That’s a problem, said Laura Colbert, the director of the patient advocacy group Georgians for a Healthy Future. “Middle-income consumers with pre-existing conditions who want to remain in the marketplace…
Blog (August 2011)
By Dr. Harry J. Heiman and Cindy Zeldin
This column was originally published in the Athens Banner-Herald on August 26, 2011.
The recent debt-ceiling debate and prime-time display of our elected leaders’ inability to work together epitomized the challenges of advancing thoughtful and impactful public policies. Following the deal in Congress, news coverage quickly moved to speculation about the “super committee,” tasked with slashing an additional $1.2 trillion in federal spending over the next decade. Lost in the coverage, and seemingly in the discussion, has been the potential impact of the committee’s decisions on vital services for the most vulnerable in our communities. At a time when the number of people without health insurance continues to rise, Medicaid and other programs that support health care access for low-income children, families, and the disabled remain at risk.
Reduced federal and state funding for Medicaid and the health safety net would be particularly traumatic for Georgia, which has been hit hard by the economic downturn and suffers from high poverty, high unemployment, and high rates of uninsured people. Nearly two million Georgians — one in five — are uninsured, and more than one in six live in poverty. These numbers are even worse in many of Georgia’s rural and inner-city communities. At 37 percent, Athens-Clarke County has one of the highest rates of uninsured people in the state. The consequence of these worsening economic indicators is increased distress experienced by Georgia’s most vulnerable citizens. This distress is reflected in Georgia’s dismal health indicators: high obesity rates, high infant mortality rates and overall poor health outcomes.
Georgia is currently weighing options to determine whether it should establish a health insurance exchange. Authorized by the Affordable Care Act, the goal behind these competitive health insurance marketplaces is to better facilitate competition and choice for health care consumers. Today, Georgians for a Healthy Future is releasing an issue brief entitled Building Georgia’s Health Insurance Exchange that outlines how a health insurance exchange can benefit Georgia consumers and makes recommendations for our policymakers as they weigh design options for an exchange.
Building Georgia’s Health Insurance Exchange addresses the following questions:
- Who is eligible for the health insurance exchange?
- What types of insurance plans will be available on the exchange?
- How will consumers afford the products offered on the exchange?
- What will Georgia’s exchange look like?
- How will the exchange benefit Georgia consumers?
- What should policymakers focus on to build a successful exchange?
- What is the timeline for implementing an exchange?
Building Georgia’s Health Insurance Exchange recommends the following policy goals for an exchange:
- Create a governance structure that can transparently and effectively oversee the exchange without any conflict of interests; insurance companies or other businesses that have a direct financial stake should not serve on the governing body
- Provide structured choices that supply the information and tools consumers need to make optimal purchasing decisions, including quality and customer satisfaction ratings as well as information about price and benefits
- Create incentives for insurance companies to compete based on value rather than by selecting the healthiest applicants: consider leveraging volume within the exchange to drive better deals with insurance companies; consider crafting exchange participation rules to allow the highest quality and value plans to participate; and align regulations inside and outside the exchange to eliminate incentives to steer consumers outside the exchange
- Serve as an easy-to-use, one-stop-shop and provide navigation assistance to programs like PeachCare for KidsTM and Medicaid where appropriate to ensure that all individuals and families eligible for these programs enroll
- Develop a robust outreach and enrollment mechanism to ensure that low-income and minority communities that historically have had the highest rates of uninsurance are engaged and that consumers in rural areas, without internet access, or with limited English proficiency can still enroll in the plan that best meets their needs
The full issue brief is available here.