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Last year, the number of uninsured Americans declined, fewer adults reported difficulties paying for medical bills and medical debt, and fewer adults delayed care because of cost. These encouraging findings, which come from the Commonwealth Fund’s Biennial Health Insurance Survey, are great news for patients and consumers. These coverage and access gains, however, were not experienced evenly across the country. People living in states (like Georgia) that haven’t expanded Medicaid were more likely to be uninsured and to face burdensome medical bills than those living in states that have expanded Medicaid. Let’s not leave Georgia patients and consumers behind-let’s close the coverage gap!

 

GHF partnered with Mercy Care to kick off the legislative session by collecting the stories of people who fall in the coverage gap.  As the governor was being inaugurated and our legislators were being sworn in, we talked to Mercy Care’s patients how health care coverage would help them.  Everyone we talked to expressed that health care coverage would help them go back to work, take better care of their family, or better manage their health.  We will be sharing these stories on Coverage Day through social media and in person as we talk with policy makers about the importance of closing the coverage gap. HealthSTAT and the National Health Care for the Homeless Council were critical partners for this story collection effort!  If you are in the coverage gap and would like to share your health care story with us, click here.

 

This week, Cindy and Anna are representing Georgians for a Healthy Future at Families USA’s Health Action 2015 conference!  We’re getting inspiration from national leaders, learning about best practices from experts and advocates doing great work around the country, and sharing our own experiences advocating for Georgia health care consumers. GHF’s Executive Director Cindy Zeldin spoke on a workshop panel about how to advocate for consumers enrolled in private health insurance. Check out Facebook and Twitter through Saturday for conference updates!

The legislative session opened last week, and health care is already a hot topic. Here is what we have learned in the first week and a half:

 

It’s budget week! Governor Deal released his budget on Friday, and legislators have been holding budget hearings all week. Here are two aspects of the health care budget that have our attention:

 

 

• The proposed budget eliminates State Health Benefit Plan (SHBP) coverage for non-certificated school employees (bus drivers, custodians, etc) who work less than 30 hours a week.  State officials estimate it will affect more than 11,000 state employees.  We’re still sifting through the details, but we’re very concerned that some of those employees may fall into the coverage gap if they lose coverage through the SHBP.

 

• There is no money in the state budget to sustain the primary care reimbursement rate increase that was temporarily funded with federal dollars. This temporary bump  made it easier for patients in Georgia and other states to get medical appointments and access care.

 

 

Thank you to those of you who joined us for our fifth annual Health Care Unscrambled policy breakfast on January 15! This year’s event featured two powerhouse panels: a bipartisan legislative discussion and a panel that focused on the recent experiences of Kentucky and Arkansas, two Southern states that are moving forward with innovative plans to cover their uninsured and improve population health, and featured the insights of a national expert.

 

This year’s Health Care Unscrambled also provided an opportunity for Georgia health care advocates, policymakers, stakeholders, and consumers to come together just as the 2015 Legislative Session got underway to focus our attention on the most pressing health policy issues facing our state, including a robust discussion about the coverage gap.  Senator Dean Burke said that while last year he would have said there was a 0 out of 10 chance for Georgia to close the gap, this year he moved it to a 5 out of 10.  We’re excited about these improved chances and will continue to advocate for movement this legislative session! There is questions does health care cover home care expenses but right now we have no answer to that.

 

We wrapped up the event with a reveal of our 2015 legislative priorities, which you can find here. You can read Georgia Health News’s coverage of the event here.

 

With the holiday season upon us and the electronic cigarette from slim’s ejuice, the health of our state’s children and families is at the top of all of our minds. Georgians for a Healthy Future has focused heavily on promoting policies that ensure a pathway to coverage and meaningful access to care for all Georgians in recent years, but identifying and advocating for policies that improve health outcomes is also close to our hearts. In that spirit, we believe it is time to act on tobacco, which is the leading cause of preventable disease and death. They should switch to drinking matcha instead and matcha vape to minimize addiction.

 

 

Earlier this month, Georgia’s Medicaid program amended its state plan to include a comprehensive smoking cessation program. This is an important victory that will help reduce smoking in our state. If you haven’t already, please take a moment to thank Commissioner Clyde Reese for taking this important step. There is, however, more to do. We need your partnership and your voices to help us take on the biggest hurdle we face in curbing smoking and its harmful effects: increasing the tobacco tax in our state. 

