07

05.10

4:00

What Happened in 40 Days?

The 2010 Legislative Session is officially over in Georgia.  We want to provide you a wrap-up of key pieces of health-related legislation and what they mean for Georgians across the state.


  • HB 307 (which ultimately was attached to HB 1055) imposes a 1.45% bed tax on hospitals.  It is estimated that HB 1055 will generate $300 million for the state.
  • HB 317 (which was attached to HB 411) states that Georgians cannot be compelled to “participate in any health care system,” and that the purchase or sale of health insurance products and/or direct healthcare services could not be prohibited.  This language is intended to exempt Georgians from the individual mandate to purchase health insurance that is included in the recently enacted national health reform law. Because federal law predominates, HB 317 is not expected to have much practical impact.
  • HB 321 now brings Third Party Administrators under Georgia’s Prompt Pay statues, creating a more attractive practice environment for physicians within Georgia and creating more physician choice for Georgia’s consumers and effectively lowering costs through increased competition.  The statute ensures that insurance providers pay medical claims within 15 to 18 working days.
  • HB 866 permits state matching grants to organizations for doctors who move to rural areas.  This legislation serves to enhance recruitment efforts in bringing physicians and specialists to underserved areas within the state thus allowing for greater health care options statewide.
  • HB 1040 allows unlicensed caretakers to perform some home health care activities.  This will enable trained, unlicensed care-partners or assistance personnel to provide some health maintenance activities under informed consent for people with disabilities and the written order of a physician, eliminating the ban on such services within the Nurse Practice Act and allowing or more affordable in-home health options.
  • HB 1268 extends the 65% federal COBRA premium subsidy for people laid off by small firms.
  • HB 1407 provides for a single administrator for dental services for Medicaid recipients and PeachCare for Kids participants thus effectively removing the administrative “middle man” in accessing dental care.
  • SB 316 will make Medigap policies available to Georgians who are living with a disability and receiving Medicare benefits, allowing for fewer chronically ill Georgians to be stuck within the Medicare donut hole or avoid other underpayment issues.
  • SB 360 and HB 23 deal with cellular phone use while driving.  The Senate bill bans texting by all drivers and the House bill bans class D drivers, mostly teenagers, from talking on their cell phones while on the road.
  • SB 367 expands the list of persons who may consent to treatment on behalf of another and provides for medical consent guardians.
  • SB 458 will require pickup drivers to join the rest of the state’s motorists in wearing seat belts. Pickups used on farms and other agricultural jobs are exempt.
  • SR 277 asks voters to approve a $10 fee for license plates to fund trauma services.



Two bills that we closely monitored throughout the Legislative Session, SB 407 and HB 1184, ultimately did not pass. We had major concerns about the impact of these bills on Georgia’s consumers, as they would have circumvented essential health insurance benefit mandates and eroded consumer protections for health care consumers by authorizing out-of-state insurers to sell health insurance plans to Georgians.


One issue that we were following throughout the session, the tobacco tax increase, failed to make it through in the final hours of session.  Despite being a win for public health, a win for tobacco prevention and a win for the state coffers, the tobacco tax was left behind for the year.  Hopefully next year it will be back on the table for negotiation.

As for the budget:
On the 40th day of the session, the FY 2011 budget was adopted. The Medicaid and PeachCare programs were largely protected from cuts because the state is operating under maintenance of eligibility requirements tied to the enhanced rate of federal matching funds (FMAP) Georgia is receiving from the federal government as part of the American Recovery and Reinvestment Act. However, the state budget does include increases to PeachCare premiums. Outside the Medicaid and PeachCare programs, there were other health care budget cuts, including cuts to health department grant-in-aid, Babies Born Healthy prenatal care, and Area Health Education Centers. For a more detailed breakdown of the budget and its implications on health care, please see the Georgia Budget and Policy Institute’s reports.


Looking Ahead:

Though the session is over, the hard work is far from over.  Over the next couple of months Georgians for a Healthy Future will be monitoring the implementation of the new national health reform law to ensure that Georgia is prepared to meet the needs of its citizens.  We will continue to keep you updated on issues that affect the health and welfare of all Georgians and we will look to you for support as we forge ahead.

Posted by Author Name in Access/ Advocacy/ Budget/ Coverage/ Health Insurance Reform/ Medicaid/ PeachCare / No Comments.
<

09

02.10

11:20

What Happens if Nothing Happens?

By Mike King


With the House and Senate health care reform bills stalled and Republicans insisting that the only way to get the reform effort moving again is to go back to square one, there’s a good chance that nothing will be accomplished during this election year. Opponents of health care reform, the Tea Baggers and a host of conservative pundits are OK with that, arguing that the system is not that flawed and that, given the national economy, the country can’t afford to do much else now.


But the cost of doing nothing will be substantial, as seen by recent developments in New York, California and Georgia.


Last week’s Georgia State University report  showed that the ranks of the uninsured swelled in 2008 to 1.67 million Georgians, an increase that took place well before the worst of the recession in 2009 when unemployment spiked above 10 percent. The hardest hit were workers at companies that employ fewer than 25 people, where business owners dropped health insurance plans that they could no longer afford. The state now ranks 9th in population but fifth in the number of residents without health insurance. This trend line has been going on for several years now. The recent efforts by the Georgia General Assembly to deal with the problem — by offering tax breaks to small businesses and individuals who purchase lower cost, high-deductible insurance plans combined with tax-exempt health savings accounts — have had no appreciable impact on the trend.


