Studio photographers specialize in corporate event photography, decor, details, incentive travel, conventions, and on-location photography in Atlanta, GeorgiaGHF Presents at Connections 2016

GHF’s Cindy Zeldin and Laura Colbert presented at the Healthcare Georgia Foundation’s 2016 Connections conference. They shared GHF organizational strengths that foster and support the development of strategic partnerships and cooperation. Check out Laura’s blog post about the conference for resources and more!

 

Whitney LWV 4.16GHF joins League of Women Voters for Annual Meeting

On Saturday, April 21st, GHF’s Whitney Griggs spoke to the Fulton County League of Women Voters about health care issues addressed in the 2016 legislative session. She highlighted bills focused on health care disparities and the coverage gap.

 

 


GOVERNOR DEAL SIGNS BIPARTISAN PROVIDER DIRECTORY LEGISLATION

IMG_8559GHF and partners attend signing of SB 302 

Last week, Governor Deal signed SB 302 into law! GHF advocated throughout the Legislative Session for this bipartisan bill to improve the accuracy and usability of provider directories. SB 302 is an important step towards making provider directories the accurate and functional tool that consumers need to make the best health care decisions for themselves and their families. Georgia’s proactive move is being noted by national partners – check out the coverage!

Consumers Union – Consumers Score Victory with Georgia Provider Directory Legislation Signed into Law

Families USA – How States Are Improving Consumers’ Access to In-Network Health Care Providers

Community Catalyst – Protecting Health Care Consumers in the Peach State

For more information and resources on provider directories, check out our blog post.


NEW AT HEALTHYFUTUREGA.ORG

Rural-Georgians-Coverage-GapInfographics page 

We know you care about advocating for a healthy future – it’s why you signed up for our emails! We also know you’re busy. So we’ve been working on ways you can learn, engage, and participate in the way that works best for you! One such avenue is through our infographics page. There you’ll find infographics on the issues you care about and easy buttons to share them on social media! If you’re on Pinterest, you can also follow our infographics board.

 


APRIL EVENTS

Inman Park Festival 2016Inman Park Festival – GHF goes to the community

This past weekend, GHF had a table at the Inman Park Festival. Whitney and Laura were on hand to talk about the coverage gap and other GHF priorities. We collected dozens of close the gap postcards and gave out goodies to those that stopped by! Thank you to our partners at Feminist Women’s Health Center for joining us at the festival!

 

 

policy-prioritiesPost Legislative Session Webinar 

If you weren’t able to attend our April 5th webinar, Changes in health Care and Policy in the 2016 Georgia Legislative Session, don’t worry, you can watch it here. The webinar reviews bills, resolutions, and budgetary items discussed during the 2016 Legislative Session that may impact Georgia’s health care system and health care consumers. Have questions that didn’t get answered? Email Laura!

 


PARTNER HIGHLIGHT

Dibeties team

American Diabetes Association – Georgia Chapter

GHF is excited to partner with the Georgia chapter of the American Diabetes Association to support health advocacy work that can improve the lives of people affected by diabetes. Advocacy collaborations involve participation in the effort to pass SB 302, expansion of the American Diabetes Association’s Safe at School training program, and a Diabetes Advocacy Day at the Capitol in 2017. For information on involvement with the American Diabetes Association please contact Rebecca Drake.

The mission of the Georgia chapter of the American Diabetes Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes in the state.


SAVE THE DATE: SEPTEMBER 28, 2016

Photo Sep 09, 9 13 38 PMJoin us for the 2nd annual Consumer Health Impact Awards!

We had a blast celebrating advocacy and health advances in Georgia with you last year and we can’t wait to do it again! Voting is now open for the Linda S. Lowe Health Advocacy Award and for the Community Impact Award. Know a person or organization whose work deserves to be recognized? Nominate them today! If you’re interested in sponsoring you can learn more here. RSVP here.


GHF WELCOMES NEW BOARD MEMBERS

DeepShah_headshotDeep Shah

Dr. Deep Shah, MD, MSc is a senior internal medicine resident at Emory University School of Medicine/Grady Memorial Hospital. He graduated summa cum laude from the University of Georgia, where he won a Rhodes Scholarship to pursue a master’s degree in comparative social policy at Oxford. Deep then went to Harvard for medical school. He has worked as a policy fellow for Senator Johnny Isakson and Governor Sonny Perdue. He serves on the American College of Physicians’ Medical Practice and Quality Committee and Committee and Council of Resident/Fellow Members. After residency, he plans to marry his interests in primary care, health administration, and public policy.

 

porter-head-shot-608x1024Melanie Porter

Melanie recently retired from John Deere, where she worked in several diverse capacities, including Director and then Vice President of the Agri Services division of the company. Melanie led HR teams in Mergers and Acquisitions, integrating new businesses into John Deere, and was then appointed to lead a newly created HR area of Change Management, where she and her team designed and developed processes and tools that enabled aligned teamwork and supported individual and team performance improvement. She then returned to HR Operations, leading a team providing HR expertise and leadership to all the corporate functional areas of the company. Melanie also served as a Master Coach at John Deere, guiding leaders in their career objectives. She was proud to serve six years as Vice Chair of the Board for Community Health Care, Inc., an organization that provides excellent, affordable in-patient medical, dental and behavioral health care to over 35,000 patients annually.

 


IN THE NEWS

Study says United exit will hurt some exchange enrollees
April 19 | Georgia Health News


State document hints at downside to insurance mergers in Georgia
April 13 | Georgia Health News

Read More.


The Peach Pulse: March 2016

The 2016 Legislative Session has Ended

Moving Forward

policy-prioritiesThe 2016 Legislative Session has come and gone. If you’re still catching up on everything that happened, check out our legislative tracking page to see what passed, what didn’t, and what’s been signed by the Governor thus far. You can also find our video series, Consumer Health Advocacy Today (CHAT), on ourYouTube page.

Click here to read a letter from our Executive Director, Cindy Zeldin, as she reflects on the session and what’s ahead for Georgia’s health care consumers.

If you missed our webinar earlier today on changes in health care policy in the 2016 legislative session, join the Georgia Health Action Network to receive the recording.


Closing Georgia’s Coverage Gap

Tracy-Screenshot

Working together to close the coverage gap

GHF and the Cover Georgia Coalition are gathering stories and signatures! Stories like Tracy’s help to put a human face to Georgia’s decision not to expand Medicaid. If you fall into the coverage gap, your story can make a difference in convincing our lawmakers to close the gap. To share your story, email Whitney.

If you’d like to show your support for closing the gap you can sign this petition to close the coverage gap and share it with your friends, family, and social network.

In addition to the petition, GHF & Cover Georgia are collecting post cards, like the one above, to show lawmakers that their constituents support closing the gap. If your organization would like hard copies of postcards, like the one above, to help collect signatures in your outreach, let us know! We’re also available to give presentations on the coverage gap and what it means for all Georgians. For more information about presentations, email Laura.


Save the Date!

slider_CHIA_savethedate

The Consumer Health Impact Awards are back!

After an amazing first year, we are thrilled to announce the date for the second annual Consumer Health Impact Awards! Nominations for this year’s awardees start soon and now is the time to start thinking about who should take home the 2016 Linda Smith Lowe Advocacy and the Community Impact Award! Already know you want to go? You can RSVP here. Sponsorship opportunities can be found here.


GHF Welcomes New Staff Member

Dobra-HeadshotSarah Dobra – Director of Development & Operations

GHF is excited to welcome Sarah to the GHF team! In her role she will provide operational, development, planning and evaluation, and editorial support to ensure that we’re functioning well across programs and projects. Prior to joining GHF, Sarah was the Disparities Manager and Cancer Care Delivery Research Program Coordinator at a community cancer center in Savannah, Georgia. In this position Sarah successfully leveraged community  partners to support cancer prevention and screening activities to address cancer disparities as part of a larger community network. Sarah obtained her law and master’s in Public Health degrees at Tulane University and holds a B.A. from the University of Oregon. Sarah can be reached at sdobra@healthyfuturega.org – join us in welcoming her!


GHF in the News

Bill aims to erase errors in insurers’ medical directories 
by Andy Miller, Georgia Health News

“Directory errors can be common. For example, a “secret shopper” survey done by Georgians for a Healthy Future found numerous errors in four “silver-level” HMOs in Atlanta that the consumer group examined. The survey found that one in five primary care doctors listed as participating in a plan’s network were not actually in that network, Cindy Zeldin, executive director of the consumer group, told GHN on Wednesday…” Read more.


The Peach Pulse: February 2016

Getting What You Pay For

groupGHF and Georgia Watch host policy forum on network adequacy, surprise out-of-network billing, and provider directory accuracy.

Early in February, GHF and Georgia Watch partnered to host policymakers, stakeholders, and advocates at a policy panel on important health insurance consumer protections. The event opened with remarks from Senator Dean Burke and included presentations from Consumers Union’s Julie Silas, Georgia Watch’s Beth Stephens, and GHF’s Meredith Gonsahn. If you missed the event, you can find presentations and materials below!

Julie Silas’s presentation: Finding Policy Solutions for Provider Directories and Surprise Medical Bills

Meredith Gonsahn’s presentation: Improving Network Adequacy and Provider Directory Standards in Georgia

Video interviews with Julie Silas on network adequacy and provider directories

Who was there? Check out the photo album.


New Policy Briefs

network-adequacy-briefEnsuring Access to Care: Setting and Enforcing Network Adequacy Standards 

When consumers enroll in a health insurance plan, they gain access to a network of medical providers. This network must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. The goals of this policy brief are to:

-explain the importance of network adequacy for access to care

-outline current network adequacy standards in Georgia

-summarize recent policy activity around network adequacy

-set forth consumer-oriented principles for network adequacy standards in Georgia

-provide policy recommendations to achieve network adequacy in Georgia.

Download the brief.

provider-directory-briefEnsuring Access to Care: Improving Provider Directory Accuracy and Usability

Provider directories are the primary tool available to consumers to determine whether the plan they are selecting has a narrow or broad network and to identify which providers are in their plan. As such,these directories should be accurate, up-to-date, and should truly function as a tool. The Georgia Legislature has taken the first steps to addressing these issues through SB 302, the Provider Directory Improvement Act. The bill passed unanimously in the Senate and is now in the House Insurance Committee for consideration.The goals of this policy brief are to:

-explain the role provider directories play as a tool for consumer decision-making

-describe current provider directory provision in Georgia

-describe common problems with provider directories

-outline recent policy activity around provider directories

-highlight other state examples of provider directory improvments

Download the brief.


Legislative Updates

Mental.Health.Day_Jan.2016_edittedGHF and partners take to the Gold Dome! 

Whitney and Laura have been spending extra time at the Capitol lately with our coalition partners. Many organizations host lobby days during the legislative session when grassroots advocates can come to the Capitol to make legislators aware of issues that they care about and advocate for relevant legislation. Our partner organizations have invited GHF to attend many lobby days to talk to their attendees about closing Georgia’s coverage gap and other items on our policy agenda. Whitney and Laura have also provided coverage gap lapel stickers so this issue is visible to all people in the Capitol, especially legislators. Thank you to all our partners for sharing your lobby days with us and helping to foster new coverage gap advocates!

Consumer Health Care at the Capitol
Throughout the session we’ve been sending weekly legislative updates about the issues we’re following at the Capitol, such as the Provider Directory Improvement Act, proposals to close the coverage gap, and other bills that could impact your health care. If you missed an email, you can find all updates here. You can also see all the bills we’re tracking here.


GEAR Update: Special Enrollment Period Changes 
We want to hear from you – new SEP rules! 
At the beginning of last year’s open enrollment period, GHF created GEAR, the Georgia Enrollment Assister Resource Network (GEAR). GEAR is a coalition of enrollment assisters and those closely involved in the enrollment process. Now the open enrollment is passed, GEAR is turning to tax time and special enrollment periods (SEPs). Last month, CMS announced the new special enrollment confirmation process. Georgians will now be required to provide sufficient proof to the marketplace to determine their SEP eligibility. Failure to provide supporting documents may lead to the denial of coverage. At GHF we advocate for policies that make enrollment in health insurance more inclusive and  fight policies that put up unnecessary barriers. We want to hear from you about this! If you’re an enrollment assister and are experiencing trouble enrolling consumers during a special enrollment period, let us know! If you’d like to join the GEAR network, you can do that here.


GHF Welcomes New Board Members
Haque-aliyyaAliyya Haque
Aliyya Haque is an associate in Alston & Bird’s Products Liability group. She represents industry in scientifically-complex matters, typically involving toxic tort, product liability, ad consumer fraud allegations. Aliyya specializes in working with experts to communicate the client’s scientific case to a non-technical audience. Representative industries include telecommunications, food and beverage, chemicals and minerals, automotive and home construction products. Aliyya received her J.D. from Emory University School of Law. Prior to attending law school, she obtained a M.P.H in health systems management from Tulane University and a B.A. in human biology and a minor in art history from Stanford University.

Caley_headshot_2014-300x300-1Sylvia Caley

Sylvia returns to the GHF’s board of directors. She is an associate clinical professor at Georgia State University and is director of the Health Law Partnership (HeLP), a medical-legal community collaboration among Children’s Healthcare of Atlanta, the Atlanta Legal Aid Society and the College of Law at Georgia State. Caley has extensive experience in health care, health law and policy, and poverty law, and her work-related interests have centered on the intersection of health and poverty. She is a member of the Grady Health System Ethics Committee and the Children’s Healthcare of Atlanta Bioethics and public Affairs Committee. Caley teaches courses on health policy and legislation and clinical skills. She also lectures extensively on legal issues affecting child health and well-being

 


GHF in the News

Closer Look – WABE
59:18: Cindy Zeldin, executive directory og GHF, expamines current state legislation related to healthcare and health policy.


A small, surprising step toward a big change in health coverage? – Georgia Health News
“The bill may not get very far this year, with time running out in the General Assembly session and without the fiscal impact yet studied. But a Senate health committee broke new ground by holding a legislative hearing on a proposal, SB 368, that would create a Medicaid expansion alternative in Georgia…”


ACA enrollment tops 587,000 in Ga., but insurers nervous over sign up rules – Georgia Health News
“More than 580,000 Georgians signed up for coverage in the insurance exchange during the third open enrollment for the Affordable Care Act…”


Bipartisan Cooperation on Health Care in Georgia, But Not Medicaid Expansion – Atlanta Progressive News
“Medicaid expansion may be dead for the year, but there appears to be bipartisan cooperation on other health policy issues..”

 


The Peach Pulse: January 2016

INTRODUCING THE GEORGIA HEALTH ACTION NETWORK (GHAN)

What is GHAN? 

GHAN is your way to keep up with and take action on the health care policy issues you care about. By signing up to be a part of GHAN you’ll receive action alerts with things you can do, like sign a petition, share an infographic with your social network, or contact your legislator to raise awareness and advocate for important consumer health issues. To join GHAN, email Anna.


LEGISLATIVE UPDATES

policy-prioritiesThe Georgia Legislative Session is in full swing

It is a short session this year and it’s amazing we’re already almost a month in! GHF is at the Capitol every day, advocating for consumer health care protections. To see a list of the bills we’re tracking,click here. We’re very excited that Senator P.K. Martin has introduced a bill, SB 302, that would increase transparency and the usability of health insurance provider directories. The bill has strong bipartisan support and is scheduled for a hearing Monday, so stay tuned for that update! Conversations also continue around surprise medical bills, network adequacy, and closing the coverage gap.

Read the Week One update.

Read the Week Two update.

Read the Week Three update.

If you’re more of a visual person, you might want to check out our video series, CHAT (or Consumer Health Advocacy Today) where we talk to policy makers and experts about what’s going on under the Gold Dome.


OPEN ENROLLMENT ENDS

Pranaya Outreach 10.15GHF helped over 100 people get covered

Open enrollment formally concluded on January 31, 2016 and 587,845 Georgians enrolled in the Marketplace (healthcare.gov).

Throughout open enrollment, GHF worked to get Georgians enrolled through direct service and the creation of GEAR (or the Georgia Enrollment Assister Resource Network). GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners who work with consumers to educate them on their health and health care coverage options. If you are interested in learning more about GEAR or want to sign up for the newsletter, email Whitney. Additionally, during this open enrollment period we have provided enrollment assistance to 78 applicants and their families, totaling 141 Georgians. Of those, 91%  received financial assistance.


WHY THE COVERAGE GAP MATTERS

Henry.-Savannah-GA-1.16On January 19th, GHF’s Outreach and Engagement Manager, Whitney Griggs, was in Savannah talking to people who fell into the coverage gap. One of them was Henry. Henry had been working as a super heavy hauler, but had to stop working in 2008 to take care of his diabetes and other health issues. He intended to return to driving once his health problems were under control, but he was diagnosed with thyroid cancer and could not return to driving or working. He is currently managing several severe health issues, including diabetes, blood clots in his lungs and legs, thryroid cancer, and COPD. Although, he is able to get some of his care from St. Mary’s, he has many unpaid medical bills. He must rely on his elderly mother to help pay some of his costs, which he says is difficult because she lives on a fixed income.  Stories like Henry’s highlight the need for Georgia to close its coverage gap to make sure all Georgians are able to get the care they need. If you or someone you know has a story of being uninsured that you would like to share, please contact Whitney.


6TH ANNUAL HEALTH CARE UNSCRAMBLED

Health Care Unscrambled 2016

Starting the Year Off Right 

There’s something wonderful about a room full of people talking about how to improve Georgians’ access to quality, affordable health care. No matter the path we advocate for, the end goal is the same. This year we hosted a bipartisan legislative panel that included Reps. Lee Hawkins and Debbie Buckner and Sens. Greg Kirk and Emanuel Jones. Following the legislative panel, two national experts, Sue Polis from Trust for America’s Health and Lynn Quincy from Consumers Union, spoke on emerging trends in health care policy. Check out this blog to see pictures from the event, read the media’s write up, and watch interviews with the panelists.


GHF IN THE NEWS

Last Call to Enroll for 2016 Insurance Under the Affordable Care Act 
New York Times | January 29, 2016

Read full article.

Legislative panel reflects divide on Medicaid expansion 
Georgia Health News | January 14, 2016

Read full article.

Rare metal: Where are the Platinum plans?
Georgia Health News | January 4, 2016

Read full article.


The Peach Pulse: December 2015

The holidays are behind us and the legislative session is here! Here’s what you need to know about December before we get too far into January!


Upcoming Events

STDHealth Care Unscrambled 2016

It’s not too late to register! Health Care Unscrambled, GHF’s signature event, is this Thursday. Join us for breakfast and conversation with a bipartisan panel of legislators who are focusing on health policy issues under the Gold Dome this session. Then stick around for a deep dive on emerging issues for health advocates with Lynn Quincy of Consumers Union and Sue Polis from Trust for America’s Health.

RSVP

 

Legislative-Webinar-4-15-2Webinar: A Look Ahead at Health Care Policy in the 2016 Georgia Legislative Session

Can’t make it to Health Care Unscrambled? You can still get the information you need to advocate on health care policy issues in the 2016 legislative session by attending our upcoming webinar. We will preview expected health care legislation,present GHF’s policy priorities, and let you know how you can get involved. The webinar is scheduled for Thursday, Jan. 21st, noon to 1 pm.

