“This has been moving at lightning speed, and it makes really big changes to our healthcare system,” said Cindy Zeldin, executive director of Georgians for a Healthy Future.
Last week, Georgians for a Healthy Future convened experts and advocates from a range of sectors including housing, criminal justice reform, education, and transportation for a discussion about social determinants and how we can break down silos to advance health. In conjunction with the convening, we released a new publication, Health Beyond Health Care: Opportunities to Advance Health by Addressing Social Determinants. This paper provides results from key informant interviews and a review of promising community-based and policy initiatives, highlights standout local examples of health in all policies approaches, and features state-level budget and policy recommendations to address the social determinants of health.
See event photos on our Facebook page.
Tuesday’s election results have the potential to dramatically shift the health care landscape nationally and here in Georgia. It’s too soon to know precisely what policy changes will occur and what their impact will be, but advocacy at both the state and federal levels on behalf of Georgians who need access to quality, affordable health care has never been more important.
The President-Elect and Congressional leadership have vowed to repeal the Affordable Care Act, landmark legislation that established a framework for coverage that has resulted in the lowest uninsured rate ever recorded, rights and protections for health care consumers, and provisions to advance health equity. Repeal is a serious threat and the consequences would be devastating: twenty million Americans and nearly 500,000 Georgians would lose their coverage, while millions more would be stripped of basic protections and face higher costs. Congressional leaders have also signaled their intention to make cuts to Medicaid and other critical health care programs, which would further threaten coverage and access to care for Georgia children and families.
Georgians for a Healthy Future is committed to lifting up the voices of Georgians whose basic access to care hangs in the balance and ensuring these voices are heard and considered as policy decisions are made. We cannot return to the days when anyone with a pre-existing condition like cancer or diabetes can be denied coverage, where women can be charged more for health insurance simply because of their gender, and where LGBT Georgians can be discriminated against in health care. We cannot allow the hundreds of thousands of Georgians who have finally experienced the sense of security that comes with health coverage to go back to being uninsured and out of options. In short, we plan to fight and we need your support and partnership.
We ask you to partner with us in the coming weeks and months as our work enters this new phase. Here is what you can do:
Thank you for all that you do.
We are proud to announce that GHF has been awarded a grant from the Community Foundation for Greater Atlanta. The Foundation works to connect the passions of philanthropists with the purposes of nonprofits. Awards were given through a highly competitive process and we are excited about this partnership as we continue to work to ensure quality, affordable health care for all Georgians. Read the Foundation’s press release.
This August, GHF invited both advocates and enrollment assisters to the second annual Getting Georgia Covered summit. Bringing these two groups together was the first step in fostering ongoing conversations and partnerships to ensure that health coverage translates into meaningful access to care for Georgians. Through the summit, GHF collected feedback and input for a report that highlights how assisters and advocates can team up for consumers. We invite you to read and share Collaborating for Consumers: How Assisters and Advocates Can Inform Policy, in which you will find opportunities and best practices for collaboration to achieve our shared goals.
The Senate Opioid Abuse study committee has begun to flesh out key issues and considerations to draft recommendations for an omnibus bill that includes prevention, treatment, regulatory and enforcement and budgetary provisions to address Georgia’s opioid crisis GHF is encouraged by the committee’s focus on prevention as we have been raising awareness of the need to view substance use disorders as a public health issue that warrants prevention through our Somebody Finally Asked Me campaign. More specifically, we have been advocating for wider use of screening tools such as Screening, Brief Intervention and Referral to Treatment (SBIRT) for youth.
While the committee did not discuss SBIRT, over the past two meetings, the committee heard from hospital systems, pharmacists, the Georgia Division of Family & Child Services (DFCS) and substance abuse research experts on other steps the state could take.
- Increasing funding and wider promotion of substance abuse education with a focus on opioid use in schools and restoring some public health funds.
- Improving provider education and training around prescribing, especially for pregnant women, and educating patients on prescription drug use.
- Increasing access to drug treatment programs for pregnant women, allowing the sale of narcan over the counter, and adding buprenorphine to the Medicaid formulary.
- Promising protocols and programs that hospitals and emergency departments could implement to improve care delivery for chronic pain management, and children with neonatal abstinence syndrome and their mothers.
- Current initiatives and ways to improve state and agency-level policies to improve response systems for law enforcement and child welfare services.
Presentations from Northside Hospital, Augusta University, DFCS, Tanner Health System, and the Georgia Substance Abuse Research Alliance are available upon request. The committee plans to dive deeper into analysis of law enforcement policies, therapeutic services and recommendations for budget appropriations during the upcoming meetings. GHF will continue to advocate for the committee to consider additional prevention methods in its recommendations. We have requested to present recommendations to activate Medicaid codes to promote the use of a substance use screening tool called SBIRT (Screening, Brief Intervention, and Referral to treatment) at the next committee meeting and are awaiting a response. The next committee meeting is scheduled for November 9, 2016 at 1:00 PM at the Capitol. Stay tuned for more updates and information!