Meanwhile, as stimulus money runs out, the Medicaid rolls will continue to swell, leaving the state to pick up a higher percentage of the cost of providing coverage for the poorest of Georgians. The bills before Congress promise to pay 90 percent of the cost of expanding Medicaid in the states to more low-income residents, but if they aren’t approved, Georgia will have to pick up a much higher percentage of the cost for residents who qualify for the program under current income guidelines. That’s led to Gov. Sonny Perdue calling for a tax on the state’s hospitals and managed care insurers to offset the increasing Medicaid costs. If his plan goes through, it’s not unreasonable to think that many of those hospitals and insurers will pass on the cost of higher taxes in price increases to patients with insurance, thereby boosting the unsustainable “cost shifting” within the health care financing system that has caused much of the problem the reform effort is attempting to solve.


Evidence of that has already shown up in New York and California.


A major struggle between UnitedHealthcare and a consortium of big New York hospitals represents the kind of ongoing arm wrestling that will continue to take place if insurance reforms aren’t enacted. As reported in The New York Times, the standoff is over, among other things, what the hospital must do if a UnitedHealthcare patient shows up in the emergency room. The insurer wants to be notified quickly of a patient’s hospitalization to determine if it is medically necessary. If not, it told the hospitals, it will cut reimbursement rates for services provided to the patient in half. It’s unclear whether the patient who happens to be caught in such a dispute would have to pay the difference out of his own pocket or the hospital would have to eat the difference. But it’s important to remember that nary a government bureaucrat is involved in this free market dispute. Insurance bureaucrats and hospital bureaucrats will be skirmishing more and more in the absence of some regulatory authority that protects patients from the warfare between insurers and providers. (For a Georgia example of this, think about the dispute between Blue Cross and Blue Shield and Piedmont Hospital a few years ago — where thousands of Blue Cross patients were told to find non-Piedmont doctors — because the hospital and the insurer couldn’t agree on a new contract. They eventually worked it out, but without substantive reform, such disputes will no doubt get meaner and more frequent and leave patients trapped in the middle.)


More recently The Los Angeles Times reports that Anthem Insurance in California proposes a whopping 39 percent increase in premiums staring March 1 for some of the state’s 800,000 individual policy holders. The staggering increase has drawn the attention of state regulators as well as the Secretary of Health and Human Services Kathleen Sebelius. Bear in mind that Anthem is a huge, for-profit insurance company; not one of these fly-by-night, street-corner-sign private insurance vendors that rip off their subscribers with low cost policies that basically cover nothing. Anthem says that the increase is justified because more and more of its individual policy customers are sicker and need more medical services.


That’s what happens without health care reform. That’s what’s been happening for the last 20 years.


Mike King is a retired journalist who specializes in writing about health policy issues. He also serves as editor and administrator of the Healthy Debate blog.






Posted by Author Name in Budget/ Coverage/ Health Insurance Reform/ Medicaid/ PeachCare / No Comments.
<

28

01.10

3:00

Do Republicans Have a Health Plan?

By Mike King

There was snickering on the Republican side of the aisle during Wednesday’s State of the Union speech when President Obama challenged detractors of health care reform to bring him an alternative plan that works. It may have been uncomfortable laughter on their part because the party, as a whole, has no real alternative to offer.


We often hear from Georgia’s senators Saxby Chambliss and Johnny Isakson, as well as the leader of the Georgia House delegation on health issues, Rep. Tom Price, that health reform can be achieved with market-based solutions, such as allowing insurance companies to sell policies across state lines, as well as the party’s favorite excuse for escalating health costs — baseless malpractice suits. Even if legislation dealing with those two issues was passed, the numbers of currently uninsured Americans being able to afford new policies and the bend of the cost curve by malpractice reform would be incremental, at best. And when the GOP was in power in the White House and Congress, it’s interesting to note — as this report on NPR and Kaiser Health News does – that there was hardly any party unity on either issue.


In truth, there was no zeal to do anything about health care reform when the GOP was in power, demonstrated by George Bush’s veto of the State Children’s Health Insurance Plan reauthorization. (Except, of course, unless you count the huge expansion of Medicare when he and Congress agreed to add $700 billion to the deficit by establishing a prescription drug benefit for Medicare patients. Where was the concern for the deficit then?)


As anyone who has studied health care policy has come to learn, occasional tweaking of the massive health care financing and delivery system rarely results in long-term reform or savings. And proposing comprehensive reform — like the effort in 1993-94, and this one now — is inherently complex, subject to willful misinformation by politicians and special interests, and demanding good faith negotiations and uncomfortable trade-offs (i.e. requiring everyone to have insurance so that everyone can afford insurance). That’s why nothing major ever gets accomplished.


The ball’s on the GOP side of the aisle now. Let’s see what they’ve got.


Mike King is a retired journalist who specializes in writing about health policy issues. He also serves as editor and administrator of the Healthy Debate blog.


Posted by Author Name in Access/ Advocacy/ Affordability/ Health Insurance Reform/ PeachCare / No Comments.
<

Next Page »

More than 1.6 million Georgians are uninsured.Source: Georgia Health Policy Center
Health insurance premiums grew 6.4x faster than earnings over the past decade.Source: Families USA
Georgia’s infant mortality rate is among the worst in the nation.Source: KidsCount
Georgia ranks in the bottom quartile of states on overall quality.Source: New American Foundation
More than 1 million Georgians don't see a doctor due to the cost.Source: BRFSS data
Millions of Georgians are at least two hours away from trauma care.Source: GA Statewide Trauma Action Team

Contact GHF

place

100 Edgewood Avenue
Suite 815
Atlanta, GA 30303

Phone: 404-567-5016
Fax: 404-935-9885
E-Mail: info@healthyfuturega.org

Connect on Facebook

Connect on Twitter

twitter
© 2009 Georgians For a Healthy Future | All Rights Reserved