Register Here

 

Getting What You Pay For: Consumer Protections for Network Adequacy, Surprise Medical Bills, and Provider Directories

February 2, 2016 – 8am
Freight Depot, Blue Room

Join us and Georgia Watch for a policy forum featuring an in-depth panel discussion on network adequacy, surprise medical bills and provider directories. Panelists will speak on how these issues are impacting consumers in Georgia and across the nation, policy implications, current legislative work and how you can get involved in supporting advocacy efforts. The panel will feature:

  • Senator Dean Burke, District 11
  • Julie Silas, Consumer Union
  • Meredith Gonsahn, Georgians for a Healthy Future
  • Beth Stephens, Georgia Watch

RSVP


Policy Updates
Study committee work has finished, reports trickle in

Georgia legislative study committees meet during the off-session to study and make recommendations for the General Assembly around specific policy issues. GHF has been following and participating in the study committees focused on health issues impacting consumers. Read our Health Policy Analyst Meredith Gonsahn’s blog for a run-down of committees that have published their reports, the issues they investigated, and report recommendations.

Read blog.

GHF releases our policy priorities

Policy_Priority_ThumbnailThe 2016 Legislative Session has officially begun and at GHF we have released our 2016 policy priorities. You can download the PDF below or you can watch the one minute video by clicking on the image to the right for a quick run-down!

Download our 2016 policy priorities


ACA Implementation Research Network

Dec18.2015forumIn December, the ACA Implementation Research Network released its Georgia state report at a policy forum held at the Community Foundation for Greater Atlanta. Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated in a discussion with advocates, policymakers, and stakeholders to reflect on the report’s findings. The conversation ranged from health insurance enrollment best practices to health system reform to what it will take to close the coverage gap in Georgia.

Download the Report


Enrollment Update

Parker & Sharda Tankoo_enrolled 2016 (3)By the 9th week of Open Enrollment 3, more than 8.6 million consumers nationally and 517,000 in Georgia have enrolled in health care coverage through the Marketplace. In addition to GHF’s collaborative work with the enrollment assistance community, we also help individuals and families enroll in health insurance! We have assisted more than 70 individuals and families with enrollment and post enrollment related services, and enrolled 60 consumers into Marketplace plans during OE3. GHF continues to provide enrollment and post enrollment assistance to consumers through its main office in downtown Atlanta, its weekly enrollment site at Switzer public library in Marietta, and through other events in partnership with community organizations, coalition partners, and other non-profit organizations.

Contact our enrollment assister 


New Look, Same GHF

Have you been to our website recently? If you haven’t, you should! We have revamped our site to be more engaging and intuitive. It’s chock full of tools and resources to help you get up to speed on the issues you care about and to take action during the legislative session and throughout the year. Check it out!


GHF In the News

Tom Crawford: Here’s a salute to the accomplishments of 2015
Gainsville Times | December 30, 2015

Exchange enrollment nears 500,000 in Georgia
AJC | December 22, 2015

Insurers’ woes threaten the Affordable Care Act
Atlanta Business Chronicle | December 18, 2015

State senator expects legislation on insurance reform
Georgia Health News | December 15, 2015

See more 


GHF Welcomes New Intern!

VictoriaVictoria Congleton joins the GHF team in our efforts to improve health policies in Georgia. Victoria will work on various tasks during her time with GHF to learn about all of the components of health advocacy in Georgia. Victoria hopes to learn more about the Affordable Care Act, Medicaid, health policies, the legislative session, and other health topics. She is currently finishing up her Bachelors in Community Health and French at SUNY Potsdam.

 

 


ICYMI: GHF is on LinkedIn

linkedin_largeGHF has joined the LinkedIn community and we’d love to connect with you! Check out our page, follow us and let the conversations begin!


See what’s happening on our social sites

linkedin_largepinterest_largefacebook_largetwitter_large_02

 

 

 

 


Peach Pulse, November 2015

POLICY UPDATES

Network Adequacy – We Have a Model Act!

The National Association of Insurance Commissioners approved an updated network adequacy model act at its Fall meeting in November. The model act is a framework that states can adopt to help ensure that consumers have meaningful and timely access to the health services in their benefit package. With more insurance companies offering narrow network plans, these basic standards are an important consumer protection, and GHF encourages state policymakers to consider tailoring and adopting the model act in Georgia. We’ll be announcing our legislative priorities for 2016 soon, and this issue will be on the list!

Study Committees Conclude Their Work

Meredith and Claire 11.15Several health-related study committees met during the summer and fall months, and most of them are wrapping up their work. The Consumer and Provider Protection Act Study Committee held its final open meeting in November with a focus on network adequacy and provider directories. Claire McAndrew from Families USA, a national consumer health advocacy organization, and Georgians for a Healthy Future’s Health Policy Analyst Meredith Gonsahn delivered testimony on the importance of setting network adequacy standards and ensuring provider directory accuracy and usability. Look out for a final report from the committee in December!

Read Meredith’s Testimony

Read Claire’s Testimony

Concerns Grow about Proposed Mergers

Earlier this year, two separate proposed health insurance mergers were announced. A November New York Times article laid out some of the concerns that consumer advocates have about the proposed mergers and featured comments from Cindy Zeldin, Georgians for a Healthy Future’s Executive Director. Our Health Policy Analyst Meredith Gonsahn is monitoring this important issue – be on the lookout for a policy brief in the new year that provides more detailed insights about the potential effects of these mergers. You can also learn more by visiting the Coalition to Protect Patient Choice.


UPCOMING EVENTS

Health Care Unscrambled 2016

STDPlease save the date for the morning of January 14th for our annual Health Care Unscrambled policy breakfast. The breakfast will feature a bipartisan panel of legislators who will preview the health care issues they plan to focus on during the legislative session, a keynote panel discussion about emerging health policy issues, and opportunities to network with fellow health advocates. Registration is now open!

RSVP!

Sponsorship Opportunities

 

 

 


GHF IN THE COMMUNITY

Coverage and Access to Care: Local Focus on Savannah

Photo Nov 06, 10 44 15 AMGeorgians for a Healthy Future hit the road again recently, this time to Savannah! We collaborated with the Georgia Budget & Policy Institute and the Chatham County Safety Net Planning Council to pull together a local roundtable discussion with individuals and organizations serving the local community. We learned so much about the coverage and access challenges facing individuals and families in Savannah.

Read Laura’s Blog

 

 

GHF in North Fulton

Laura North Fulton 11.15North Fulton Community Charities, a non-profit human service agency that assists families in need in North Fulton County, invited Georgians for a Healthy Future to present our Medicaid chart book to its community leaders. Board members, city and county council people, and state legislators were in attendance, along with interested community members. We had a constructive conversation with participants about how Georgia can close the coverage gap. If your organization, church, or community group would like us to present at your next meeting (either about closing the coverage gap or about helping people enroll in health insurance), contact Laura.

 

 

 


 

PUBLICATIONS AVAILABLE IN SPANISH

Get Insured. Stay Insured.

Spanish toolkitThis toolkit is designed to walk people through each step of the enrollment process, from how to select the right plan for them, to how to find a doctor, and even things to keep in mind when filing taxes if they receive a subsidy. Hard copies of the Spanish toolkit are available, please email Whitney for more information.

Download Spanish Toolkit.

 

 

 

My Health Insurance User’s Manual

Spanish workbookThis workbook is a take-home, interactive resource for the newly enrolled. People can fill in the workbook with their own information so they have all of their important health coverage information in one place. If your organization is interested in obtaining hard copies of the workbook in Spanish, please contact Whitney.

Download Spanish Workbook.

 

 

 

Thank You!

GGD2015_logo_home133wIn addition to November being a busy month full of community engagement, health insurance enrollment, and public policy advances, it was also a month for gratitude and reflection. This Thanksgiving, the 300,000 Georgians who fall into the coverage gap were in our thoughts. In the coming year, we plan to redouble our efforts to close the coverage gap in Georgia. Your contributions on Georgia Gives Day will support our advocacy campaign in 2016 to close this gap. The Georgians for a Healthy Future team thanks you for your support. And if you missed Georgia Gives Day, don’t worry – you can still give here.

 

 

 

 


GHF in the News

Obamacare insurance premiums on the rise in Georgia

AJC | November 29, 2015

Closer Look: Health Care; Peachtree-Pine Shelter; And More

WABE | November 24, 2015

States Urged to Review Health Insurance Mergers

New York Times | November 20, 2015

 


Peach Pulse, October 2015


NEW PUBLICATIONS

Get Insured. Stay Insured.

ghf_toolkit_160x600Our new toolkit is designed to walk people through each step of the enrollment process, from how to select the right plan for them, to how to find a doctor, and even things to keep in mind when filing taxes if they receive a subsidy. Each piece of the toolkit can be used individually based on where the person is in the enrollment process or it can be used as one comprehensive piece. If you have any questions about the toolkit or would like to receive hard copies (for pick up only in most cases) please contact Whitney Griggs.

Download Toolkit.

My Health Insurance User’s Manual

Cover_ImageThis workbook is a take-home, interactive resource for the newly enrolled. It covers topics that enrollment assisters may not have time to cover during the enrollment appointment, such as how to find a primary care provider, how to make your first appointment, and even how to make a budget. People can fill in the workbook with their own information so they have all of their important health coverage information in one place.

Download Workbook.


 

Study Committees Continue Their Work

Cindy TiftonGeorgians for a Healthy Future’s Executive Director Cindy Zeldin traveled to Tifton in October to participate in the second meeting of the Consumer and Provider Protection Act Study Committee. The meeting was held at the Tift Regional Health System and featured testimony from a range of health care stakeholders. The third meeting of the committee was held on Monday, November 9th at 9am at the State Capitol in Atlanta and focused on network adequacy, an important issue for health care consumers. Click here to read Cindy’s blog on the study committee’s work.


 

 

PAST EVENTS

GEAR Webinar

GHF_5_pcpinoutetworkThis webinar introduced the Georgia Enrollment Assistance Resource (GEAR) Network. We created GEAR to be a resource for navigators, certified application counselors, community-based nonprofits, and other stakeholders who are interested in outreach and enrollment in Georgia. Through GEAR, you can access an array of Georgia-specific consumer-facing materials in English and Spanish. Participation in GEAR is free and is intended to be a community resource.

Sign up for the GEAR Newsletter.

Watch the Webinar.

 

Getting and Keeping Georgia Covered.

GHF and Enroll America teamed up to host an all day conference in advance of the start of Open Enrollment. If you missed it, check out this resources page for tons of valuable resources!

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Policy Luncheon on Preventing Youth Substance Use

This forum featured a panel of experts who shared their academic, research, and personal experiences, demonstrating not only the need for, but the effectiveness of SBIRT in preventing substance use disorders. Check out the videos below hear more about by SBIRT matters.

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Read the policy report.

 


UGA’s State of Public Health Conference: Featuring GHF

SOPH 9.15Last week, GHF was on the road again traveling to Athens for UGA’s annual State of Public Health conference. The SOPH conference is a chance for public health researchers, practitioners, and students to share and learn about the newest public health initiatives and research happening across Georgia. We were excited to be featured as a presenter among other experts, advocates, and leaders in Georgia’s public health domain. In a workshop dedicated to the Affordable Care Act, GHF teamed up with Georgia Watch to talk about Marketplace enrollment efforts in Georgia.  The presentation was based on GHF’s “Getting Georgia Covered” report, which explored the successes and barriers to outreach and enrollment efforts in Open Enrollment 2. We also previewed the upcoming open enrollment period, which starts on Sunday, Nov. 1, 2015, and advocated for closing Georgia’s coverage gap. The other presenters in the workshop, including another presentation from our partner Georgia Watch, comprehensively covered the new ACA requirement for hospitals to complete a community health needs assessment (CHNA) of their service area every 2-3 years and how that is being implemented in Georgia. The workshop generated some excellent questions and constructive conversation about these two very different aspects of the ACA.


IN THE NEWS

Georgians face key health insurance decisions during open enrollment

Atlanta Journal-Constitution

 

About one in four Georgians with Obamacare insurance drop plans
Atlanta Journal-Constitution

 

Year 3 of ACA enrollment: Big penalty, little growth
Georgia Health News

 

Ga. House Democratic Caucus to hold Medicaid expansion town hall meeting in Columbus
WRBL

 

Report: GA’s Working Families Would Benefit from Closing Coverage Gap
Soundbite Services

 

See more.


GHF Welcomes Yaminah, new Grassroots Advocacy Fellow!

YaminahYaminah Romulus joins the GHF team as the Grassroots Advocacy Fellow. She will work to develop GHF’s outreach strategy and collaborate the staff on policy analysis work. Yaminah is currently pursuing a Master’s of Public Health with a concentration in Health Policy and Management at Rollins School of Public Health at Emory University. Some of her interests include access to care for vulnerable populations, barriers to quality care, and the improvement of health care delivery systems.


Peach Pulse, September 2015


NEW PUBLICATIONS

A Chart Book for Understanding Medicaid in Georgia and the Opportunity to Improve It

Georgians for a Healthy Future and the Georgia Budget and Policy Institute are proud to release our joint publication: Understanding Medicaid in Georgia and the Opportunity to Improve It. Inside you will find infographics, new data, and compelling charts that simplify the complex issue of Medicaid in Georgia.

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 12_Percent Uninsured GA Map  04_MedicaidPeachCare

Part one explains who gets Medicaid in Georgia, how Medicaid protects Georgians during economic downturns, how Medicaid controls costs in the state, and more.

Part two outlines Georgia’s opportunity to close the coverage gap.  Here you’ll find out what Georgia’s health insurance coverage gap is, how we can use Medicaid to close it, and who stands to benefit detailed by job sector, demographics, and veteran status.

Part three details economic and social benefits of closing the coverage gap. Why is closing the coverage gap is a good deal for Georgia and the state’s economy? What are the savings other states realize by closing the gap? How does coverage affect a person’s financial and physical health?

A limited number of hard copies of this new publication are available. Please let us know if you or your organization would like one. We are also available to provide presentations to your members about Medicaid in Georgia and the opportunity to improve it by closing the coverage gap. Please contact Laura Colbert if you’re interested in a community presentation.

Download the chartbook!

Many Working Parents and Families in Georgia Would Benefit from Extending Medicaid Coverage

Rate_of_Uninsurance_in_GA_CCFWe  know that closing Georgia’s coverage gap would help adults who are uninsured. But how does it affect families and children in our state? GHF and Georgetown University Health Policy Institute’s Center for Children and Families have teamed up to bring you new research to answer that question. Key findings include:

  • Nearly three-in-ten Georgians potentially eligible for coverage should Georgia choose to close the coverage gap are parents with dependent children residing in their home.
  • Of those parents that could benefit from expanded Medicaid eligibility, nearly two-thirds (57 percent) are employed. Nearly half of all uninsured parents (46 percent) work in restaurants, retail, or professional service occupations.

Children enrolled in Medicaid are more likely to receive well-child care and are significantly less likely to have unmet or delayed needs for medical care, dental care, and prescription drug use due to cost.


 

UPCOMING EVENTS

GEAR up for Open Enrollment

Webinar
October 19
2:00 – 3:00 PM

Please join us for a webinar to introduce the new Georgia Enrollment Assistance Resource Network-GEAR! GEAR is the new central hub of resources for Georgia’s enrollment assisters and stakeholders who work to educate people on their health and health coverage options. GEAR is full of handouts, interactive consumer tools, important updates, and other materials that will help enrollment assisters and community organizations better educate Georgians on health insurance enrollment, health insurance literacy, and more.

Toolkit_Logo toolkit5

Want to learn more about GEAR and how you and/or your organization can benefit?  Join us on October 19th for a webinar where we will demonstrate how to access GEAR and review some of the materials that can be found there. We will also get your feedback about other resources you would like to see included on GEAR in the future. GEAR is built to help more Georgians connect to health coverage and we want it to work for you!

Sign up for the webinar!

 

Policy Luncheon on Preventing Youth Substance Use

October 22, 11:30 AM – 1:45 PM
Loudermilk Center, Ann Cramer Room

SBIRT bookmarkPlease join us for a policy forum to take a deep dive into promising, cost-effective best practices to reduce youth substance abuse in Georgia. This lunchtime event will be held just prior to the second meeting of the Senate Study Committee on Preventing Youth Substance Use Disorders and will feature opening remarks by Senator Renee Unterman, the chair of the study committee and the Senate Health and Human Services committee. The forum will also include a panel discussion featuring:

Dr. Paul Seale, Navicent Health

Dr. Gabe Kuperminc, Georgia State University

Leigh Colburn, Director, Graduate Marietta Student Success Center

Bertrand Brown, Georgia Council on Substance Abuse

After the panelists’ presentations there will be time for question and answer. This is a free event, but we ask that you RSVP so that we may order enough food.

RSVP Now!


 

PAST EVENTS

Local Spotlight on Augusta

In Augusta last week, GHF met with local providers, advocates, and consumers to talk about Augusta’s coverage gap. More than a presentation, the event was a constructive conversation about finding a solution and making Augusta healthier. It was clear to us that people in Augusta are dedicated to helping their neighbors and closing the coverage gap.

 Augusta5  Photo Sep 24, 9 16 04 AM

The event was previewed and then written up in the Augusta Chronicle.

Event Write Up

“The state of Georgia will eventually expand its Medicaid program “because the numbers are so compelling,” a health care economist for Georgia State University said Thursday at a policy forum in Augusta.”

Event Preview

“Medicaid already covers 1.9 million people in Georgia, about 64 percent of whom are children, despite “very restrictive” limits on who can qualify, particularly for adults, according to a report being released today by Zeldin’s group and the Georgia Budget and Policy Institute.”

 

GHF’s First Annual Consumer Health Impact Awards

What a night! GHF honored Georgia’s most inspiring health advocates, community partners, and policymakers at our first annual Consumer Health Impact Awards dinner in September. If you missed the event and want to see what all the fuss was about, check our our Storify or the photos on Facebook.

Thank you to our sponsors!

 

 

 

 

 

 

 


Legislative Study Committee Insights

Cindy Study Committee 9.15Study committees are the framework for the legislative session. It’s where legislators, experts, and advocates roll up their sleeves and study the issues facing Georgians. Below you’ll find two windows into the study committee process. The first is a deep dive into the Senate Study Committee on the Consumer and Provider Protection Act (SR 561) by GHF Executive Director Cindy Zeldin who serves on the committee and is very involved in addressing network adequacy.  The second is a breakdown by GHF Policy Analyst Meredith Gonsahn on the health-related committees meeting over the next several weeks.