October is Breast Cancer awareness month and at Georgians for a Healthy Future we are committed to helping women access essential cancer screenings, including mammograms to detect breast cancer, through working to ensure that all Georgia women have access to health insurance. Uninsured, low-income women often face financial barriers to receiving recommended screenings for breast and cervical cancer and in Georgia, minority women face additional breast cancer disparities. However, research has shown that women who live in a state that has expanded Medicaid are more likely to get a mammogram than women that live in a non-expansion state. In 2008, women in every state had the same likelihood of getting a mammogram, but in 2015 a study found that women in expansion states were 25% more likely to get screened. As you can see, expanding Medicaid allows women to get the potentially life-saving preventive care they need. So for all the women in your life, please sign our petition to close the gap here.
But it doesn’t have to be that way.
As we approach the 2017 legislative session, we have the opportunity to close the coverage gap and ensure that some becomes all. Check out our new video about the Georgians stuck in the coverage gap and our opportunity to close it.
Today, we are asking that you be a part of the movement and contribute $25 to our campaign to close the coverage gap. Your contribution will allow us to travel across the state meeting with and raising up the voices of Georgians in the gap. It will fund our media efforts so that everyone, from Blueridge to Bainbridge, will know that these people can’t wait. The time to close the coverage gap is now.
Georgians for a Healthy Future is now several weeks into our training partnership with Enroll America. As you might recall, Enroll America selected GHF as the first organization, nationally, to participate this year in the Leadership Academy in a train-the-trainer model. Enroll America is using the Leadership Academy train-the-trainer model to disseminate their expertise on how to conduct trainings with Enroll America information in order to reach a wider audience.
We have covered topics including list building, reaching the remaining uninsured, and how to design a follow up program. Pranay Rana, GHF’s Consumer Education and Enrollment Specialist, is currently planning several trainings that will take place in October to start the process of imparting our new knowledge to partner organizations. We will also be adding some of the Enroll America training content to our GEAR emails, so keep an eye out for new information on best practices for reaching uninsured consumers, building an outreach plan, and more!
If you have any questions or would like to learn more about the partnership please reach out to Pranay.
Direct consumer support plays an important role in assisting consumers to enroll into and maintain their health coverage. Georgians for a Healthy Future, primarily a health advocacy organization, provided direct enrollment services to Georgians in the last two open enrollment periods through enrollment events, in-person appointments, phone assistance and referrals. GHF continues to engage with other enrollment entities through its Georgia Enrollment Assistance Resources (GEAR) network which is a central hub of Marketplace resources, and provides technical support to assisters through newsletters, e-blasts, trainings, webinars, and forums.
In OE3, GHF primarily focused on post enrollment work undertaking more complex consumer cases such as resolving coverage issues with the Marketplace and insurance providers, payment issues, tax filing and reconciliation issues, and issues with supplemental documents. In this role, GHF provided crucial support to consumers and enrollment assisters to resolve these types of issues and help consumers maintain their coverage.
Here is what our consumers reported about their experiences
GHF conducted a post-enrollment consumer satisfaction survey with 25 consumers between April and July 2016. The survey participants reported that they sought a combination of services during their appointments. The table below provides the details for each type of post-enrollment assistance.
Twenty-four out of 25 (96%) participants reported that they were able to resolve the issues that they sought assistance for, as explained by these quotes…
“Paid my premium, sent supplemental documents, added two kids to the application, received delayed cards” – Res# 1, Female, 30.
“My coverage had been suspended for over a month due to a technical issue. GHF helped me reinstate my suspended insurance by advocating on my behalf with both Marketplace and Ambetter. My benefits were reinstated within 3 business days”— Res# 16, Female, 62.
GHF Success Stories:
Tony Caldwell, a consumer with disability, was waiting to get his power wheelchair for over a year. With direct enrollment support from GHF, he was able to get his application completed during SEP and select a plan that covered his wheelchair. Tony quotes, “I finally ended up getting my power wheelchair that I had been waiting for over a year. It has helped me from passing out. Thanks to you all.”
Clyde Mohammed and his wife Sharda (West Indian couple) came to renew their marketplace plan at Switzer Public Library in Marietta. They also wanted to change their current plan since the premium was going up in 2016. Assisted the consumers to complete their application. They were found eligible for subsidies. They enrolled into a health plan with $57 monthly premium and $600 family deductible. The family was able to save over $150 in monthly premium by switching their plan.
The majority of the participants reported the Marketplace application process to be very complicated and that they couldn’t have resolved their issues without the help of an enrollment assister. Those participants who found the process to be comfortable reported the assistance they received to be the key reason. Participants also reported that the education from enrollment assisters made it easier for them to understand and use their new health insurance.
