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 (October 2015)
Georgians for a Healthy Future and the Georgia Council on Substance Abuse have joined together to advocate for making substance use prevention services more widely available to kids, teens, and young adults in our state. That’s why we are promoting a cost-effective, evidence-based preventive screening tool called SBIRT: screening, brief intervention, and referral to treatment. Today, we are excited to release a new policy brief that explains the role of prevention in addressing youth substance use disorders, describes the three major components of SBIRT, reviews successful prevention-based pilot projects in Georgia, and makes policy recommendations for the state to activate Medicaid codes for SBIRT services. The policy brief makes the following recommendations to ensure that our young people are healthy and have a bright future:
- Open Medicaid billing codes for alcohol and/or substance use structured screening and brief intervention services
- Authorize the set of providers listed under Medicare guidelines to bill for SBIRT services in Georgia’s Medicaid plan
- SBIRT services should be implemented in emergency departments, primary care offices and school settings
- Provide SBIRT coverage for individuals age 12 and older
Yesterday’s policy 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. Check out the videos below to hear what some of them had to say.
Dr. Paul Seale of Navicent Health and Mercer University School of Medicine on Georgia’s potential to lead of substance use prevention.
Georgia Overdose Prevention Project’s David Laws is a parent who is passionate about the impact SBIRT can have on Georgia’s youth.
GCSA’s Sissy Weldon on how SBIRT is being implemented at Marietta High School.
Dr. Kuperminc of Georgia State University on the research that has been done on SBIRT’s effectiveness.
Call to Action
Georgians for a Healthy Future is excited to release our new enrollment toolkit! The toolkit is a comprehensive compilation of fact sheets, neatly organized, that are designed to walk consumers through each step of the enrollment process – from how to get health insurance (enrollment) to how to use health insurance once they have it (post enrollment). You can download it here.
Need more information like this? You’re in luck! GHF has created the GEAR Network for people just like you. GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners that are working with people to educate them on their health and health coverage options. We’ll send out weekly emails full of local resources and the information you need to know through OE3 and beyond. For more information on GEAR, check out this presentation.
Who, what, when, where and why
By Pranay Rana
Pranay is GHF’s Consumer Education and Enrollment Specialist. A certified application counselor, he assists consumers with enrollment into health insurance through the Marketplace. Pranay can also help you once you have enrolled with questions about how your coverage works. To set up a meeting with Pranay you can email him or give him a call at 404-567-5016 x4.
Open Enrollment 2016 (OE3) is less than 10 days away! Open enrollment is an annual period when individuals and families can choose from a variety of coverage options in the marketplace, apply for tax credits, and purchase a health plan that best meets their needs. Consumers can get 24/7 over-the-phone enrollment assistance via the Health Insurance Marketplace at 1-800-318-2596 or can find local in-person assistance at localhelp.healthcare.gov. Individuals and families with incomes between 100% and 400% of the 2015 federal poverty level (FPL) may be eligible to receive financial assistance to help pay for their monthly premiums (see the chart below for what FPL means in real dollars). Consumers with lower incomes (between 100% and 250% of the FPL) may be eligible for additional help with out-of-pocket costs if they choose a “silver bars” plan. In 2015, 9 out of 10 Georgians who enrolled into marketplace plans were able to access tax credits. Consumers who do not qualify for subsidies may still be able to purchase plans through the marketplace at a full price.
So, when does my coverage start?
|Coverage Dates||Enrollment Deadlines|
|January 1, 2016||December 15, 2015|
|February 1, 2016||January 15, 2016|
|March 1, 2016||January 31, 2016|
The marketplace will discontinue subsidies for those consumers who did not fulfill their tax filing requirements for 2014 in order to reconcile their income and subsidies at the end of the year. Consumers are advised to fulfill their tax filing requirements every year and call the marketplace or local assisters for help if subsidies are being dropped without any legitimate reasons. Consumers who do not qualify for subsidies because their income is too low are also advised to obtain an Exemption Certificate Number (ECN) to avoid tax penalties.
What do I need to do to renew my existing plan?
You may simply call the marketplace for 2016 application renewal if you need to change plans for 2016 or update your information. If you are happy with your existing plan and have no updates to make then you do not need to do anything. The marketplace will simply auto-renew your application for 2016.
What if I need help?
- You can call GHF’s enrollment assister at 404-331-9981 or email firstname.lastname@example.org
- You can call the marketplace 24/7 at 1-800-318-2596
- You can also find local help at healthcare.gov.
Federal Poverty Level Table, 2015
Last 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.
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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.
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We 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.