Study Committee on the Consumer Provider and Protection Act

Read more about the study committees


 

IN THE NEWS

Expanding Medicaid coverage in Georgia has benefits, experts say

Augusta Chronicle | September 24, 2015

 

Georgia, Augusta are missing out on Medicaid, group says 

Augusta Chronicle | September 23, 2015

 

Health insurance rates headed up in 2016

Georgia Health News | September 14, 2015

– See more at: http://backup.jasonaxelson.com/september-peach-pulse#sthash.2QoeAfib.dpuf


Peach Pulse, August 2015


Atlanta Journal-Constitution Op-ed on GA Uninsured Rate

DSC_0912 (2)GHF’s ED Cindy Zeldin took to the pages of theAtlanta Journal-Constitution last month to make the case for coverage:
“The clearest evidence we have shows us the decision by the majority of states (30 and counting) to expand Medicaid is foundational in transforming the health system. We cannot make progress as a state if 15 percent of our population is uninsured. Too many Georgians fall into a coverage gap our leaders can fix. Medicaid expansion should be on the table, not as a perfect solution, but as a necessary first step.”
Read more


 

IN THE NEWS

Medicaid experiment should foster dialogue

Atlanta Journal-Constitution | August 28, 2015

 

Narrow networks are the exchange norm here

Georgia Health News | August 25, 2015

 

State outlines argument against Medicaid “waiver”

Georgia Health News | August 13, 2015

 

Former state insurance chief wary of big mergers

Georgia Health News | August 2, 2015


 

We’re updating our look!

As we grow, GHF is looking to the future. We’ve updated our logo and this fall we will be rolling out a new website! Stay tuned for more details.

Logo PNG

 


Peach Pulse, July 2015


Network Adequacy Takes the Stage

During the 2015 Legislative Session, the State Senate established the Consumer and Provider Protection Act Study Committee. This committee will review and make recommendations around several health insurance practices, including network adequacy. GHF has identified network adequacy, or the sufficiency of the health care providers patients can access when they enroll in a health insurance plan, as an important emerging consumer health issue. Our Executive Director, Cindy Zeldin, is a member of the study committee and looks forward to bringing the consumer perspective to the committee’s work. Cindy also recently appeared on WABE and Top Docs Radio to talk about network adequacy and participated in a panel discussion along with several state legislators at the Medical Association of Georgia’s Summer Legislative Education Seminar to discuss this important issue. Stay tuned for study committee agendas, updates, and opportunities to weigh in!

Study Committee Schedule
September 14, 9:00 – 12:00
State Capitol

October 26, 2:00 – 5:00
Tift Regional Healthy System, Tifton

November 9, 9:00 – 12:00
State Capitol

 


Don’t Miss Out: GHF’s Consumer Health Impact Awards

CHIA TwitterYou’re invited to Georgians for a Healthy Future’s First Annual Consumer Health Impact Awards! Please join us for a silent auction, dinner, and awards presentation on the evening on September 9th at Park Tavern.  We look forward to gathering with friends old and new as we celebrate the work being done by those dedicated to ensuring all Georgians have access to quality, affordable health care.
Get Tickets!

 


GHF in the News

Local leaders disagree on how far Medicaid coverage should go as program celebrates 50 years
Gainesville Times | July 30, 2015
Ga. Officials Looking Into Access for Healthcare Providers
WABE | July 27, 2015

Mega-merger would bolster Blue Cross here
Georgia Health News | July 24, 2015
Top Docs Radio Show
July 15, 2015


Medicaid Turned 50!

Over the past 50 years, Medicaid has ensured that our family members, friends, and neighbors have the quality health care they need. Be it our seniors accessing long term care services, kids seeing a doctor, or people with disabilities living independently, millions of people are better off because of this critical program.

Medicaid has also shown itself to be an effective and cost-efficient program. Administrative costs are substantially lower than private insurance and because people using Medicaid have access to preventive services, small issues can be addressed before they end up as big, costly illnesses.

catalyst1finalChildren in particular benefit from Medicaid. Studies show that kids with coverage show up at school ready to learn, are more likely to graduate from college, and end up with more earning potential as adults. In fact, more than 1 million Georgia children (about 35% of kids in our state) currently get their health care coverage through Medicaid.

As we reflect on what Medicaid has meant for children and families here in Georgia, it has been nothing short of transformative. And while about 1.9 million Georgians overall benefit from the essential health care access that Medicaid provides, approximately 300,000 Georgians are still stuck in a coverage gap: they don’t qualify for Medicaid under its existing stringent standards, aren’t offered coverage at work, and earn too little to qualify for tax credits through the Health Insurance Marketplace. The majority of states have accepted federal funding to close this gap, but Georgia hasn’t yet taken that step. Closing this gap and extending Medicaid coverage to all low-income Georgians would be a powerful tool for improving the health of individuals and families throughout our state. At Georgians for a Healthy Future we are proud to advocate for the Medicaid program that has been proven to improve health and saves lives. For the millions of Americans, and many Georgians, whose quality of life has been improved because of Medicaid, we’re so happy to celebrate the 50th anniversary of the life-changing program.

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More about Medicaid in Georgia!


 

Have you gotten married recently?

ghf_covered_medskyMajor life events, such as getting married, changing jobs, or having a baby, qualify for you a special 60 day enrollment period.  So after the honeymoon is over, it’s time to #GetCovered!

If you need assistance, our health care Navigator, Pranay Rana, is here to help!

Once you have health insurance, Whitney Griggs, our Consumer Education Specialist, can help answer the questions you have about finding a provider, accessing preventive services, filing a complaint or appeal, or any other question you may have!



 

We’re here to help!

IMG_2520Georgians for a Healthy Future staff is available to come to your coalition or organization meeting to cover any of these topics!

Laura Colbert, Community Outreach Manager.Laura can present on topics like closing Georgia’s coverage gap, how you and your organization can get involved in health advocacy, the effects of health policies on the health of Georgians, and more.
Pranay Rana, Health Insurance Navigator.  Pranay can give presentations on the health insurance marketplace and what you need to know before enrolling in health insurance.  Pranay is also available for individual enrollments.

Whitney Griggs, Consumer Education Specialist.

Whitney can present on health insurance literacy (a breakdown of important health insurance terms and concepts) and how to get the most out of your health insurance. This is especially helpful for groups and communities that have many newly insured members.

Set up a presentation!


 

ICYMI: Social Media Trends

To celebrate Medicaid’s 50th Anniversary, advocates and consumers across the country participated throughout the web with#KeepingUsHealthy and #MedicaidAt50

Check out the Twitter Storm on Storify!
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Peace Pulse, June 2015


King v. Burwell Recap

FB SCOTUS Cover Image

 

 

 

Last month, the Supreme Court upheld subsidies for health insurance bought through the federal marketplace, leaving more than 400,000 Georgians secure in their coverage.

“We celebrate an important victory for health care consumers, and we are relieved that hundreds of thousands of Georgians can keep their coverage,” said Cindy Zeldin, Georgians for a Healthy Future’s Executive Director. “But there is still work to do. Georgia has the second highest rate of uninsured in the country, and three-hundred thousand Georgians fall into a coverage gap that was created by Georgia’s decision not to expand Medicaid.”

Now that the outcome of King v. Burwell is clear, we must not forget these workers, parents, and veterans in our state who still lack access to quality, affordable health insurance. It’s time to close the coverage gap.

Add your voice of support for closing the coverage gap!


Need health enrolling or using your insurance?

Jazzie-Jones-Smith-&-Sonny-Jones-Smith

Have you had a major life event recently, such as getting married? You may qualify for a special enrollment period. Pranay Rana, GHF’s health care navigator, is here to help you get covered!   Email Pranay for an appointment or check out his schedule below.

Once you have health insurance, Whitney Griggs, our Consumer Education Specialist, can help answer any questions you may have about finding a provider, accessing preventive services, or filing a complaint or appeal.

Pranay’s Schedule:
 

Switzer Central Library

266 Roswell St, Marietta, GA 30060

Every Thursday 11 AM – 4:00 PM


Moving Forward

 

GHF surveyed and interviewed enrollment assisters across the state to understand not only the “what,” but also the “why” behind the second open enrollment period.  The results of that research have led us to several policy recommendations to maximize health insurance enrollment and retention and to ensure that coverage translates to meaningful access to timely and appropriate medical services for Georgia health care consumers.

  1. Close the coverage gap in Georgia. Approximately 300,000 Georgians fall into the coverage gap, meaning they do not qualify for Medicaid under existing income eligibility guidelines in Georgia but their income is still too low to qualify for financial assistance (tax credits) to purchase health insurance on the Marketplace. Eligibility for tax credits begins at 100 percent of the Federal Poverty Level, or $11,770 for an individual or $20,090 for a family of three in 2015, while Medicaid eligibility for most adults in Georgia cuts off at income much lower. Thirty states including DC have closed their coverage gaps thus far with promising results. We encourage Georgia policymakers to take this important step as well to ensure all Georgians have a pathway to coverage.
  2. Set and enforce network adequacy and transparency standards. Many of the plans sold through the Health Insurance Marketplace are Health Maintenance Organization (HMO) plans that feature narrow provider networks. While these narrow networks can help keep premiums down, a trade-off many consumers may be willing to make, consumers do not currently have sufficient information to make this choice. There is no information available to consumers at the point of sale about whether a provider network is ultra narrow, narrow, or broad, and provider directories are routinely inaccurate. More transparency and oversight are needed to ensure that consumers have accurate and useful information to make these choices. It is also important that all provider networks allow for meaningful access to all covered benefits. To ensure this, we support putting in place and enforcing network adequacy standards.
  3. Encourage public-private partnerships and remove unnecessary restrictions on consumer education and assistance. Many of the enrollment assisters we surveyed indicated that reducing barriers to partnering with state government organizations such as public colleges, universities, and health departments would lead to stronger and more effective partnerships. Specifically, many respondents indicated that improved coordination between enrollment assisters, the Marketplace, and the Georgia Department of Community Health (DCH) to better facilitate PeachCare for Kids and Medicaid enrollment would be helpful. The “Health Care Freedom Act,” passed in 2014 as part of HB 943, prohibits state and local governmental entities from operating a health insurance navigator program and places other limitations on governmental entities. This provision has been counterproductive, creating confusion around what educational and consumer assistance activities local entities can engage in as they work to serve their community members. We recommend lifting these restrictions.

GHF UPCOMING EVENTS

 

Save the Date_cropped

You’re invited to Georgians for a Healthy Future’s First Annual Consumer Health Impact Awards!

Please join us for a silent auction, dinner, and awards presentation on the evening on September 9th at Park Tavern.  We look forward to gathering with friends old and new as we celebrate the work being done by those dedicated to ensuring all Georgians have access to quality, affordable health care.  Tickets can be purchased below.

Do you know someone who should be recoginized for one of the below awards?  Nominate them here! Nominations will be accepted through July 31st.

You can view sponsorship opportunities here, or if you have an item you’d like to donate for the silent auction, please email Anna.

Linda Smith Lowe Health Advocacy Award

The Linda Smith Lowe Health Advocacy Award is given each year to an advocate whos work advances access to quality, affordable health care in Georgia. Nominees can be either professional advocates or volunteer advocates and must place a focus on vulnerable populations in their work and must work to achieve policy change. This award is named in honor of Linda Smith Lowe. Linda has dedicated her career to serving as an advocate on behalf of underserved Georgians who need a voice on health and human services issues.

Community Impact Award

The Community Impact Award is given each year to an individual or organization who has made an exceptional contribution to the health of their community in the past year. The impact of this contribution can be either at the individual, local, or state level. Nominees must work with individuals or local organizations to drive advancements in the health of the population served. Nominees may be health care providers, enrollment assisters, health educators, or others.

Powerhouse Policymaker Awards

The Powerhouse Policymaker Awards are given each year to local or state policymakers in Georgia who have exhibited excellence and courage in championing health issues in the public policy arena. Award recipients will have a particular focus on consumers or vulnerable populations and will have worked to advance our vision of a day in which all Georgians have access to the quality, affordable health care they need to lead healthy lives and contribute to the health of their communities.


GHF IN THE NEWS

Cindy King V BurwellAll eyes were on health insurance last month and we were excited to celebrate the victory with the press and with Georgia!
Georgia reacts to Obamacare decision – AJC
Georgia lawmakers react to ruling on Affordable Care Act – WSBTV
Ruling revives call for Medicaid expansion in Georgia – Augusta Chronicle
More Media Coverage


GHF Updates

Meredith HeadshotGHF welcomes a new staff member! Meredith Gonsahn is Georgians for a Healthy Future’s Health Policy Analyst. She joined Georgians for a Healthy Future in July 2015.  In this role she identifies key issues in health policy and how they impact Georgia health care consumers.  Meredith also monitors major trends in public and private health insurance, health system reform and other key policy areas to keep the organization abreast of emerging issues. Meredith comes to Georgians for a Healthy Future from the Atlanta VA Medical Center where she served as a Study Coordinator for a wound care clinical trial. Prior to this position, Meredith was a Research Associate for the Center for Health Policy and Health Services Research at Henry Ford Health System. In this role she identified and analyzed key health system reform policies at the Federal, state and local levels to shape the policy agenda for the System. She also served as a liaison to coordinate and submit Affordable Care Act demonstration project applications for System business units.  Meredith has a Master’s of Public Health with a concentration in Health Policy and Management from Rollins School of Public Health at Emory University. She also has a Bachelor of Arts in History from Duke University.

GHF is also pleased to announce our Executive Director Cindy Zeldin’s appointment to the Senate study committee for SR 561, the Consumer and Provider Protection Act. Full information about study committee appointments can be found here.


ICYMI: Social Media

#ACAHereToStay and #ACAIsWorking started trending in response the the Supreme Court decision

Our favorite tweet last month:
@healthyfuturega June 18
Highlight of #SHP2015 w/@chuck4senate52#teamgeorgia


Our favorite infographic last month:
SCOTUS

 


Peach Pulse, May 2015


Open Enrollment 2 Analysis

May was all about analyzing the second open enrollment period.  What went well, what can be improved on and how Georgia did.  GHF staff interviewed health care enrollment assisters across the state and combined that with a detailed analysis of the numbers to put together Getting Georgia Covered: Lessons Learned, Best Practices, and Policy Recommendations from the Second Open Enrollment Period.  

The report covers how new health insurance opportunities created through the Affordable Care Act (ACA ) have led to historic reductions in the nation’s uninsured rate. Here in Georgia, more than half a million consumers signed up for health insurance during the open enrollment period that ended this past February, known as OE 2.

These strong enrollment numbers mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families. The reduction in our state’s uninsured rate, although smaller than that of the nation as a whole, also has positive implications for the vitality of local health care systems and communities throughout Georgia.

Too many Georgians, however, remain uninsured, either because

  • they are unaware that there are coverage options that can meet their needs and budget
  • face cultural, linguistic, financial, or other barriers to coverage; or
  • fall into the “coverage gap” that was created when Georgia declined to expand Medicaid as authorized under the ACA

The goals of this report are

  • to explain the role of in-person assistance on enrollment outcomes and consumers’ experiences
  • to explore best practices that helped achieve robust enrollment in Georgia
  • to identify any common challenges or barriers to enrollment that Georgia consumers faced during OE2
  • to highlight promising strategies and approaches to reach the remaining uninsured who qualify for affordable health insurance
  • to put forth policy recommendations that can help facilitate a positive experience for health care consumers, both for those who are newly enrolled and for those who remain uninsured.
Georgia OE2 by the Numbers GHF_enrollment_sticker

 


Getting Georgia Covered Event

On May 13, GHF hosted a lunch panel discussion on best practices, lessons learned, and policy recommendations from the second open enrollment period.  During the event, GHF released it’s new report on the topic.  You can download it here.

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To see additional pictures from the even, please visit our facebook page!

Additional Resources from the event:

Whitney Girggs’s Presentation – GHF

Dante McKay’s Presentation – Enroll America

Lisa Stein’s Presentation – Seedco

Sarah Sessoms’s Presentation – InsureGA

 

Panelists

Enroll America: Danté McKay, Georgia State Director

Georgians for a Healthy Future: Whitney Griggs, Consumer Education Specialist

US Department of Health & Human Services: Dr. Pamela Roshell, Region 4 Director

InsureGA: Sarah Sessoms, Executive Director

SEEDCO:  Lisa Stein, Vice President Work and Family Supports


GHF in the News!

nwsppr

From the end of open enrollment to the looming King v Burwell decision to the ongoing need to close Georgia’s coverage gap, health policy continues to dominate the headlines, and GHF is at the forefront of the conversation! Check out the news coverage below to learn more about what’s happening in Georgia and how it impacts health care consumers in our state.

 

 

 


Open Enrollment Success, Lessons Learned, and Policy Recommendations

Whitney Griggs, a consumer education specialist with Georgians for a Healthy Future, speaks on A Closer Look with Rose Scott and Denis O’Hayer about the recently approved FLEX bus serving Cobb communities. (Photo/Brenna Beech)

Whitney Griggs, a consumer education specialist with Georgians for a Healthy Future, speaks on A Closer Look with Rose Scott and Denis O’Hayer about the recently approved FLEX bus serving Cobb communities. (Photo/Brenna Beech)

Click the articles below to learn more about what worked well for consumers, what challenges and barriers they still face, and what changes can be made at both the community and policy levels to connect Georgians to health coverage and make sure that coverage translates to meaningful access to care.

Numbers Show Obamacare Reducing the Ranks of Ga’s Uninsured – WABE
Obamacare enrollment soars in Georgia – AJC
Gwinnett, metro Atlanta top exchange enrollment – Georgia Health News
Obamacare Subsidy May Impact Tax Returns – WABE


 

Op-ed in the AJC

CindyZeldin_Headshot - CopyA road to health coverage for Georgians

“More than a half-million Georgians signed up for health coverage during the Affordable Care Act open enrollment period that ended in February. Many were previously uninsured. These robust enrollment figures show Georgia consumers strongly value health insurance and the access to care and financial security it can bring. An unmet demand is finally being met.

To gain a better understanding of this enrollment success story and what’s next for Georgia’s newly covered consumers, Georgians for a Healthy Future reached out to the enrollment assistance community – health insurance navigators and certified application counselors – and reviewed available data on plan offerings, premiums and enrollment. Three key themes emerged.”

Read the complete article


King v. Burwell

suprme court“We can’t just close the door on hundreds of thousands of Georgians who finally had it opened for them.” Sometime in the next few weeks, the U.S. Supreme Court will hand down its decision in King v. Burwell, the high profile case that could place health coverage at risk for an estimated 430,000 Georgia consumers. Georgians for a Healthy Future has been monitoring the case closely and talked to the Atlanta Journal-Constitution about the need for Georgia policymakers to step in if the court rules for the plaintiff. This story was featured on today’s front page.

430,000 Georgians could lose Obamacare insurance – AJC


Medicaid Experiment

CindyThere have been several news stories over the past couple of weeks about a Medicaid pilot project under consideration by state policymakers. WSB-TV sat down with Georgians for a Healthy Future’s Executive Director last week to talk about whether this policy discussion brings us a step closer to closing the coverage gap in Georgia. Georgia Health News, the Atlanta Journal-Constitution, and Georgia Report are all tracking the issue. Click below for media reports featuring GHF and our partners!

Conservatives upset with Gov. Deal on health care – WSB-TV
Deal, hospitals continue discussions on health coverage – Georgia Report
Grady outlines plan to transform care for uninsured – Georgia Health News


How are we doing? Let us know!

feedback 2At Georgians for a Healthy Future we strive to send you emails and content that are valuable to you and your work. To help in our efforts to improve our communications, please take this two question survey! Thank you!

 

 

 


ICYMI: We’re on Pinterest!

