Ensuring health coverage for all Georgians

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.

 

King v Burwell: what’s at stake for Georgia?

King Burwell Potential ResultOn 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.

Action Alert!

Action Alert—Stop HB 707!

 

House Bill 707 would prohibit the state of Georgia from leveraging federal dollars to cover the uninsured and from providing consumer assistance to Georgians enrolling in health insurance. HB 707 was designed and promoted by the tea party to prevent hard-working Georgians from accessing health care, and it is in danger of becoming law in Georgia. We need your voice! Georgia citizens deserve better than to have the door slammed in their face when they seek out information about how to cover themselves and their family. Our state’s struggling hospitals and uninsured citizens deserve an honest policy discussion about Medicaid expansion, not a gag order on state and local employees. Call Lt. Governor Casey Cagle at 404-656-5030 and your state senator (locate your state senator here) and ask them to oppose HB 707.

 

House Bill 707 would:

 

  1. Prohibit any state agency, department or political subdivision from using resources or spending funds to advocate for the expansion of Medicaid. This would stifle conversation and analysis about how to leverage federal dollars from covering the state’s uninsured.

 

  1. Prohibit the state of Georgia from running an insurance exchange or accepting federal dollars related to an exchange. This broad language could stop quality local programs that provide assistance to vulnerable Georgians getting coverage through the exchange.

 

  1. End the University of Georgia Health Navigator Program. Currently, the University of Georgia is providing enrollment assistance to consumers seeking out health insurance with federal grant money. HB 707 would prohibit UGA from sitting down with uninsured consumers and helping them enroll in a private health insurance plan.

 

  1. Prohibit the Commissioner of Insurance from investigating or enforcing any alleged violation of federal health insurance requirements mandated by the Affordable Care Act. Under HB 707, if a consumer has been treated unfairly by their health insurance company, they may have no state recourse.

 

 

HB 707 has already passed the state House of Representatives and may be up for a vote in the State Senate early next week. We need your voice to prevent this harmful bill from becoming law!

 

Georgians for a Healthy Future

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100 Edgewood Avenue
Suite 1015
Atlanta, GA 30303

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

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