Trends from our direct consumer support experiences and those we have heard from our partners suggested that direct enrollment assistance was crucial for consumers in making enrollment decisions as well as tackling post-enrollment issues. Direct assistance will continue to be crucial for consumers, both new enrollees and re-enrollees, in the days to come as there will be changes in participating insurance providers, premium price, and personal details such as household size and income all of which will require enrollment assisters’ expertise.
Some of the most pressing and contentious health and insurance issues facing Georgians will be front and center during anticipated legislative study committee meetings this fall. Study committees meet during the off-session to take a closer look into specific policy issues and develop recommendations for the upcoming legislative session. Check out a full listing of House and Senate study committees. Below is a summary of the committees GHF will be actively engaged on the advocacy and policy fronts:
Senate Study Committee on Surprise Billing Practices (SR 974)
This study committee is charged with assessing laws to protect consumers against surprise billing. Surprise billing can occur when an insured consumer receives care from an out-of-network provider and is charged for the amount the insurance did not pay. In some cases consumers seek care knowing the risk. In other cases consumers end up with bills despite making appropriate efforts to stay in-network or because inadequate provider networks require them to go out-of-network to receive care they need. Surprise billing was a hot button issue during the 2016 legislative session as more consumers reported receiving a surprise bill and experiencing financial repercussions. This led to the introduction of legislation (SB 382). This legislation included a wide range of provisions for consumer notifications, network adequacy standards, independent dispute resolutions and regulatory oversight. Although SB 382 did not pass it served as a starting point for discussion and preparation for this study committee. GHF has identified surprise billing and the need for legislation that holds consumers harmless in surprise billing scenarios as a policy priority. GHF, in partnership with Georgia Watch, has been actively engaged on this issue and will present recommendation to the committee. If you are interested in providing testimony or input to this committee, please contact Senator Renee Unterman, the study committee chair. The meeting schedule has not been announced but stay tuned for updates.
Senate Study Committee on Premium Assistance (SR 1056)
This committee will closely examine models and policies for premium assistance programs as an alternative to Medicaid expansion and is anticipated to be a forum for a robust discussion about policy options to close the coverage gap. Because Georgia has not yet accepted federal funds to cover low-income Georgians through Medicaid or a Medicaid waiver, approximately 300,000 Georgians remain stuck in a coverage gap. These Georgians do not qualify for Medicaid under current rules and do not earn enough money to qualify for financial help through the Marketplace. Closing the coverage gap by opening up coverage through Medicaid to all Georgians with incomes up to 138 percent of the federal poverty level is a policy priority GHF champions. During the last legislative session SB 368 was introduced and policymakers took a first step toward conversation on ways to close the coverage gap. Although SB 368 did not pass, it sparked a process that led to the upcoming study committee. GHF will present recommendations to the committee and amplify our campaign to close the coverage through our Cover Georgia Coalition. Cover Georgia is a coalition of more than 70 organizations that have come together to educate the public, engage Georgia’s policymakers, and advocate to close the coverage gap by expanding Medicaid. To learn more about Cover Georgia click here and to join please contact Laura Colbert at email@example.com or 404-567-5016 ext. 2. Study committee appointments and meeting schedule have not been announced. If you are interested in providing testimony or input to this committee stay tuned for updates.
Senate Study Committee on Opioid Abuse (SR 1165)
In light of the rise of opioid addiction and related overdose deaths, this study committee was created to examine legislative approaches Georgia could take to curb the opioid epidemic and save lives. Committee members have been appointed and include the commissioner of public health, Director of Georgia Drugs and Narcotics agency, a pharmacist, medical doctor and citizen with personal experience with opioid overdose. The first committee meeting is scheduled for September 30th in Gainesville and the second meeting will be held October 27th at the Capitol. Save the dates and we will provide more information soon. GHF in partnership with the Georgia Council on Substance Abuse will present recommendations on activating Medicaid codes to promote the use of an evidence-based substance use screening and prevention tool known as SBIRT (screening, brief intervention, and referral to treatment) statewide and a fiscal analysis of the costs and benefits of implementing SBIRT through Medicaid to the committee. To find out more about SBIRT and our Preventing Youth Substance Use Disorders coalition visit our website. If you are interested in providing testimony or input to this committee please contact Senator Renee Unterman, the study committee chair.
Other Study Committees to Watch
- Senate Study Committee on Hearing Aids for Children (SR 1091)
- Senate Study Committee on Emergency Cardiac Centers (SR 1154)
- Senate Study Committee on State Sponsored Self-Insured Group Health Insurance Plan (SR 1166)
- House Study Committee on Mental Illness Initiative (HR 1093)
- House Study Committee on Professional Employer Organizations (HR 1341)