PinterestGHF in now on Pinterest!  While you’re skimming pins for what you’re going to cook for dinner tonight or that next DIY project you are definitely going to do, let us be your daily dose of inspiration.  Follow our boards for photos of people in the coverage gap, our Somebody Finally Asked Me campaign, and access to all the great infographics we share.


Peach Pulse, April 2015


Coverage Gap Update

While Georgia has made little progress on closing its coverage gap, the subject is a hot topic elsewhere.

  • Montana has closed its coverage gap! As the 29th state to close the gap, Montana will provide 70,000 Montanans with quality, affordable health care coverage.  The state is currently working with CMS to gain approval for its expansion proposal.
  • Face Off in Florida–The debate over closing the coverage gap is as hot as sunburnt skin after spring break! Floridians have seen a sudden and unexpected adjournment of the legislative session, a stand-off with HHS over the low-income pool (LIP), and their governor file suit against the federal government.  The debate is far from over as the legislature plans to reconvene in June to complete their legislative responsibilities.
  • Policy makers in both Alaska and Louisiana are discussing if and how to close their coverage gaps.  While their legislators debate whether or not to close the coverage gap during a special session, polls show that Alaskans are hugely in favor of the policy.  In Louisiana, Gov. Jindal remains opposed to the idea of closing his state’s coverage gap, but legislators are discussing their options.

While Montana closes its gap and other states think through their options, more and more studies are revealing that closing the coverage gap is good for states! It saves money in state budgets and facilitates job growth, especially in the health care sector.  Families USA summarized the new data in a recent blog post.

Medicaid Expansion 4.15

 

 

 

 

 

 

 

 

 


Need help enrolling or using your insurance?Pranaya Navigating

Pranay Rana, GHF’s health care navigator, is here to help you get covered!  Email Pranay for an appointment or check out his schedule.

Once you have health insurance, Whitney Griggs, our Consumer Education Specialist, can help answer the questions you have about finding a provider, accessing preventive services, filing a complaint or appeal, or any other question you may have!

Whitney and Pranay are both available to make educational presentations to community-based organizations in Georgia about how to enroll in health insurance and how to use coverage to access care once enrolled. If your organization would like to provide this type of presentation for your community members, please let us know! We can help!

 


Tax time special enrollment period a success!

 

taxesThe last chance to sign up for health insurance this year under the Affordable Care Act ended in April, when an extended deadline for enrollment expired.  The extension was offered to give consumers who did not know they would owe a penalty if they did not have health insurance an additional opportunity to secure coverage. Thousands took advantage of the extension and, as of April 13th, about 68,000 people had signed up nationwide under the extension.  Call centers had an average wait time of 10 minutes, showing consistent traffic.  GHF’s navigator personally assisted over 30 people during the special enrollment period!

While the next open enrollment period doesn’t begin until Nov. 1, 2015 you may qualify for a special enrollment period throughout the year.  For example, losing your health coverage because of the loss of a job, getting married, having a baby, or moving to a different state that does not offer your current plan could trigger eligibility for a special enrollment period.

If you have questions about owing a fine or special enrollment periods, please reach out to Whitney Griggs, our Consumer Education Specialist, today!


GHF Upcoming Events

GHF_enrollment_sticker

Getting Georgia Covered: Lessons Learned from Open Enrollment 2

 

Hear from an expert panel on best practices and lessons learned  during the second open enrollment period. We’ll learn about the successful strategies that enrollment assisters deployed in helping consumers, identify the challenges and barriers that remain for consumers, and discuss policy recommendations that can help get more Georgians covered. This is a free event.

Sign Up!

 

 

 


GHF Past Events

Legislative Webinar 4-15 (2)Changes in Health Care and Policy in the 2015 Georgia Legislative Session: Webinar

Watch the Webinar

Download the Presentation

 

 

 


ICYMI: Social Media Trends

ACA Celebrate#betterwithobamacare was trending on Twitter as we celebrated five years of the increased coverage and security that’s come with the Affordable Care Act.

#getcovered and #staycovered were the battle cry of OE2.  Follow those hashtags to stay on top of the enrollment movement!


Peach Pulse, March 2015


Legislative Update

georgia-capital-buildingWith Crossover Day behind us, we are fast approaching the 40th and final legislative day for the year, April 2nd.  This week, GHF spoke with House Insurance Chairman Richard Smith about what he saw as the most important role he played as chairman. You might be surprised with his answer – click the image below to watch the video!

With just a little more than two weeks to go, here’s an update on health care legislation important to Georgia health care consumers.  For a detailed chart of every health care bill we’re watching, click here.

The FY 2016 Budget passed the House of Representatives and is now in the Senate. The Senate expects to finish their revisions to the budget this week, possibly with some new revenue. They will then send it back to the House and then to a conference committee before it is finalized.

Medicaid Parity:  The Senate proposed $5.9 million in increased reimbursements for certain OB/GYN services and $13.6 million for certain primary care services, which is an increase over the House of Representatives’ proposal ($2.96 million for OB/GYN and $1.5 million for primary care services). Because Medicaid parity has been shown to be an effective strategy for improving access to care for consumers, GHF supports raising Medicaid reimbursement rates to parity with Medicare rates. We are advocating for a higher appropriation amount for Medicaid reimbursement rate increases as the budget moves through the process.  Click here to read Georgia Health News’s coverage of this latest development.

SBIRT Resolution:  Senate HHS Chairwoman Renee Unterman officially introduced SR 487 to form a Senate Study Committee on preventing youth substance use disorders. Through GHF’s work with the Georgia Council on Substance Abuse, we are advocating for a public health approach to substance use disorders that focuses on prevention. This resolution gets the conversation started about how to do that in Georgia. Please take the time to thank Senator Unterman for her support of this effort and to let your elected officials know you support SR 487.

SB 158: (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee where it received a hearing on Wednesday, March 3.  GHF provided testimony in committee, focusing specifically on the network adequacy component of the bill. GHF also met with committee members individually about the bill after the committee hearing to talk about why it is an important issue for consumers.  While the bill is not expected to move in its current form this legislative session, there will likely be a study committee on the network adequacy component. GHF has identified network adequacy as an important consumer issue and plans to remain engaged on this topic as discussions move forward.

Closing the Coverage Gap: No hearings have been scheduled or are pending to address the possibility of expanding Medicaid in Georgia. Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians, an approach which GHF supports.  Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither crossed over. Please thank the cosponsors of these bills, Rep. Rahn Mayo and Senator Vincent Fort, for their support and show your support by filling out a postcard that we’ll mail to your legislators!

Tobacco Tax:  No additional standalone proposals have been made to increase Georgia’s tobacco tax (other than HB 445 as previously reported).  The Senate however, may respond to the House proposal on transportation funding by including a tobacco tax increase to the regional average of around 68 cents. Importantly, Alabama’s Governor is proposing an increase in their state tobacco tax to $1.25 per pack, which would increase the regional average.  GHF continues to advocate for an increase to the national average by raising our tobacco tax by $1.23.  Such an increase would generate $585 million per year according to the fiscal note generated by the non-partisan fiscal office at GSU.  Check out our fact sheet for more info!


Medicaid Minute

Opponents often argue that closing Georgia’s coverage gap would be too expensive for our state, but data from states that expanded their Medicaid programs in 2014 contradict that claim.  According to a new study, closing the coverage gap produced big savings and increased revenues for states.

Early data from Kentucky and Arkansas show state budget savings that will offset the costs of covering the newly eligible Medicaid population beyond state fiscal year (SFY) 2021. Kentucky expects to see $820 million in net savings over the next seven years, while Arkansas expects to see $370 million over the same time period.  The savings and increased revenues fall into three major categories: 1) State savings from using new federal funds; 2) State savings from enhanced federal matching; 3) Revenue gains from provider and insurer taxes/fees.

The full issue brief, complete with a summary table of Medicaid-related savings and revenues in both states, can be found here.


GHF Welcomes New Navigator!

PranayPranaya Rana joined Georgians for a Healthy Future this week as our new Navigator! In this role, Pranaya will work with consumers to help them enroll in health insurance through the Marketplace.  Pranaya is a former Lieutenant from the Nepalese Army Elite Forces. He has served as a U.N. Peacekeeper in post-earthquake Haiti and as a Refugee Resettlement Program Officer in Connecticut before he came to Kennesaw State University, Georgia to pursue his Ph.D. in International Conflict Management in 2012.   He has been working as a certified Healthcare Navigator in Metro Atlanta since the first open enrollment began in 2013. He recently completed his 6 months long Navigator’s term at Georgia Watch before joining Georgians For a Healthy Future.  He specializes in refugees and international communities and has served a wide variety of international communities enroll into affordable healthcare using a community specific service model developed through continued outreach, education and  needs assessment. He is Fluent in Nepali and Hindi besides English, and, speaks Urdu and intermediate French. If you’d like to contact Pranaya by email or at 404-567-5016.


Using your Coverage: Tax-Time Special Enrollment Period

taxesDid you go without health insurance in 2014 and are now subject to a tax penalty? Good news! – You may still be able to enroll in coverage through the Health Insurance Marketplace. Starting last Saturday, March 15th, some people who are facing a fine on their taxes for not having coverage can now enroll in the Marketplace through a time-limited special enrollment period. To be eligible for this special enrollment period, you must not be currently enrolled in health insurance, attest that you owe the penalty for 2014, and attest that you first became aware of the penalty when you filed your 2014 taxes. This tax-related special enrollment period will run through April 30th, 2015.  Click here to learn more about who can qualify for this special enrollment period.


Health Advocates Day at the Capitol – 3/25

informationPlease join us on Wednesday, March 25, from 8:45 am to mid-day for a morning of advocacy!  GHF will provide individuals and organizations with the opportunity to advocate for the important health issues that matter to you in the closing days of this legislative session.  You may want to advocate for closing the coverage gap, Medicaid payment parity, raising the tobacco tax, rural health care access, or another health policy issue.  You’re all invited to participate!  We’ll provide breakfast, an advocacy training, and an opportunity to share and network with other health advocates.

To sign up, click here.  If you have any questions, please contact Laura Colbert.


Post-Legislative Session Webinar

Mark your calendars!  Please join GHF and Laura Colbert for a post-legislative session webinar. The webinar is free and will provide a review of bills, resolutions, and other actions taken by the Georgia General Assembly that will affect health care and health policy in our state.

Date:Thursday, April 9

Time:12:00 – 1:00 EST

Sign up here!


 

Infographic of the Week

MEDICAID_EXPANSION_Working-Adults_infographic_final_021615

 


Peach Pulse, March 12, 2015

Legislative Update

georgia-capital-buildingToday is the 29th day of the 2015 Legislative Session.  That means that tomorrow, Friday March 13, is crossover day.  GHF Executive Director Cindy Zeldin on what crossover day is and what it means for the rest of the legislative session.

The day before crossover day is a day of uncertainties.  Because of that, we will send out an email Monday with a full update and analysis on where legislation important to consumers’ health care stands.  For a compete list tracking health related bills – click here.


More Good News about Georgia’s Open Enrollment Numbers!

Last month it was announced that over half a million Georgians enrolled in coverage through the Health Insurance Marketplace. Now a new report released by the Department of Health and Human Services contains even more encouraging data about the state of enrollment in Georgia. According to the report, 31% of Georgians that enrolled were between the ages of 18-34, which is a key age group since they tend to be healthier than older adults. Additionally, 90% of Georgians that selected a plan through the Marketplace received financial assistance in the form of Advanced Premium Tax Credits. The average monthly premium for Georgians using a tax credit was $73. Click here to see the full report.  Georgians for a Healthy Future’s ED talked with the Augusta Chronicle about why these numbers are so encouraging for Georgia.


Using your coverage

Preventive Services

coverageDid you know that thanks to the Affordable Care Act, you can receive certain preventive services at absolutely no cost? It’s true! One of the key requirements of the ACA is that insurance companies must cover recommended preventive services at no cost to the consumer – even if you haven’t met your deductible. These include services such as mammograms, annual physicals, colonoscopies, well-woman exams, cholesterol screenings, tobacco cessation, and many more. Click here for a full list of the preventive services that must be covered by all insurance companies. There is also an additional list of required services for women and a separate one for children. It’s important to take advantage of these no-cost preventive services to keep you and your family healthy. Evidence shows that preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they become complicated and debilitating conditions.

If you have any questions about your insurance, please contact our Consumer Education Specialist, Whitney Griggs by email or at 404-567-5016 x 5


Medicaid Minute

current-status-of-the-medicaid-expansion-decisions-healthreform

States across the country are closing their coverage gaps!  The map above shows the 29 states (including DC) that have chosen to expand Medicaid.  Seven additional states are in discussions – below is a quick update on those states and their debates.

Idaho: Governor Butch Otter’s Medicaid Redesign Workgroup voted in November 2014 to recommend pursuing total health care system transformation, which includes Medicaid expansion. In addition to the Governor’s support, the Idaho Association of Commerce and Industry is helping to draft Medicaid expansion legislation, and a coalition of hospitals, providers, and consumer groups is working to support that legislation.

Tennessee: In late 2014, Governor Bill Haslam announced he had reached a deal with CMS to close the coverage gap. Governor Haslam’s plan, Insure Tennessee, had the support of the hospital industry (who had agreed to fund any costs that would fall onto the state), the business community, and a strong consumer coalition. Unfortunately, Insure Tennessee failed to make it out of committee during special session in early 2015.

Utah: Governor Gary Herbert’s plan to close the coverage gap, Healthy Utah, has strong support from hospitals, businesses, county commissioners, the criminal justice community, and church leaders, and it recently passed in the Senate. However, the House has passed an alternative proposal, Utah Cares, that would provide much more limited coverage to only a portion of the population in the coverage gap. With just a few days left in the legislative session, it remains to be seen whether the legislature will reach a compromise that will close the coverage gap this year.

Maine: In 2013 and again in 2014, the Democratic-controlled legislature passed several bills to close the coverage gap, only to have them vetoed by Governor Paul LePage. Even though Republicans took control of the Senate in 2014, advocates believe there are still enough votes to pass compromise legislation. Hospitals, who had remained largely on the sidelines the past two years, are now fully engaged in the campaign to close the coverage gap there.

Alaska: Recently-elected Independent Governor Bill Walker announced plans to expand Medicaid, but there will likely be roadblocks in the Republican-dominated legislature. Hospitals are on board.

Montana: Governor Steve Bullock is strongly supportive of closing the coverage gap, and has his own proposal for doing so. It is unlikely that a bill will pass the Republican-controlled legislature.

Wyoming: Governor Matt Mead developed a plan to close the coverage gap in 2015, and a key House committee developed a competing plan. But just a few days after the special session to close the gap in Tennessee failed, the Wyoming Senate shot down Governor Mead’s expansion plan, and the House committee then pulled its bill.


Join us for Health Advocates Day at the Capitol!

informationPlease join us on Wednesday, March 25, from 8:45 am to mid-day for a morning of advocacy!  GHF will provide individuals and organizations with the opportunity to advocate for the important health issues that matter to you in the closing days of this legislative session.  You may want to advocate for closing the coverage gap, Medicaid payment parity, raising the tobacco tax, the Family Care Act, rural health care access, or another health policy issue.  You’re all invited to participate!  We’ll provide breakfast, an advocacy training, and an opportunity to share and network with other health advocates.

To sign up, click here.  If you have any questions, please contact Laura Colbert.


Sign Up for a Post-Legislative Session Webinar

Mark your calendars!  Please join GHF and Laura Colbert for a post-legislative session webinar. The webinar is free and will provide a review of bills, resolutions, and other actions taken by the Georgia General Assembly that will affect health care and health policy in our state.

Date: Thursday, April 9

Time: 12:00 – 1:00 EST

Sign up here!


Infographic of the Week

affordable-care-act-infographic GEORGIA WATCH


Peach Pulse, March 6, 2015


Legislative Update

georgia-capital-buildingYesterday marked the 27th day of the 2015 Legislative Session. Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015, is set for next Friday, March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.

It has been a big week for health care issues at the State Capitol. GHF brought the consumer perspective to Senate Insurance on Wednesday and shared with the committee through testimony from our Executive Director the challenges that consumers face in obtaining accurate information about provider networks at the time they sign up for health insurance and why setting network adequacy standards is important for consumers. Her testimony was provided as part of the discussion around SB 158. Also this week, legislation was introduced in the Senate that would establish a study committee on preventing youth substance use disorders, the Senate began its work on the FY 2016 budget, and a range of other health care bills were discussed.

The State Budget:  The FY 2016 Budget passed the House of Representatives and is now in the Senate. The Senate expects to finish their revisions to the budget this week and send it back to the House and then to a conference committee.

Medicaid Parity:  Last week, the House of Representatives added $2.96 million in the budget to increase reimbursement for certain OB/GYN services and $1.5 million for reimbursement rate increases for certain primary care services. Because Medicaid parity has been shown to be an effective strategy for improving access to care, GHF supports raising Medicaid reimbursement rates to parity with Medicare rates. We are advocating for a higher appropriation amount for Medicaid reimbursement rate increases as the budget moves through the process.

SBIRT Resolution:  Senate HHS Chairwoman Renee Unterman officially introduced a resolution (SR 407) to form a joint House and Senate Study Committee on preventing youth substance use disorders. Through GHF’s work with the Georgia Council on Substance Abuse, we are advocating for a public health approach to substance use disorders that focuses on prevention. This resolution gets the conversation started about how to do that in Georgia. Please take the time to thank Senator Unterman for her support of this effort and to let your elected officials know you support SR 407.

SB 158 (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee where it received a hearing on Wednesday, March 3.  GHF Executive Director Cindy Zeldin testified in committee, focusing specifically on the network adequacy component of the bill. GHF also met with committee members individually about the bill after the committee hearing.  While the bill is not expected to move in its current form this legislative session, there will likely be a study committee on the network adequacy component. GHF has identified network adequacy as an important consumer issue and plans to remain engaged on this topic as discussions move forward.

Closing the Coverage Gap: No hearings have been scheduled or are pending to address the possibility of expanding Medicaid in Georgia. Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians, an approach which GHF supports.  Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills, Rep. Rahn Mayo and Senator Vincent Fort, for their support and show your support by filling out a postcard that we’ll mail to your legislators!

Tobacco Tax:  No additional standalone proposals have been made to increase Georgia’s tobacco tax (other than HB 445 as previously reported).  The Senate however, may respond to the House proposal on transportation funding by including a tobacco tax increase to the regional average of around 68 cents. Importantly, Alabama’s Governor is proposing an increase in their state tobacco tax to $1.25 per pack, which would increase the regional average.  GHF continues to advocate for an increase to the national average by raising our tobacco tax by $1.23.  Such an increase would generate $585 million per year according to the fiscal note generated by the non-partisan fiscal office at GSU.


Other Bills of Interest

Below is a summary of bills that may impact health care consumers in Georgia, with information about where they are in the legislative process.

SB 1 (Sen. Bethel) provides certain insurance coverage for autism spectrum disorders. SB 1 has passed the Senate and is in the House Insurance Committee.

HB 1 (Rep. Peake) would allow for the limited use of medical marijuana for conditions including cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, crohn’s disease, mitochondrial disease, fibromyalgia, parkinson’s disease, and sickle cell disease.  HB 1 passed the House of Representatives and is now in the Senate Health and Human Services Committee.


Peach Pulse, February 27, 2015


Legislative Update

georgia-capital-building

Yesterday marked the 23rd day of the 2015 Legislative Session. We are getting closer to Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015. Crossover Day is set for March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.

As part of this week’s legislative update, we sat down with Representative Debbie Buckner and spoke with her about access to care in rural communities, Georgia’s coverage gap, and other health care issues on her mind this Legislative Session.

To watch the video, click on the image below.

The State Budget

The FY 2016 Budget passed the House of Representatives this week and now heads to the Senate for hearings. Of note, the House of Representatives added $2.96 million in the budget to increase reimbursement for certain OB/GYN services, $1.5 million for reimbursement rate increases for certain primary care services, $1.3 million to increase the hourly rate for personal support services under the Independent Care Waiver Program, and $500,000 to increase reimbursement for air-ambulance services for adult patients. The House also added in $3 million to implement the recommendations of the Rural Hospital Stabilization Committee. The House removed $22.8 million for new treatment medications for patients with Hepatitis C and $12.1 million for costs to launch a new case management program for enrollees eligible under the Aged, Blind, & Disabled program. Also of note, the House reinstated health coverage for non-certificated part-time school employees; however, local school districts and not the state would be responsible for those costs. Click here for an analysis of the health care provisions in the budget that passed the House from our friends at the Georgia Budget & Policy Institute.

Closing the Coverage Gap

Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians. Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills, Rep. Rahn Mayo and Sen. Vincent Fort, and show your support for closing the coverage gap by filling out a postcard that we’ll mail to your legislators!

Tobacco Tax

HB 445 (Carson) represents the first additional or alternative funding proposal to the transportation funding bill (HB 170). While the overall bill includes regressive provisions including an increased sales and grocery tax combined with a reduction in the income tax that GHF does not support, it is notable that a tobacco tax is in the mix in the bill. This keeps the tobacco tax on the radar and provides an opportunity for health advocates to continue to push for an increase to the national average in the tobacco tax to curb smoking rates and bring in much-needed revenue.

Other Bills of Interest

Below is a summary of bills that may impact health care consumers in Georgia, with information about where they are in the legislative process.

SB 1 (Sen. Bethel) provides certain insurance coverage for autism spectrum disorders. SB 1 has passed the Senate and is the House Insurance Committee.

SB 158 (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee.

HB 1 (Rep. Peake) would allow for the limited use of medical marijuana for conditions including: cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, crohn’s disease, mitochondrial disease, fibromyalgia, parkinson’s disease, and sickle cell disease.  HB 1 passed the House of Representatives and is now in the Senate Health and Human Services Committee.

HB 195 (Rep. Cooper) and SB 51 (Burke) provides parameters for substitutions of interchangeable biological products. HB 195 passed the House Health and Human Services Committee and is expected to come out of the Rules Committee next week, and Senate Bill 51 has passed the Senate and has been assigned to the House HHS committee, but is not expected to get a hearing until after crossover day.

HB 482 (Rep. Willard) seeks to eliminate two of the requirements that the Cancer Treatment Centers of America are currently subject to when they were allowed into Georgia as a destination hospital.

HB 416 (Rep. Rogers): Routinely referred to as the badge bill, HB 416 seeks to provide clarity and transparency for the patient as to the qualifications of the provider that they are seeing.  The bill calls for providers to identify the health care practitioner’s name and the type of license or educational degree the health care practitioner holds. The bill will be heard in the House HHS committee on Monday March 2, 2015 at 3 PM.

HB 34 (Rep. Dudgeon) is known as the “Right to Try” bill and calls for patients with advanced illnesses and in consultation with their doctor to use potentially life-saving investigational drugs, biological products, and devices.


Georgia’s Plan to Strengthen Rural Hospitals

Earlier this week, the Rural Hospital Stabilization Committee (RHSC), created by Governor Deal to address the needs of struggling rural hospitals and find solutions that address those needs, issued its final report. The recommendations in the report include:

  • A four site “Hub & Spoke” pilot program
  • Maintenance and protection of Certificate of Need laws
  • Expanded scope of practice for non-physician providers, like physicians assistants and nurse practitioners
  • More support for school-based health centers

The committee’s work shines a spotlight on the health care access challenges that rural Georgians face and puts forth constructive recommendations.  While we support these recommendations whole-heartedly, we are also disappointed that the committee did not address the coverage gap and Medicaid expansion in its report.

Georgia Health News interviewed Georgians for a Healthy Future’s Executive Director on this issue (click here to read the full article), and in that article she pointed to the early success of states like Kentucky, which recently reported improvements and coverage rates and in health care access due to Medicaid expansion. She also encouraged policymakers to take a comprehensive approach that includes closing Georgia’s coverage gap to help get people into health insurance and provide a reimbursement stream for rural hospitals.

Back in December, Georgians for a Healthy Future, together with several consumer and community-focused organizations including the Georgia Budget and Policy Institute, Georgia Watch, and Families First, submitted a report and provided public comment to the committee making a detailed case for such an approach. You can read that full report here.


Medicaid Minute

Medicaid provides health insurance to low-income families and vulnerable populations in states across the country, allowing them to access necessary health care services. In states that have opted to implement the Medicaid expansion, people are enrolling in the program and uninsured rates are plummeting. Nationwide, 10.8 million Americans gained coverage through Medicaid just between October and December 2014. Unfortunately, these coverage gains vary widely among states. According to the US Department of Health and Human Services, states that expanded Medicaid saw a 27 percent increase in Medicaid and CHIP enrollment in the last year, while non-expansion states saw only a 7 percent increase. Too many Georgians are still stuck in the coverage gap.  Fill out an e-postcard that we’ll send to your legislators letting them know that it’s time Georgia fixed this problem and closed its coverage gap.


What is a 1095-A?
And other burning questions about health insurance and tax filing?

flowchart

If you are a consumer who enrolled in health insurance through the Marketplace with a tax credit, you likely received a 1095-A form in the mail. You may also have some questions about how to complete the health insurance information on your tax filing form. If your organization works directly with consumers, either providing enrollment assistance or helping them with tax preparation, you may also be hearing about the 1095-A and may have some questions about how health insurance and tax filings intersect. Below is a primer, replete with flow chart, which breaks it all down for you.

Where consumers get their coverage—Marketplace, employer, Medicaid—will determine the impact coverage has on their taxes.  Consumers who have health insurance through their jobs will likely see no changes when they file their taxes – they just check the box on their tax forms indicating they had coverage throughout the year.  The same thing applies to consumers who are covered by Medicaid, Medicare, or their parent’s health plan.  Pretty simple!

During this year’s open enrollment period, 536,929 Georgians purchased health insurance through Healthcare.gov and about 90% received financial assistance to help lower the cost of their premiums.  To keep that tax credit, they’ll have to fill out Form 8962, which asks questions about their health insurance and their income. To help complete that form, all consumers that received a tax credit should have received Form 1095-A in the mail from the Marketplace. Consumers can also find this form on their Healthcare.gov account.

The health insurance tax credit is based on income and household size. When consumers applied for coverage, they estimated their income for the coming year and that amount was used to determine their tax credit. If a consumer misestimated their income, the credit they received may be too high or too low. During the tax filing process, the difference between estimated and actual income is reconciled, and the corresponding tax credit may be adjusted up or down.  This means some consumers may get a refund and some consumers may have to pay back part of their tax credit. If a consumer did not apply for a tax credit previously, they can apply for a credit to be included in their tax refund.

If a consumer went without health care coverage at any point in the year, they may need to fill out an additional Form 8965 to determine whether or not they will need to pay a fine. This year the maximum fee per family will be $285, but fines will increase each year, up to 2% of a person’s annual income.  If a person falls into Georgia’s coverage gap, they will not have to pay the fine, but will need to file the appropriate documents to prove they do not have access to affordable coverage

Household, family, and income changes should be reported throughout the year to Healthcare.gov in order to avoid surprises at tax time.

If you have questions about how your health coverage may affect your taxes, consult a tax professional.  Our partners at Georgia Watch can connect you with free tax preparation help—just click here.


So You Have Coverage…Now What?

If you have recently gained health insurance through the Health Insurance Marketplace, it may seem like you need to learn a whole new language to understand your coverage. Health insurance can be confusing, especially if you have never had it before or haven’t had it in a while. Just understanding a few key terms, such as premium, deductible and co-pay, will go a long way in helping you use your health insurance effectively. Click here for a simple guide to help you understand your new coverage. Additionally, if you are having trouble using your health insurance you can contact Whitney Griggs, GHF’s Consumer Education Specialist, at wgriggs@healthyfuturega.org or at (404) 567-5016, extension 5.


Action Alert: CHIP in Danger

Federal funding for the Children’s Health Insurance Program (CHIP), known as PeachCare for Kids in Georgia, expires in September 2015.  More than 200,000 Georgia kids rely on this program for access to health care services.  The U.S. Congress has signaled that it is willing to consider extending CHIP funding. This is great news. However, some of the discussion include provisions that provide access barriers.  Some concerning provisions include the removal of protections that were included in the ACA, an optional 12-month waiting period for coverage, and cuts to CHIP funding for certain groups of children in some states. (Click here for a full analysis of the draft plan.)  You can help by telling your legislators to pass a clean renewal of CHIP funding that does not impose barriers to enrollment and coverage for kids.  Here are some ways to get in touch:

  • Write a letter or call your congressman. Click here to see suggested language from our partners, Voices for Georgia’s Children.  Click here to find your congressman, senator and their contact information.
  • Tweet at your representatives in congress. See the list below for their Twitter handles.  Use the hashtags #ExtendCHIP #keepkidscovered and #CHIPWorks
  • Share this image from Voices for Georgia’s Children (@georgiavoices) on social media to spread the word.

CHIP_monkey

Senate

Johnny Isakson

@SenatorIsakson 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

David Perdue

@sendavidperdue 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

House

Buddy Carter (1st District)

@RepBuddyCarter 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Sanford Bishop Jr. (2nd District)

@SanfordBishop 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Lynn Westmoreland (3rd District)

@RepWestmoreland 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Hank Johnson Jr. (4th District)

@RepHankJohnson 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

John Lewis (5th District)

@repjohnlewis 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Tom Price (6th District)

@RepTomPrice 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Rob Woodall (7th District)

@RepRobWoodall 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Austin Scott (8th District)

@AustinScottGA08 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Doug Collins (9th ,District)

@RepDougCollins 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Barry Loudermilk (11th District)

@RepLoudermilk 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Rick Allen (12th District)

@RepRickAllen 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

David Scott (13th District)

@repdavidscott 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)

Tom Graves (14th District)

@RepTomGraves 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)


Peach Pulse, February 20, 2015


Legislative Update

georgia-capital-buildingToday marked the 19th day of the 2015 Legislative Session (almost at the halfway point)! Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015, is set for March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.

As part of this week’s legislative update, we caught up with Senator Chuck Hufstetler and spoke with him about his proposal to increase the state’s tobacco tax by $1.23, which would bring Georgia up to the national average.  According to a fiscal note released this week by Georgia State University at legislative request, this increase would yield more than $500 million in new revenue. To read more about the tobacco tax, download our one pager.  To see the media coverage, check out our “In the News” page.


Other issues we’re watching include:

The State Budget

Our friends over at the Georgia Budget & Policy Institute have put together an analysis of the health care spending within the proposed 2016 state budget. Click here to read GBPI’s health care budget overview.

 

Medicaid Payment Parity

cindy on medicaid parityThis week, the House Appropriations Health Subcommittee held a hearing on the FY 2016 Budget. A range of organizations and individuals provided testimony in support of payment parity, citing the evidence that shows provider rate increases result in better access to care for patients and consumers. Georgians for a Healthy Future spoke in support of payment parity at the hearing.

 

Closing the Coverage Gap

Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians. Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills for their support and show your support by filling out a postcard that we’ll mail to your legislators!


More than half a million Georgians enroll in Marketplace health insurance

Open Enrollment for the Health Insurance Marketplace ended Sunday and over half a million Georgians enrolled in plans through the Marketplace! Georgia’s enrollment was the fourth highest of states using the Federally Facilitated Marketplace, trailing only behind Texas, Florida, and North Carolina. The state’s enrollment numbers passed the 500,000 mark in large part due to a last minute surge in sign-ups. This year’s enrollment numbers greatly exceed last year’s exchange enrollments of 316,543. Nationally, 11.4 million Americans selected plans or were automatically re-enrolled through the Marketplace. Click here to learn more about Georgia’s enrollment numbers.

For Georgians who begun the enrollment process prior to the deadline but, due to issues with either healthcare.gov or call centers, were unable to complete their enrollment, CMS has extended a Special Enrollment Period (SEP).  These people are “in line” and still eligible to enroll this year.  This SEP will end February 22nd.  If you or someone you know thinks they qualify for this extended enrollment period visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596.


Miss open enrollment? You may still be able to get coverage!
Open Enrollment has officially ended but some Georgians that missed signing up during the three month period may be able to still get coverage. Those “in line” during this last three days of Open Enrollment who were unable to select a plan due to long call center wait times or technical issues have until Sunday, February 22 to enroll. In this circumstance, coverage will begin March 1st.  Otherwise, consumers who have a “qualifying event” may be able to get coverage through a Special Enrollment Period. Special Enrollment Periods can occur at any time during the year and are usually triggered by specific events. These events include life changes such as a marriage, birth, change in eligible immigration status and a permanent move. Another type of event that could qualify consumers is a loss of other health coverage. These types of events could include an involuntary loss of employer coverage, loss of Medicaid coverage, and a death or divorce that results in a loss of coverage. In most cases, the Special Enrollment Period lasts for 60 days after the qualifying event occurs. To learn more about what types of events could trigger a Special Enrollment period, click here. If you think you may qualify, visit https://www.healthcare.gov/get-coverage or https://localhelp.healthcare.gov/ to find in-person assistance in your area.

Additionally, the Centers for Medicaid and Medicare Services just announced a Special Enrollment Period for tax season for consumers who were penalized for not having coverage in 2014 and are not currently enrolled in health insurance. To qualify for this Special Enrollment Period consumers must also attest that they were not aware of the penalty for not having health insurance until after the end of Open Enrollment (February 15th , 2015) because they filed their 2014 tax return after that date. This Special Enrollment Period will begin March 15th and end April 30th, 2015. Click here to learn more about the announcement.


 GHF welcomes new Consumer Education Specialist

WhitneyWhitney joined Georgians for a Healthy Future this week as our Consumer Education Specialist. In this role, Whitney will educate consumers who have questions about how to understand and use their health insurance as well as assist consumers who encounter problems with their insurance plan. Whitney will also be on the lookout for patterns that can help inform GHF’s policy and advocacy work in the area of private health insurance. Whitney comes to GHF from the Healthy Mothers Healthy Babies Coalition of Georgia, where she was lead health navigator. As a health insurance navigator, Whitney provided enrollment assistance for the Health Insurance Marketplace to consumers in rural Georgia. In this role she also conducted extensive outreach throughout the state to inform consumers about the Affordable Care Act and the new health insurance options available under the law. Prior to her role as a navigator, Whitney worked for Healthy Mothers Healthy Babies as an Information and Resource Specialist for their health care referral service, called the Powerline. In this position she helped find and verify health care providers throughout the state for the referral line. Whitney has also worked in the Child Life Division at Children’s Healthcare of Atlanta. Whitney earned her B.S. in Psychology with a focus on Biological Psychology from Clemson University. Whitney can be reached at wgriggs@healthyfuturega.org.  Please welcome her to Georgians for a Healthy Future!


National partner features our collaboration with the Diverse Elders Coalition and the Bhutanese Association of Georgia

351Check out Community Catalyst’s blog featuring the collaboration between GHF, the Diverse Elders Coalition, and BAG to help Bhutanese refugees living in Clarkston, Georgia enroll in health insurance!


Medicaid Minute

Kentucky_beforeKentucy_After

New data released from Kentucky show the success of Kentucky’s Medicaid expansion program.  Here are a few quick highlights.

  • 375,000 Kentuckians got covered
  • Hospitals gained more than $500 million in just the first year
  • 12,000 new jobs were created (with an additional 28,000 jobs expected over the next 7 years)
  • Uncompensated care in hospitals fell 60%
  • Estimated costs of expansion in current and subsequent biennial budget are more than offset by savings and new revenues generated from economic activity resulting from new health care spending
  • Choosing not to expand would have cost the state about $100 million

Fill out our survey and tell your legislators know it’s time for Georgia to close its coverage gap!


 

Infographic of the Week

MCD_Georgia-Medicaid-gap-and-employment_infographic


Peach Pulse, February 12, 2015


Legislative Update

georgia-capital-buildingToday marked the fifteenth day of the 2015 Legislative Session—we’re more than one-third of the way through already! Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015, is set for March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.

Georgians for a Healthy Future is monitoring and advocating on bills of importance to health care consumers in Georgia. As part of this week’s legislative update, we spoke with Senate Insurance Committee Chairman Charlie Bethel about the legislation moving through his committee and about his priorities with respect to health care policy in Georgia. This conversation also includes a discussion of Senate Bill 1, which would provide for certain insurance coverage for autism spectrum disorders.

Other issues we’re watching include:

The State Budget

Our friends over at the Georgia Budget & Policy Institute have put together an analysis of the health care spending within the proposed 2016 state budget. Click here to read GBPI’s health care budget overview. 

Medicaid Payment Parity

Last week, Sen. Unterman talked to us about her request for $60 million to restore Medicaid payment parity.  Sen. Unterman and advocates continue to work with the health appropriations chairmen in both chambers, but no decisions have been made to date.

Closing the Coverage Gap

Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians. Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills for their support and show your support by filling out a postcard that we’ll mail to your legislators!

Tobacco Tax

Georgians for a Healthy Future and our coalition partners continue to support a $1.23/pack increase in Georgia’s tobacco tax to bring us in line with the national average, decrease smoking rates, and bring in needed revenue for health care investments in our state. Click here for our new fact sheet on why Georgia should increase the tobacco tax. While no legislation has been introduced this session to increase the tobacco tax, we expect it may enter the mix as legislators discuss transportation funding.

We will continue to monitor this issue and will let you know when advocacy opportunities arise.


Time is running out – get covered today!

Open enrollment is quickly coming to a close, ending this Sunday, February  15th.  If you haven’t gotten covered yet or you know someone who doesn’t have coverage, don’t wait!  Act now before Sunday’s deadline.  Click here to find a Navigator near you or visit healthcare.gov to sign up.  These Georgians got covered and you can too!

Got Covered - CorneliaCornelia, a recent college graduate, had coverage on her parents’ plan…until she turned 26 and became ineligible.  She really wanted to stay with the same insurer, but also needed an affordable plan.  She applied and found that she qualified for a plan with the same carrier with even better coverage for less money. After her subsidy, Cornelia’s plan cost her only $83 per month.

Got Covered - ScottScott Quimby found an enrollment event near his home by visiting getcoveredamerica.org. He and his wife were able to enroll in a plan, which is a big deal because his wife had a pre-existing condition.  She had suffered brain trauma previously and expressed how grateful she was that she could get covered at an affordable price because of the Affordable Care Act: “I know I made the best decision because I came and got help.”

Got Covered - Mechul2Mechul had gone uninsured previously—for six years—going to the ER when he was seriously ill. He lost coverage when he turned 18, having been enrolled in Medicaid until then as a foster child under his grandmother’s care. He was told when he was younger he was pre-diabetic and felt anxious not have a way of getting regular care.  In March, he went to healthcare.gov to try to enroll but then decided to a navigator to get more information, and finally completed enrollment himself at home. He found a no cost silver-level plan, which was great because cost was the most important factor for him.  Now Mechul is employed and will get coverage through his employer, but he said it was a relief and gave him peace of mind to have health insurance there when he needed it.

If you or someone you know has an enrollment success story they’d like to share, let us know!  With your help, others can get covered and stay covered.


King v. Burwell — What’s at stake for Georgia?

King Burwell Potential Result

On March 4th, the United States Supreme Court will hear oral arguments in King v. Burwell, a lawsuit challenging the tax credits that consumers utilizing the federal Health Insurance Marketplace receive to help make health insurance affordable. Consumers in thirty-four states, including Georgia, use the federal Marketplace to find and enroll in coverage. Nearly nine out of 10 people who enrolled in coverage through healthcare.gov received financial help and paid 75 percent less than the full monthly premium. This has helped bring the nation’s uninsured rate to an historic low.

A study by the Robert Wood Johnson Foundation and the Urban Institute found that the majority of health care consumers who would be impacted and who would likely become uninsured if the tax credits were struck down live in the South. Here in Georgia, hundreds of thousands of people are at risk for becoming uninsured.

We believe there is no legal basis for this challenge and that in June, when a decision comes down, we’ll all breathe a sigh of relief. If the court does, however, strike down the tax credits, such a decision would disproportionately impact the South and would put states like Georgia at a competitive disadvantage by exacerbating existing regional health disparities. If this comes to pass, Georgians for a Healthy Future will advocate for a contingency plan to ensure that Georgians have the same access to tax credits that their counterparts in states like New York, California, Colorado, and Kentucky (states that set up their own health insurance exchanges) have.

Our friends at Families USA have put together a resource page for advocates interested in learning more about King v. Burwell. Click here to find out everything you need to know about the case!


Medicaid Minute

This week, we learned that the Tennessee legislature failed to pass the Insure TN plan.  This is a big disappointment for the 300,000 Tennesseans who fall into the coverage gap and who could have had access to health insurance if the Tennessee plan moved forward. This outcome shows how important it is to garner support from elected officials on both sides of the aisle. There are lessons we can learn for our work here in Georgia. Thank you to all of the Georgia advocates who continue to reach out to your legislators across the state to let them know you support closing Georgia’s coverage gap.  If you’d like to get involved and join the Cover Georgia coalition, email Laura Colbert.


Infographic of the Week

deadline-fine


Peach Pulse, February 5, 2015


Legislative Update

With this week’s legislative update, we bring the Gold Dome to you! Our biggest update this week is that Senator Renee Unterman is making a $60 million appropriations ask in the state budget to maintain Medicaid payment parity. Medicaid payment parity is an effective strategy to increase access to health care services for low-income children and families enrolled in Medicaid (click here to learn more about what payment parity is and why it matters for health care access). Your GHF team was at the Capitol this week to talk with Senator Unterman about her proposal.

Renee_Unterman_Screenshot

Also this week, the Senate Appropriations Subcommittee on Health held a hearing that included discussion about Medicaid payment parity. No decisions were made at the hearing but we expect the topic will come up again. What can advocates do?  Contact one or more of these legislators!

  1. Call or email Senator Unterman and thank her for leading the charge on this important initiative!
  2. Call or send an email to Senator Burke, who chairs the Senate Appropriations Subcommittee on Health, and Representative Butch Parrish, who chairs the House Appropriations Subcommittee on Health, and thank them for their support on Medicaid payment parity.
  3. Contact Senate Appropriations Chair Jack Hill and House Appropriations Chair Terry England and let them know you support Medicaid payment parity.

Other issues we’re watching.

Medicaid Expansion

There has been no action to date on closing the coverage gap by expanding Medicaid. Please contact your legislators and the leaders of the Health and Human Services and Appropriations Committees to ask them to hold hearings on this important issue.

Click here to let your state senator and representative know that you support closing Georgia’s coverage gap.

Tobacco Tax

Georgians for a Healthy Future and our coalition partners continue to support a $1.23/pack increase in Georgia’s tobacco tax to bring us in line with the national average, decrease smoking rates, and bring in needed revenue for health care investments in our state. All eyes in the House and Senate have been on the transportation funding proposal unveiled last week on the House side, which did not include an increase in the tobacco tax. However, the Senate is expected to take a more diversified approach in this area and the possibility of a tobacco tax increase may be on the table. We will continue to monitor this issue and will let you know when advocacy opportunities arise.

Other Health-Related Bills

Senate Bill 1, which would require insurance companies to provide limited autism benefits for Georgians enrolled in certain individual and small group plans passed the Senate and is now on the House side. A hearing has not been scheduled for the bill on the House side.

Senate Bill 74, which would authorize tax credits for donors to health charity organizations, has been introduced in the Senate and referred to the Senate Finance Committee.


Knowledge is power: Terry’s enrollment story

Terry S“This is your health we’re talking about.  How important is it to you?”  Terry Stidom, an Atlanta health care consumer, cares about his health and is glad about his decision to get covered. “It became a no-brainer,” he said about his decision to enroll in a health plan through the Health Insurance Marketplace last year.  This year, with the increase in providers and plans available in Georgia, he was able to find an even more affordable, comprehensive plan.  What does he love about his plan?  “[It] includes medical, dental, vision, no deductible, low doctor visit co-pays, I get $20 a month in cash back just for going to a gym at least 8 times per month — the list goes on.”  While Terry researched his options and signed up on his own, he encourages others to seek help.  “As you sit and look at each plan, don’t be intimidated by the numbers.  If you’re unsure, call someone to help you.  Knowledge is power!”

Open enrollment ends February 15th – don’t miss out on the opportunity to find the plan right for you and your family.  Click here to find a Navigator in your area and get covered today!

If you or someone you know has an enrollment success story they’d like to share, let us know!  With your help, others can get covered and stay covered.


2015 Advocate’s Guides are Here!

Advocates_Guide_2015Each year Georgians for a Healthy Future develops our signature A Consumer Health Advocate’s Guide to the Legislative Session, and the 2015 editions are in! Whether you are an individual interested in contacting your legislators to let them know you care about health care issues or if you work for an advocacy group and want to get multiple copies for your volunteers, we’re happy to get the guides into your hands. We create them each year to help you be a better advocate.

In this year’s guide, you will find:

  • Detailed legislative process overview
  • Listing of all representatives and senators, their offices and numbers
  • Key contacts in the governor’s office and relevant agency staff
  • Members of key committees and subcommittees
  • Contact information for other health advocate organizations
  • Media contacts
  • Tips to make you an effective advocate

You can download a PDF version or contact Laura Colbert and arrange to pick up hard copies from GHF’s office.


Medicaid Minute

Welcome-to-Indiana-3x2-555x370CMS has approved Indiana’s plan to expand health care coverage for low-income Hoosiers through a waiver program known as Healthy Indiana.  This is great news for the 350,000 Indianans who will now have access to health care coverage. The Healthy Indiana plan, however, includes some features that raise concerns, such as a 6-month lock out policy for people with low incomes who can’t afford to make payments on premiums. Some of these features could create barriers to access. For a breakdown of the pros and cons of the Healthy Indiana plan and what advocates should be watching, see this analysis from our friends at the Georgetown Center on Children and Families.


Infographic of the Week

katy_perry

 


Your voice is needed!

Coverage Gap _ Georgia_EDITTEDWe all know how crucial closing the coverage gap is – it would improve access to health care services for low-income Georgians, bolster our state’s health care delivery system, and strengthen local economies throughout Georgia. We are asking our legislators to schedule hearings on this issue, and we need your help!  Last year, the legislature sent the message with HB 990 that they wanted to be part of the conversation around finding a Georgia solution to cover the uninsured.  We have yet to see them take steps towards opening up that debate.  Tell your legislators that it is time to close the coverage gap.  Send them an e-postcard telling them why you think covering the uninsured should be a priority for the 2015 legislative session.


Peach Pulse: January 30, 2015


Legislative Update

georgia-capital-building

The Legislature has completed eight days of the 40-day session and will convene Monday through Wednesday next week. There will also be several committee hearings next week, including:

1) Senate Appropriations Community Health subcommittee meeting Tuesday at 3 PM in CLOB 307.  The agenda for this hearing will feature testimony about the importance of maintaining Medicaid parity for primary care providers in Georgia.

2) Senate Health and Human Services committee meeting on Tuesday at 1 PM in CAP 450 (Agenda to be announced).

3) House Health and Human Services committee meeting on Monday at 3 PM in CLOB 606 to discuss HB 47.

Committee meetings are open to the public and we encourage health-focused advocates to attend. Of course, your Georgians for a Healthy Future team is monitoring legislative developments and advocating for our priority issues throughout the legislative session and we will keep you informed about key opportunities for advocacy as they emerge. Below is a status report on the issues Georgians for a Healthy Future is supporting this year.

Closing Georgia’s Coverage Gap: There has not yet been any legislative activity in this area, as the General Assembly has been focused on addressing the transportation funding issue.  Georgians for a Healthy Future supports holding hearings on the need to close Georgia’s coverage gap as a first step to achieving this legislative priority. Please contact your Representative and Senator and tell them you support holding hearings on Medicaid expansion this year. You can find your legislators here.

Increasing Georgia’s Tobacco Tax: There has been early momentum around increasing Georgia’s tobacco tax, and a bill has been drafted to increase the state excise tax on cigarettes by $1.23 per pack. The bill also includes a comparable increase on other tobacco products. This bill is awaiting a fiscal note from the state, which we expect to be completed by the first week in February.  See our one-pager on how increasing the tobacco tax can help reduce smoking and improve health in Georgia. Georgians for a  Healthy Future is proud to be part of a coalition of health organizations working on this important issue—please stay tuned for updates on this issue once the fiscal note is in!

Medicaid Payment Parity:  Georgians for a Healthy Future supports maintaining payment parity for primary care providers (see this week’s Medicaid Minute for an explanation of how this improves access to care for Georgia patients) by restoring the temporary reimbursement rate hike that expired at the end of 2014.  Senator Renee Unterman has proposed a $60 million appropriation for this, and Medicaid payment parity will be a topic of conversation at next week’s Senate Appropriations subcommittee hearing (on Tuesday at 3pm).  This hearing presents an opportunity to weigh in with your state legislators to let them know you support the payment bump and to ask them to include it in the FY 2016 Budget.


Coverage Day at the Capitol Recap

IMG_2595 IMG_2568 IMG_2589

This past Tuesday was Coverage Day at the Capitol! Laura Colbert, GHF’s Community Outreach Manager, spearheaded the day with the help of many Cover Georgia partner organizations.  The opportunity to talk with legislators about the coverage gap drew about 75 advocates and volunteers to the State Capitol. After an advocacy training session, the group met with their legislators throughout the morning by “working the ropes.”  The group reconvened for lunch and a press briefing, covered by both WABE and the Georgia Report! Members of the Cover Georgia coalition displayed their information, materials, and projects in the Capitol Rotunda throughout the afternoon. It was a full day of advocacy in support of closing Georgia’s coverage gap!  We’re hoping that Georgia’s legislators heard our message loud and clear – it’s time to start talking about closing Georgia’s coverage gap!


GHF Receives MLK Community Service Award

IMG_0286GHF celebrated Martin Luther King Jr. Day last week by receiving an award at Emory University’s 23rd annual MLK Community Service Awards.  This year’s award program recognized organizations that work to address injustices in the Atlanta community, often before those injustices become headlines.  Harry Heiman, out-going board chair, and Laura Colbert accepted the award on GHF’s behalf.  In Harry’s acceptance speech, he remembered Dr. King’s quote: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”  GHF works hard to ensure equal access to high quality, affordable health care for all Georgians.  We are honored to accept this award and congratulate the other very deserving awardees.


Medicaid Minute

Georgia’s Medicaid patients could face longer wait times for doctor’s appointments without legislative action. That’s because a nation-wide bump in primary care provider reimbursement rates expired at the end of 2014, triggering a need for state action. This temporary rate bump resulted in an average eight percent increase in appointment availability, according to a new study published in the New England Journal of Medicine. The study examined ten states, including Georgia, and concluded that payment rate increases are an effective strategy for enhancing access to primary care services. According to a participating physician in Texas, his practice was able to double the amount of Medicaid patients seen during the two year time the pay bump was in effect.  By restoring the rate bump, known as Medicaid payment parity, Georgia policymakers can help ensure patients get timely access to primary care in an appropriate setting and help keep patients from ending up in the emergency room.


GHF Board Changes

With the New Year, GHF kicks of a new board.  Kathy Floyd has stepped into the position of board chair, taking the reins from Harry Heiman.  A board member of several years, we know she will bring strong leadership and vision to our growing organization.  We are also thankful for Harry’s incredible run and accomplishments as board chair during a period of growth for GHF. We are excited to welcome new board members Danté McKay, Jay Berkelhamer, Natalie Hernandez, and Monica Ponder!  Each brings substantial experience and expertise and we’re excited to have them as part of the GHF team.  As the same time, we are sad to see wonderful partners rolling off the board.  Julie Edelson, Marci Thomas, Jeffery Graham, Sylvia Caley, and Iris Feinberg have all finished their board terms and, while we will miss them, we hope they will enjoy their newfound free time!


Infographic of the Week

Countdown infographic end of open enrollment


Peach Pulse: January, 23, 2015


Coverage Day at the Capitol 

IMG_0771Please join us this coming Tuesday, January 27, from 9 am to noon for a day of advocacy!  GHF and the Cover Georgia coalition have planned a full day of activities to raise awareness about the important role that coverage plays in the health and financial security of all Georgians and to ask our legislators to close Georgia’s coverage gap.  More than 15 organizations are already participating, and it’s not too late to join us! We’ll provide breakfast and lunch, an advocacy training, and opportunities to share your materials and personal health care stories at our afternoon Capitol Rotunda display.

To sign up, click here.  If you have any questions, please contact Laura Colbert.


The 2015 Legislative Session is Underway!

georgia-capital-buildingThe legislative session opened last week, and health care is already a hot topic. Here is what we have learned in the first week and a half:

It’s budget week! Governor Deal released his budget on Friday, and legislators have been holding budget hearings all week. Here are two aspects of the health care budget that have our attention:

  • The proposed budget eliminates State Health Benefit Plan (SHBP) coverage for non-certificated school employees (bus drivers, custodians, etc) who work less than 30 hours a week.  State officials estimate it will affect more than 11,000 state employees.  We’re still sifting through the details, but we’re very concerned that some of those employees may fall into the coverage gap if they lose coverage through the SHBP.
  • There is no money in the state budget to sustain the primary care reimbursement rate increase that was temporarily funded with federal dollars. This temporary bump  made it easier for patients in Georgia and other states to get medical appointments and access care.

There has also been some early momentum at the Capitol around an increase in the tobacco tax, one of Georgians for a Healthy Future’s legislative priorities! As bills and budget items impacting health care in Georgia are introduced and discussed, we will keep you posted and identify opportunities for advocacy. We’ll be at the Gold Dome throughout the session so look for updates and alerts in each Peach Pulse!


Thank you for making Health Care Unscrambled a huge success!

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Thank you to those of you who joined us for our fifth annual Health Care Unscrambled policy breakfast on January 15! This year’s event featured two powerhouse panels: a bipartisan legislative discussion and a panel that focused on the recent experiences of Kentucky and Arkansas, two Southern states that are moving forward with innovative plans to cover their uninsured and improve population health, and featured the insights of a national expert.

This year’s Health Care Unscrambled also provided an opportunity for Georgia health care advocates, policymakers, stakeholders, and consumers to come together just as the 2015 Legislative Session got underway to focus our attention on the most pressing health policy issues facing our state, including a robust discussion about the coverage gap.  Senator Dean Burke said that while last year he would have said there was a 0 out of 10 chance for Georgia to close the gap, this year he moved it to a 5 out of 10.  We’re excited about these improved chances and will continue to advocate for movement this legislative session!

We wrapped up the event with a reveal of our 2015 legislative priorities, which you can find here. You can read Georgia Health News’s coverage of the event here.


GHF goes to Washington

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This week, Cindy and Anna are representing Georgians for a Healthy Future at Families USA’s Health Action 2015 conference!  We’re getting inspiration from national leaders, learning about best practices from experts and advocates doing great work around the country, and sharing our own experiences advocating for Georgia health care consumers. GHF’s Executive Director Cindy Zeldin spoke on a workshop panel about how to advocate for consumers enrolled in private health insurance. Check out Facebook and Twitter through Saturday for conference updates!


Story collecting with Mercy Care

Mercy Care EventGHF partnered with Mercy Care to kick off the legislative session by collecting the stories of people who fall in the coverage gap.  As the governor was being inaugurated and our legislators were being sworn in, we talked to Mercy Care’s patients how health care coverage would help them.  Everyone we talked to expressed that health care coverage would help them go back to work, take better care of their family, or better manage their health.  We will be sharing these stories on Coverage Day through social media and in person as we talk with policy makers about the importance of closing the coverage gap. HealthSTAT and the National Health Care for the Homeless Council were critical partners for this story collection effort!

 If you are in the coverage gap and would like to share your health care story with us, click here .


Medicaid Minute

Last year, the number of uninsured Americans declined, fewer adults reported difficulties paying for medical bills and medical debt, and fewer adults delayed care because of cost. These encouraging findings, which come from the Commonwealth Fund’s Biennial Health Insurance Survey, are great news for patients and consumers. These coverage and access gains, however, were not experienced evenly across the country. People living in states (like Georgia) that haven’t expanded Medicaid were more likely to be uninsured and to face burdensome medical bills than those living in states that have expanded Medicaid. Let’s not leave Georgia patients and consumers behind-let’s close the coverage gap!


Infographic of the week

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Peach Pulse, December 18, 2014


Time to Act on Tobacco

With the holiday season upon us and the 2015 Legislative Session just around the corner, the health of our state’s children and families is at the top of all of our minds. Georgians for a Healthy Future has focused heavily on promoting policies that ensure a pathway to coverage and meaningful access to care for all Georgians in recent years, but identifying and advocating for policies that improve health outcomes is also close to our hearts. In that spirit, we believe it is time to act on tobacco, which is the leading cause of preventable disease and death. 

Earlier this month, Georgia’s Medicaid program amended its state plan to include a comprehensive smoking cessation program. This is an important victory that will help reduce smoking in our state. If you haven’t already, please take a moment to thank Commissioner Clyde Reese for taking this important step. There is, however, more to do. We need your partnership and your voices to help us take on the biggest hurdle we face in curbing smoking and its harmful effects: increasing the tobacco tax in our state. 

According to the American Lung Association’s annual state report card, Georgia scores an “F” on tobacco taxes. Georgia currently ranks as the 48th lowest tobacco tax in the country at just 37 cents per pack.  Not only does this make tobacco much more accessible to youth (and all Georgians), but it takes much needed revenue off the table for Georgia as the state tries to find funding for transportation infrastructure, education, and health care coverage for Georgians.

In fact, Georgia is so far below the national average for tobacco taxes that we could raise our tax by over a dollar per pack and still just be at the national average.  That is why this year GHF and a coalition of supporters will propose raising Georgia’s cigarette tax by $1.23 per pack.  It’s as easy as 1-2-3! 

One – for the kids who we can prevent from ever starting

Two – for the improved health outcomes that smoking reductions will bring

Three – for the revenue the tobacco tax will bring to our state that can be invested in coverage, access, and prevention.


Network Adequacy: Action Alert

If you’ve been following the Peach Pulse you know that network adequacy is a hot topic in health care right now. (And if you missed it, check here and here to get caught up!) Decision-makers are weighing policy choices that will have implications for health care consumers in Georgia and across the nation. We know that they are hearing from health industry stakeholders; now they need to hear from you!  

1) The US Department of Health and Human Services (HHS) Proposed Rule on the 2016 Notice of Benefit and Payment Parameters is open for comment until December 22, 2014.  To submit a comment, click here.         

2) The National Association of Insurance Commissioners (NAIC) is currently updating its model act on network adequacy. This model provides an example that states can use to enact their own legal protections to guarantee private insurance consumers an adequate provider network once they are enrolled in coverage. Advocates can email jmatthews@naic.org until January 12, 2015 with input.

Consumer advocates are asking these two entities to put in place 1) specific network adequacy standards such as time and distance standards and appointment wait time standards and 2) rules that provide consumers the right to go out-of-network at no extra cost if their plan cannot provide them timely, geographically accessible, and appropriate in-network care. Please take a few moments to submit your comments to HHS and to the NAIC with this important request. If your organization is interested in engaging more deeply on this issue, please contact Laura Colbert at lcobert@healthyfuturega.org to let us know you’re interested in collaborating.


GHF Around Town

It’s been a busy couple weeks for us here at GHF.  The Rural Hospital Stabilization Committee met to hear public comments two weeks ago and we were out in force!  We presented our report to the committee.  In addition, our own Laura Colbert and representatives from the Georgia Budget and Policy Institute, HealthSTAT, Jewish Community Relations Council, Georgia Legal Services, and Voices for Georgia’s Children all pressed how crucial closing the coverage gap is as a the first step to saving our rural hospitals. 

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The following week, the GHF team attended the 29th Biennial, a gathering of legislators and advocates from across the state.  GHF spoke with members on both sides of the aisle and encouraged conversations around closing the coverage gap to give hard working Georgians the access to care they deserve. 

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Start the New Year right with GHF!

January is an exciting month for GHF and Georgia! With the start of the legislative session, advocates across the state will be hard at work educating our legislators and working for the changes we need to improve the health of all Georgians. GHF is no exception!

HCU_dateOur 5th Annual Health Care Unscrambled event is January 15th. For more information on the event, sponsorship opportunities, and ticket prices, click here.

 

 

 

IMG_0778Coverage Day at the Capitol. Please join us on the morning of January 27th to talk with your legislators about why closing the coverage gap is important to you. If you haven’t spoken with your legislators before, we will provide training and talking points to help guide you through the process. If you would like to participate, RSVP to Laura Colbert at lcolbert@healthyfuturega.org.

 

georgia-capital-buildingWebinar: Health Care Policy and Advocacy for the 2015 Legislative Session, 2015. For those of you who can’t make it to Health Care Unscrambled for the unveiling of GHF’s 2015 policy priorities or want to know how to better advocate for health in Georgia, join us for our first-ever advocacy webinar! To register for the free webinar, click here.

 

 

 


Medicaid Minute

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This week, Tennessee announced its intention to move forward with a plan to close the coverage gap!  In a statement, Governor Bill Haslam said “This plan leverages federal dollars to provide health care coverage to more Tennesseans, to give people a choice in their coverage and to address the cost of health care, better health outcomes and personal responsibility.”  We are thrilled for Tennessee and hope our own elected officials will take note and work to provide a Georgia solution for our hard working, uninsured families.

 


Infographic of the Week!

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Nykita Navigates

IMG_9114One month down, two to go!  Already, nearly 2.5 million Americans already signed up for health insurance.  Early numbers show that about half of those who have signed up are new enrollees.  If you haven’t enrolled yet or want to shop around before selecting a new plan, there is still time!  Click here to see Nykita’s schedule for upcoming events in your neighborhood.  If you don’t see any close to home, please give her a call to set up a one-on-one appointment. 


Peach Pulse: December 4, 2014


Health Insurance Hot Topic Update: Network Adequacy

megaWith open enrollment in full swing, Georgia consumers are once again exploring their health insurance options and signing up for coverage. When consumers enroll in a health insurance plan, they gain access to a network of medical providers with whom their insurer has contracted. For health insurance to facilitate meaningful access to care, this network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits and services. In a recent issue of the Peach Pulse, we provided a primer on network adequacy, a hot topic in health policy (click here to get caught up on what network adequacy means and why it matters for consumers, advocates, and policymakers). In that overview, we promised to keep you updated on policy developments around network adequacy, in particular the ongoing process at the National Association of Insurance Commissioners (NAIC) to update its model law. This model law can provide a framework for states to establish and enforce standards to ensure that provider networks are adequate. At its fall meeting in November, the subgroup at the NAIC working on network adequacy announced it would take comments on an initial draft of proposed revisions for the model act until January 12, 2015. To learn more about this process and to see the draft, click here.

To ensure the needs of consumers are considered in this process, the NAIC consumer representatives released a report featuring the results of a survey of state Departments of Insurance and recommendations for state policymakers, regulators, and the NAIC to consider as they work on updating network adequacy standards. These recommendations include:

  • Establish quantitative standards for meaningful, reasonable access to care, such as minimum provider-to-enrollee ratios, reasonable wait times for appointments based on urgency of the condition, and distance standards that require access to network providers within a reasonable distance from the enrollee’s residence.
  • Ensure consumers are provided sufficient information to identify and select between broad, narrow or ultra-narrow networks. In areas without sufficient choice, require health plans to offer at least one plan with a broad network or an out-of-network benefit, with limited exceptions to be determined by the Commissioner.
  • Require health plan provider directories to be updated regularly, publicly available for both enrolled members and individuals shopping for coverage, and include standards for information that must be included to provide consumers with information on network differences and the potential financial impact on consumers depending on which plan they choose.

There are 17 recommendations in all. For advocates interested in learning more about this issue and in speaking up for consumers in this process, see the full report here.

If you would like to weigh in at the state level, please contact Georgia’s Department of Insurance and ask the Commissioner to support the NAIC’s process to revise the model act and specifically to support the consumer recommendations described above.

If you are an individual consumer enrolled in a commercial health plan and the provider directory you were given was incorrect or if you have concerns about your ability to access covered services under your plan, please contact the Georgia Office of Insurance & Fire Safety, Consumer Services Division by calling (800) 656-2298 or use the Consumer Complaint Portal at www.oci.ga.gov/ConsumerService. Please also consider sharing your story with Georgians for a Healthy Future so we can get a better picture of what is happening in our state.


Rural Hospital Stabilization Committee: Your voice is needed!

hospitalWe’re hoping you read our report released two weeks ago to the Rural Hospital Stabilization Committee (RHSC) on how closing the coverage gap can help save our rural hospitals.  (And if you didn’t – here is it!)  This Friday, the RHSC is taking public comment and your voice is needed!  You may register to make comments when you arrive at the meeting. Comments will be presented on a first come, first serve basis. No power points, but handouts (should you be so inclined) are allowed.  If you interested in commenting, but are unsure of how to best shape your argument, feel free to reach out to Laura Colbert, GHF’s Community Outreach Manager.  Even if you aren’t comfortable speaking, please show up and show your support!  Details are below.

Location: Two Peachtree Street.  5th floor.  Located on the corner of Peachtree Street and Marietta Streets.  The Five Points MARTA Station is just south of Two Peachtree.

Time: 10:00 AM to 1:00 PM


Connecting Georgians to Coverage: GHF partners with the Bhutanese Association of Georgia to get people covered

Every Saturday morning, many Bhutanese immigrants gather at their temple in Clarkston for SAT prep, U.S. citizenship, and English classes.  Recently, Laura Colbert, Georgians for a Healthy Future’s Community Outreach Manager, joined them to provide information about health care coverage and the Affordable Care Act’s open enrollment period.  With the help of a translator, Laura spoke with approximately twenty community members about the benefits of health care coverage, how to get covered, and where to find affordable medical care if they were not eligible for coverage. She also answered their questions about health care coverage for their children and Medicaid.  (In return, Laura learned quite a bit about Bhutanese culture.)

This educational event was the product of a partnership with the Bhutanese Association of Georgia (BAG), which works to integrate Bhutanese refugees into life in Georgia. GHF and BAG have been working together over the past year to educate the Atlanta-based Bhutanese community about health care coverage and to increase health coverage enrollment.  In addition to educational events, several fact sheets have been created by GHF and translated into Nepalese to be distributed in the community.

Georgians for a Healthy Future continues to work to increase enrollment among all Georgians, especially in communities that may need extra education or encouragement to enroll.


Medicaid Minute: Who qualifies?

Each state has slightly different eligibility criteria for Medicaid.  When we talk about closing the coverage gap– as 28 other states have either through Medicaid expansion or a state-specific 1115 waiver – it’s important that we all know just who is (and isn’t) eligible for Medicaid today in Georgia and who could gain coverage if we close that gap.

  • Very low income parents. Medicaid is offered to parents who make up to 40% of the Federal Poverty Level (FPL).  For a family of four, parents with income up to $9,036 annually or $753 per month can receive health coverage through the Medicaid program.
  • Pregnant Women. Pregnant women who earn up to 220% FPL.  For a family of four, a pregnant woman with income up to $52,488 would be eligible for Medicaid
  • Most Children. Children are covered at varying income limits based on their age and family size. The Children’s Health Insurance Program (CHIP), known as PeachCare for Kids in Georgia, is layered on top of the Medicaid program. Together, these programs provide coverage to children in families with incomes up to 247% of the FPL.  For a family of four, that’s $58,932 annually.
  • The low-income elderly. In addition to Medicare, many, but not all, low income elderly adults whose income is less than $25,560 per year qualify for Medicaid.
  • Low-income women diagnosed with breast or cervical cancer.
  • Aged, Blind, and Disabled. With varying income limits, those who receive Social Security Income, live in a nursing home, or community care center qualify.
  • Qualified Medicare Beneficiaries. These are the aged, blind or disabled who have hospital insurance and have incomes below 100% FPL.  Medicaid will cover some of their Medicare expenses.
  • Low-income Terminally Ill. Those with an annual income of less than $25,956 and who are expected to live less than six months.

*Numbers are pulled from the GA Department of Community Health and Peach Care for Kids webpages.


Nykita Navigates

IMG_9114Nearly half a million people enrolled in health insurance through the federal marketplace in the first week of open enrollment!  The deadline for January 1st coverage is fast approaching: December 15th.  Don’t miss out!  If you need in person assistance, please see the below events or contact Nykita at 404-567-5016 or nhowell@healthyfuturega.org.


Upcoming events:

January 19:  15th Annual United Ebony Society MLK Day Celebration and Health Fair (Lawrenceville, GA)


Recurring events:

Cobb County Public Health (Marietta, GA) Every Tuesday, Starting November 18, 2014 and ending February 10, 2015 (with the exception of November 25, 2014)

Clarkston Library, DeKalb County (Clarkston, GA) Every Thursday, Starting November 20, 2014 and ending February 12, 2015

Fayette County Library Presentation (Fayetteville, GA) December 8, 2014; January 12, 2015, and February 2, 2015

Events are subject to change, and new events are added all the time – check back here regularly for updates!


Peach Pulse: November 13, 2014


Open Enrollment Starts Saturday!

megaIf you receive our Peach Pulse, there’s a good chance you already know that open enrollment for health insurance starts this Saturday, November 15 and goes through February 15.  Two important things to remember and share with your friends, family, colleagues, and community members:

  • Even if you enrolled last year, you should go to healthcare.gov and shop around as your plan and premiums may have changed, or you may qualify for more financial assistance.
  • Unless you qualify for an exemption, the penalty fee for not obtaining health insurance has risen to $325 or 2% of your income (whichever is higher).

If you have enrolled successfully through the Health Insurance Marketplace or remain uninsured and think you fall into the coverage gap (Not sure what that is?  Check out this Kaiser Family Foundation resource that explains the coverage gap!), please consider sharing your story.  Highlighting your stories is crucial to showing our lawmakers that the ACA is working and that we need to close the coverage gap so that no Georgian is left uninsured.


Nykita Navigates

IMG_9114With open enrollment starting this Saturday, our Navigator, Nykita, has been very busy!  GHF is excited to highlight some of Nykita’s materials, as well as some great work from our partner organizations.  The following materials are great to print out at home for your own use or if you’re helping others enroll.

  • Affordable Care Act Basics: Guide to the Marketplace – Your basic guide to the ACA and the health insurance market place
  • Marketplace Application Checklist – Your check list of what you should bring to your appointment with a Navigator (it’s longer than you think!).
  • Health Insurance 101 – Not quite sure the difference between an HMO and a PPO?  How about co-insurance and co-pay?  This brochure will answer your questions.
  • Enrollment Brochure – Important dates and numbers to remember throughout open enrollment.
  • Navigator Resource Guide – Georgetown University’s Center on Health Insurance Reforms (CHIR) has launched its web-based Navigator Resource Guide on Private Health Insurance and the Health Insurance Marketplaces.  Targeted at Navigators, this is an amazing resource to help answer the tough questions.

Ready to get enrolled?  Check out Nykita’s schedule to see what events are happening in your neighborhood.  Check back often for updates.


Medicaid Minute

All eyes are on open enrollment, but for more than 400,000 Georgians, there still isn’t a health care option available.  Our elected state officials have the power to solve this problem. The health care law was designed to provide a path to health insurance to all Americans, but our state government has to opt in to make that a reality. Governor Deal and the state legislature have so far declined to use federal tax dollars that have already been set aside to provide coverage to those in the gap, but the opportunity to accept this money is still available.  We can opt in now by expanding Medicaid eligibility to all low-income Georgians who currently do not qualify.  Still need more details?  Click here to learn more.


It’s Not Too Late To Give!

GA Gives DayAs you know, Georgia Gives Day is in full swing!  The day isn’t over and as of sending time we are 30% of the way to achieving our goal of $1,000!  Your participation and support allows us to continue the work we do: educating the public and our lawmakers, providing valuable resources to partner organizations and leading the charge for closing the coverage gap in Georgia.  If you haven’t, please consider a small donation.  To donate, click here.


Peach Pulse: October 30, 2014


SBIRT: A Public Health Initiative

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Yesterday, Georgians for a Healthy Future together with the Georgia Council on Substance Abuse unveiled our new initiative “Somebody Finally Asked Me…” at a benefit party held at the home of Iris and Bruce Feinberg.  This project aims to prevent and address youth substance use disorders through increased use of an evidence-based public health approach known as SBIRT (Screening, Brief Intervention, and Referral to Treatment).

To learn more about SBIRT, click here.

If you were unable to attend the event and would like to make a donation to help us reach our fundraising goal for this project, click here.

To watch a video about how alcohol and drug addiction impact the lives of youth and why we are committed to preventing addiction before it starts,click here.


Georgians for a Healthy Future awarded Robert Wood Johnson Foundation grant

Georgians for a Healthy Future (GHF) is excited to announce that we have been awarded a Consumer Voices for Coverage grant from the Robert Wood Johnson Foundation, the nation’s largest health philanthropy. Georgians for a Healthy Future will work in conjunction with Community Catalyst, who serves as the national program office for the Consumer Voices for Coverage program. As one of 18 state-based consumer health advocacy organizations around the country to receive a grant under the Robert Wood Johnson Foundation’s Consumer Voices for Coverage initiative, Georgians for a Healthy Future will develop and carry out collaborative and best-practice based strategies to maximize health insurance enrollment and retention, increase health insurance literacy, and create a more favorable policy environment for Georgia health care consumers. This project will have a particular emphasis on vulnerable and hard-to-reach populations in Georgia.

“We are honored to be part of the Consumer Voices for Coverage community and excited to deepen our work on behalf of Georgia health care consumers through this grant,” said Cindy Zeldin, Georgians for a Healthy Future’s Executive Director. “The health care policy landscape in Georgia and across the nation is rapidly changing, and it is critically important that there be a strong voice for consumers as these changes are determined and implemented.”

Georgians for a Healthy Future will draw upon our extensive experience and expertise in building and mobilizing coalitions as well as strong relationships with dozens of community organizations with deep reach across the state. These partnerships will be essential for outreach, dissemination of culturally and linguistically appropriate educational materials, and for soliciting feedback from diverse communities about the specific challenges faced regarding health insurance so that themes can be identified and shared with state policymakers and other key stakeholders and decision-makers.

About Georgians for a Healthy Future: Georgians for a Healthy Future’s mission is to build and mobilize a unified voice, vision, and leadership to achieve a healthy future for all Georgians.  Since our founding in 2008, Georgians for a Healthy Future has provided substantive health policy information to community leaders and advocates throughout the state, conducted seminars to equip consumers with the tools to become strong advocates, successfully injected the consumer perspective into dozens of health care stories in the media, and engaged with policymakers to spark policy change for a healthier Georgia.


It’s Time to Get Covered

lgbt_iconLearn about your options for health care coverage at the LGBT Health Insurance Town Hall

Join Georgia Equality, Georgians for a Healthy Future and The Health Initiative on Thursday, November 13th at 7 pm at the Rush Center.  Whether you still need health care coverage or you have coverage and want to re-enroll, you probably have questions about the upcoming open enrollment period.  Consumers, just like you, who got enrolled in health coverage last year will share their experiences and advice.  Navigators will be on hand to answer your questions about how to get covered or re-enrolled.  Bring your coverage questions, your uninsured friends and family, and your health coverage stories.  Open enrollment for 2015 coverage begins November 15, 2014 and ends February 15, 2015.

Bonus! We don’t know about you, but talking health care always works up our appetite – stop in at Radial Café before or afterwards to receive either 20% of your meal or order a special dinner for two for $30!

Click here to RSVP!

Not in Atlanta – We’ve still got you covered!

Because we know that many of you have questions about your coverage options and what to look for in a health insurance plan, we will also be live-streaming the town hall meeting. You’ll not only be able to watch the presentations in real time, you’ll also be able to ask your questions of our panelists and experts.

Click here to RSVP for the live-stream!


Children’s Health Insurance Program in Danger

The Children’s Health Insurance Program (CHIP) provides health insurance for children whose families make too much to allow the children to be covered by Medicaid, but make too little to be able to provide insurance for their children themselves.  CHIP covers 7.7 million children nationwide and 220,000 in Georgia.  Georgia’s CHIP program is called PeachCare for Kids (aka PeachCare).  . PeachCare is administered by the state of Georgia and jointly financed by the state and federal government.

PeachCare provides coverage for primary, preventive, specialty, dental and vision care for enrolled children ages 18 and under.  In addition, the insurance covers hospitalization, emergency room visits, prescription medications and mental health care.  PeachCare helps ensure the well-being of many Georgia children who may not be covered otherwise.

Future funding for the program is in danger.  Even though the program is legislated to exist until 2019, Congress has only approved funding for CHIP until next September.  By choosing not to approve federal dollars for CHIP in the 2016-2019 budgets, Congress would leave millions of children without access to health insurance and would shift the financial burden of covering our kids to the Georgia state budget.

Contact your Congressperson and ask them to make sure that Congress secures CHIP funding through 2019.

For more information visit Voices for Georgia’s Children and the Georgetown Center on Children and Families.


Medicaid Minute

Looking for more proof of why we should close the coverage gap?  A nonpartisan Kaiser Family Foundation analysis reported that states that have not expanded Medicaid and closed the coverage gap (like Georgia) will see a greater increase in spending than those that have.  In states like Georgia we can expect to see a 6.8 percent increase in tax dollars going to support Medicaid in fiscal year 2015.  That compares to a 4.4 percent rise in states that have closed the coverage gap already.


Nykita Navigates!

IMG_9114In the last edition of our Peach Pulse newsletter, we introduced you to Nykita Howell, Georgians for a Healthy Future’s new health insurance navigator. Nykita has hit the ground running in her new position in advance of health insurance open enrollment, which begins November 15!

If you are part of a community-based organization and would like to learn more about the types of health insurance options available to your community members and gain a better understanding of how to enroll in coverage, please feel free to contact Nykita to request a presentation. If you are an individual consumer in need of health insurance enrollment assistance, you can also contact Nykita to set up an appointment.

What does a navigator do, you might ask?

Health insurance navigators help consumers determine their eligibility for health insurance and for advanced premium tax credits through the Health Insurance Marketplace, provide enrollment assistance to consumers by helping them prepare their applications, and conduct outreach and education to raise awareness about the Marketplace. Navigators receive training and are certified at both the state and federal levels. They provide free and unbiased services to consumers.

Georgians for a Healthy Future is part of a consortium of 12 nonprofit organizations led by Seedco that received a federal navigator grant from the US Department of Health and Human Services. That funding supports this important service.

Events in the next two weeks:

  • Community Church of God and Christ (Atlanta, GA), November 15, 2014  1pm to 4pm  

Infographic of the Week!

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Peach Pulse: October 17, 2014


Navigators and the Consumer Experience

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Georgians for a Healthy Future partnered with Seedco at a briefing in Atlanta on October 16 to present and discuss findings from a comprehensive evaluation of the impact of health insurance navigators on consumer experiences during the first open enrollment period. The evaluation was conducted by a team of researchers at the University of Georgia, and its key findings include:

  • Navigators succeeded in assisting consumers from diverse communities and in reaching those in need of affordable health services
  • Rates of achieving enrollment or application success with navigators differed by region, by demographics, and by consumer financial status
  • Navigator interpersonal communications, and especially follow-up, was the biggest factor in consumer satisfaction

As we gear up for the next open enrollment period, which begins on November 15, 2014, the findings from this report can inform the work of enrollment assistance personnel and community-based organizations in Georgia and across the country. Selected recommendations from the report include:

  • Continue partnering with community agencies that serve diverse populations
  • Publicize the navigator role and concrete ways to access free in-person assistance
  • Follow up with consumers after they receive in-person assistance

For a summary document highlighting and describing these and other key findings and recommendations, click here. To read the full study, click here.


Georgians for a Healthy Future Met the Press!

GHF’s Executive Director Cindy Zeldin met last week with the Kaiser Family Foundation’s (KFF) Media Fellows and shared her perspective as a consumer health advocate with the group. The KFF Media Fellows are highly regarded health care journalists from major national and local publications who spent three days in Georgia discussing and learning about the implementation of the Affordable Care Act (ACA) and other health policy issues in the state from local experts, advocates, academics, and practitioners. Georgians for a Healthy Future was honored to be a part of their agenda.

The fellows prepared for their visit to Georgia by reading KFF’s new “The Georgia Health Care Landscape.”  This document provides a comprehensive overview of Georgia’s population health, the implementation of the ACA in Georgia, and Georgia’s health care infrastructure.  It is an excellent primer for those who want to know more about Georgia’s health care landscape or who want to have key Georgia health care stats at your fingertips.  Some facts in particular stand out from the issue brief:

  • As of January 2014, 22% of uninsured Georgians were in the coverage gap, meaning they were ineligible for Medicaid because Georgia has not expanded its program and earned too little to qualify for premium subsidies for private coverage.
  • 87% of Georgians who enrolled in health coverage through the Marketplace received premium subsidies to purchase coverage.
  • Georgia has many Health Professional Shortage Areas and a high level of unmet need for care. As of August 2014, only 59% of the primary health care need in Georgia was being met. Even worse, only 45% of the need for mental health care services and 28% of the need for dental services were being met.
  • More than one in five non-elderly people in Georgia is uninsured, and high unemployment rates and poorer than average health care outcomes for many measures suggest a greater need for health coverage among many low-income Georgians.

Georgia Gives day is 26 days away!

We’re hoping for a big turnout for Georgia Gives Day on November 13th for Georgians for a Healthy Future (GHF), but there’s something you can do between now and then and it takes almost no time!  Take a picture, like the one below, and tell us why you support our work and quality access to health care.  Include the hashtags #GAGivesDay and #unselfie and tag us on Facebook or include our twitter handle @healthyfuturega to enter us to win $500 from GA Gives Day!  It’s a competition, so go to GA Gives Facebook page and vote for your favorite GHF submission!

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Your support and participation doesn’t just support GHF but it supports accessible, quality and affordable health care for all Georgians.  Don’t forget to check back with us on November 13th to make a donation and show your support for health equity and for GHF!

 

 

 

 

 

 


GHF Welcomes New Staff: Health Insurance Navigator Nykita Howell

IMG_9114Georgians for a Healthy Future is excited to welcome Nykita Howell, our new Health Insurance Navigator, who joined us this week!  In this role, Nykita provides Marketplace enrollment assistance to Georgia health care consumers. Prior to joining Georgians for a Healthy Future, Nykita worked in the fields of clinical and community based research and as a navigator for the first open enrollment period of the national Health Insurance Exchange. Her research efforts have been on studies focused on retention strategies for an NIH-funded cohort based at Umass Medical School, and a church-based diabetes project housed at Mercer University. Her work as a navigator prior to joining Georgians for a Healthy Future included building community partnerships and educating consumers over a seven county area. She holds an MPH from Mercer University School of Medicine and is a Certified Health Education Specialist. Prior to her graduate studies, Nykita received her B.S. in Biology from Clark Atlanta University, in Atlanta, GA.  If you or anyone you know needs assistance navigating the health care system, please contact Nykita at nhowell@healthyfuturega.org or 404-567-5016.  Remember, open enrollment begins Nov. 15th—just one month away!


Medicaid Minute: 60% Support Closing the Coverage Gap!

A new report on consumers’ experiences and views on health care found that 60% of Georgians disapprove of the state’s decision not to expand Medicaid, which includes 43% who strongly disapprove.  Over 90% of Georgians think Medicaid is important – and we agree!  It’s time to close the coverage gap and provide a pathway to coverage for all Georgians. Follow @healthyfuturega on Twitter to stay up-to-date about our efforts to #coverga.


Infographic of the Week

From our partners at Enroll America!

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Join us for a benefit party!

Benefit Party1

Please join Georgians for a Healthy Future (GHF) and the Georgia Council on Substance Abuse on October 29 from 6 to 8 PM for our SBIRT (Screening, Brief Intervention, and Referral to Treatment) Benefit Party to launch our new public advocacy campaign – Somebody finally asked me! The project seeks to prevent youth substance use disorders through the implementation of universal screening.  In addition to launching our SBIRT project, we have been challenged to raise $30,000 in Georgia to help support this work—a big opportunity to leverage the national dollars coming into Georgia through the Hilton Foundation.  We hope you will join us and make a gift that is meaningful to you as we work together towards this goal.  To learn more about this project click here.  To RSVP now, click here.


GHF Executive Director is honored by the League of Women Voters

Georgians for a Healthy Future’s Executive Director Cindy Zeldin was honored last week by the League of Women Voters with an Empowerment Award at their annual lunch.  GHF is so proud of Cindy’s dedication to health advocacy throughout the last five years!

cindy award

john lewis


Peach Pulse: October 6, 2014


Next in Health Care: Network Adequacy Explained

question When consumers enroll in a health insurance plan, they gain access to a network of medical providers. Insurance companies contract with a range of providers, including both primary care and specialty physicians, to deliver health care services included within the plan’s benefit package. This network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. This is what is meant by network adequacy.  More specifically, to be considered adequate, a network must provide adequate numbers, types, and geographic distribution of providers; must ensure that access to care is timely; and must include essential community providers that serve predominantly low-income, medically underserved individuals. Additionally, accurate information about providers must be made available to consumers.

Network adequacy has become a hot topic over the past several months because many consumers who enrolled in new health plans through the Health Insurance Marketplace found that their plan came with a narrow network of providers. Provider directories weren’t always accurate or up-to-date, and consumers expressed a fair amount of confusion over which providers were in their plan’s network.

At the same time, the National Association of Insurance Commissioners (NAIC), which develops model laws and rules that states often adopt, has been working to update its network adequacy model law. Stakeholders ranging from insurers to medical providers to patient and consumer advocates are weighing in on this process, making network adequacy a hot topic in the policy arena too. Georgians for a Healthy Future has been monitoring this process through the participation of our executive director as one of the consumer representatives to the NAIC. Earlier this summer, the consumer representatives submitted comments to the NAIC focusing on developing a stronger standard and better oversight of network adequacy, an end to “balance billing” by out-of-network providers in in-network facilities, and greater transparency of provider networks.

Georgians for a Healthy Future will continue to monitor this process and will advocate at all levels, in conjunction with state and national partners, to ensure consumers have meaningful access to care.

If you are an individual consumer enrolled in a commercial health plan and the provider directory you were given was incorrect or if you have concerns about your ability to access covered services under your plan, please contact the Georgia Office of Insurance & Fire Safety, Consumer Services Division by calling (800) 656-2298 or use the Consumer Complaint Portal at www.oci.ga.gov/ConsumerService. Please also consider sharing your story with Georgians for a Healthy Future so we can get a better picture of what is happening in our state.

For more information on network adequacy, please see the following reports and resources:

From Georgetown Center on Health Insurance Reforms: Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-Draft a Model State Law

From Robert Wood Johnson Foundation and Georgetown University Health Policy Institute: ACA Implications for State Network Adequacy Standards

From Families USA: Network Adequacy and Health Equity: Improving Private Health Insurance Networks for Communities of Color


Connecting Georgians to Coverage

The ACA and people living with HIV/AIDS: what you need to know

PrintThe Affordable Care Act (ACA) makes health insurance more affordable, more accessible, more understandable, and more complete for all Georgians. Health care and health insurance are especially important to people living with HIV/AIDS (PLWHA) so that they can stay healthy and well.  PLWHA often have very specific needs and questions regarding their health coverage and care options.  To answer them, Georgians for a Healthy Future and Georgia Equality have created a fact sheet that breaks down the biggest concerns and decisions for PLWHA.  The fact sheet details new rights and protections under the ACA, walks through important questions to ask prior to choosing a health plan, and provides contacts for further assistance.

This fact sheet was made to be shared! You can view and download this new fact sheet on the GHF website. If you would like hard copies to distribute to your members, clients, or community partners, please contact Laura Colbert, GHF’s Community Outreach Manager at lcobert@healthyfuturega.org.


Georgia Gives Day

GA Gives DayGeorgians for a Healthy Future works hard every day to bring about our vision of a day when all Georgians have access to the health care services they need to lead productive lives and contribute to the health of their communities. Whether we’re enrolling people in health insurance, advocating on behalf of health care consumers at the state capitol, working to address substance use among young adults, or convening a coalition to expand Medicaid, we are focused on you and your health.

November 14th is Georgia Gives Day.  This is a day for Georgians across the state to express their support for the non-profit organizations that enrich our lives.  We hope that you will put November 14th on your calendar and take a few minutes out of your day to support Georgians for a Healthy Future by making a small contribution.  Look for alerts leading up to the day and please follow us on Facebook and Twitter as we celebrate and work toward our vision of a healthy Georgia.


Stories that Cause Change: How you can make a difference!

The public discussion around the Affordable Care Act is often about its politics. What the pundits miss is that each person’s experiences-whether it is the elation, relief, and sense of security that come with enrolling in health insurance for the first time or the frustration that comes from finding out you fall into the coverage gap–is important.  Whatever your story, we want you to share it with us!

Volunteer!  Throughout open enrollment we will be talking to consumers throughout the state.  You can help us in this important effort by attending an event in your neighborhood and talking to consumers.  We will prepare you with supplies and materials, a how-to guide, and more.  If you would like to help out, please email our outreach manager, Laura Colbert.

Share your story and encourage others to do the same. If you or someone you know has successfully enrolled in a health insurance plan through the marketplace, tell us about it.  If you fall in the coverage gap, let us know.  If you are able to access care that you couldn’t afford before, we want to hear about it.  Tell us your story by contacting our communications coordinator, Anna Cullen.

Together we can make a change.


Medicaid Minute: Uncompensated Care Cost

ER-Hospital-SignLast week, HHS released a report highlighting one way Georgia can help our hospitals and reduce uncompensated care costs: closing the coverage gap by expanding Medicaid.  In states that have expanded, uninsured/self-pay admissions as well as uninsured/self-pay emergency visits have fallen.  Those same states have seen hospital admissions for patients with Medicaid increase.  In short, they have more paying customers.  And Georgia is getting left out.  The report shows a $5.7 billion savings to hospitals in uncompensated care because of the Affordable Care Act.  $4.2 billion (74%) of those savings will be to states that have expanded.  Just one more reason why closing the coverage gap is the best option for Georgia’s economy and Georgia’s people!

 


Peach Pulse: September 13, 2014


healthy kids logoCovering Kids: Health Insurance for the Whole Family 

New from GHF!

All kids need reliable access to quality health care.  Children need to see the doctor even when they are healthy:  shots for school, well-child visits, and dental care are all important for kids to grow up healthy and strong.  Their parents need coverage too to stay on track with regular screenings and preventive care, to access the health care system if they become sick, and to experience the financial peace of mind that comes with being covered. 

Thanks to new health insurance options available through the Marketplace, the uninsured rate among parents is dropping. Still, too many of Georgia’s low-income parents fall into what has become known as the “coverage gap,” meaning they don’t earn enough to qualify for subsidized private insurance and they earn too much to qualify for Medicaid because Georgia has so far declined to join the 27 states (and counting!) who have expanded Medicaid.

In an effort to provide accurate information to parents about the coverage options for themselves and their children, GHF has created a set of fact sheets about health insurance coverage for kids and parents in Georgia.  These fact sheets are intended to be a resource for individual consumers and for organizations who represent or provide services for Georgia families.  

Affordable Health Care for Your Children and For Uninsured Parents help parents understand the coverage options for themselves and their children. If you work with low- to moderate-income families through a charity care clinic, at a school or church, or in a community-based organization, you may want to provide these resources to the families you serve. 

Covering Kids paints a picture for policy makers and the media who want to better understand children’s health care coverage in Georgia.  If you work with policy makers or want to talk to your legislators about health care coverage for kids, this fact sheet will be a helpful resource.  

A fourth fact sheet serves as a reference for those who need to know the income limits for the Medicaid and PeachCare programs.

You can view and download these new fact sheets on the GHF website. If you would like hard copies to distribute to your members, clients, or community partners, please contact Laura Colbert, GHF’s Community Outreach Manager.


compassConnecting Georgians to Converage: GHF’s Navigator Program Will Again Assist During Open Enrollment!

Last week, the U.S. Department of Health and Human Services (HHS) awarded health insurance navigator grants to 90 organizations in states with federally facilitated or partnership marketplaces. Health insurance navigators help consumers understand and compare health insurance options, enroll in coverage, determine eligibility for tax credits, and utilize new coverage once enrolled. Georgians for a Healthy Future is excited to announce that, for the second year in a row, we are part of a consortium of 12 nonprofit organizations, led by the national nonprofit organization Seedco, which received one of two grants for Georgia!

With the next open enrollment period just 58 days away, we are already getting ready. In the coming weeks Georgians for a Healthy Future will bring on a full-time health insurance navigator who will work closely with consortium partners to provide outreach, education, and enrollment assistance to Georgia individuals and families. More than 300,000 Georgia consumers signed up for coverage during last year’s open enrollment period, but hundreds of thousands more who are eligible for affordable coverage remain uninsured. Reaching these uninsured Georgians will require targeted outreach strategies and new partnerships with local community-based organizations throughout the state. Additionally, consumers who enrolled during the last open enrollment period will need assistance navigating re-enrollment and may have questions about how to understand and use their new coverage. Health insurance navigators played a critical role during the first open enrollment period and are poised to assist consumers again this fall, when the second open enrollment period begins.

Georgians for a Healthy Future is honored to participate in these efforts.

Click here to see a full list of organizations that have received funding through Seedco.


Stories That Cause Change: How You Can Make a Difference!

Did you recently sign up for health insurance for the first time? Were you locked out of the market before because you had a pre-existing condition? Was insurance too pricey for you in the past and did you finally find an affordable plan that meets your needs? Or maybe you tried to enroll in coverage and found out that you fell in the “coverage gap” and can’t gain eligibility for Medicaid until Georgia policymakers move forward with Medicaid expansion? Or perhaps you enrolled in coverage but have had difficulty accessing an in-network provider nearby? Whatever your health care story is, we want you to share it with us!

The public discussion around the Affordable Care Act is often about its politics. What the pundits miss is that each person’s experiences-whether it is the elation, relief, and sense of security that come with enrolling in health insurance for the first time or the frustration that comes from finding out you fall into the coverage gap–is important. Georgians for a Healthy Future believes that telling those stories is a powerful tool that can help bring about a better policy environment for health care consumers in Georgia. Over the next several months, GHF, along with other organizations within the Cover Georgia coalition, will collect these stories and share them across the state.

To do this, we need your help in two important ways:

  1. Volunteer!  Throughout open enrollment we will be talking to consumers throughout the state.  You can help us in this important effort by attending an event in your neighborhood and talking to consumers.  We will prepare you with supplies and materials, a how-to guide, and more.  If you would like to help out, please email our outreach manager, Laura Colbert.
  2. Share your story and encourage others to do the same. If you or someone you know has successfully enrolled in a health insurance plan through the marketplace, tell us about it.  If you fall in the coverage gap, let us know.  If you are able to access care that you couldn’t afford before, we want to hear about it.  Tell us your story by contacting our communications coordinator, Anna Cullen.

Together we can make a change.


Medicaid Minute

Medicaid Counter

Every day that Georgia does not close the coverage gap and expand Medicaid, federal dollars are lost.  To show just how much we are really losing, Pro Georgia has created a Georgia Medicaid Counter to track the dollars lost in real time.  Below is the code it embed it on your website.  Please use and share!

<script type=”text/javascript” src=”http://progeorgia.org/wp-content/uploads/2014/01/counter.js”></script>


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