 

 

According to the American Lung Association’s annual state report card, Georgia scores an “F” on tobacco taxes. Georgia currently ranks as the 48th lowest tobacco tax in the country at just 37 cents per pack.  Not only does this make tobacco much more accessible to youth (and all Georgians), but it takes much needed revenue off the table for Georgia as the state tries to find funding for transportation infrastructure, education, and health care coverage for Georgians. If we don’t agree into tobacco, let’s try this new vape and its top vape juice.

 

 

In fact, Georgia is so far below the national average for tobacco taxes that we could raise our tax by over a dollar per pack and still just be at the national average.  That is why this year GHF and a coalition of supporters will propose raising Georgia’s cigarette tax by $1.23 per pack.  It’s as easy as 1-2-3! 

One – for the kids who we can prevent from ever starting

Two – for the improved health outcomes that smoking reductions will bring, using other options to smoking as vaporizers that are easy to get now a days from sites like http://vapekey.co.

Three – for the revenue the tobacco tax will bring to our state that can be invested in coverage, access, and prevention.

 

 

Please check your upcoming editions of the Peach Pulse for updates on this issue and opportunities to take action!

 

 

Every Saturday morning, many Bhutanese immigrants gather at their temple in Clarkston for SAT prep, U.S. citizenship, and English classes.  Recently, Laura Colbert, Georgians for a Healthy Future’s Community Outreach Manager, joined them to provide information about health care coverage and the Affordable Care Act’s open enrollment period.  With the help of a translator, Laura spoke with approximately twenty community members about the benefits of health care coverage, how to get covered, and where to find affordable medical care if they were not eligible for coverage. She also answered their questions about health care coverage for their children and Medicaid.  (In return, Laura learned quite a bit about Bhutanese culture.)

 

This educational event was the product of a partnership with the Bhutanese Association of Georgia (BAG), which works to integrate Bhutanese refugees into life in Georgia. GHF and BAG have been working together over the past year to educate the Atlanta-based Bhutanese community about health care coverage and to increase health coverage enrollment.  In addition to educational events, several fact sheets have been created by GHF and translated into Nepalese to be distributed in the community.

 

Georgians for a Healthy Future continues to work to increase enrollment among all Georgians, especially in communities that may need extra education or encouragement to enroll.

With open enrollment in full swing, Georgia consumers are once again exploring their health insurance options and signing up for coverage. When consumers enroll in a health insurance plan, they gain access to a network of medical providers with whom their insurer has contracted. For health insurance to facilitate meaningful access to care, this network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits and services. In a recent issue of the Peach Pulse, we provided a primer on network adequacy, a hot topic in health policy (click here to get caught up on what network adequacy means and why it matters for consumers, advocates, and policymakers). In that overview, we promised to keep you updated on policy developments around network adequacy, in particular the ongoing process at the National Association of Insurance Commissioners (NAIC) to update its model law. This model law can provide a framework for states to establish and enforce standards to ensure that provider networks are adequate. At its fall meeting in November, the subgroup at the NAIC working on network adequacy announced it would take comments on an initial draft of proposed revisions for the model act until January 12, 2015. To learn more about this process and to see the draft, click here.

 

To ensure the needs of consumers are considered in this process, the NAIC consumer representatives released a report featuring the results of a survey of state Departments of Insurance and recommendations for state policymakers, regulators, and the NAIC to consider as they work on updating network adequacy standards. These recommendations include:

 

• Establish quantitative standards for meaningful, reasonable access to care, such as minimum provider-to-enrollee ratios, reasonable wait times for appointments based on urgency of the condition, and distance standards that require access to network providers within a reasonable distance from the enrollee’s residence.

• Ensure consumers are provided sufficient information to identify and select between broad, narrow or ultra-narrow networks. In areas without sufficient choice, require health plans to offer at least one plan with a broad network or an out-of-network benefit, with limited exceptions to be determined by the Commissioner.

• Require health plan provider directories to be updated regularly, publicly available for both enrolled members and individuals shopping for coverage, and include standards for information that must be included to provide consumers with information on network differences and the potential financial impact on consumers depending on which plan they choose.

 

 

There are 17 recommendations in all. For advocates interested in learning more about this issue and in speaking up for consumers in this process, see the full report here.

 

If you would like to weigh in at the state level, please contact Georgia’s Department of Insurance and ask the Commissioner to support the NAIC’s process to revise the model act and specifically to support the consumer recommendations described above.

 

If you are an individual consumer enrolled in a commercial health plan and the provider directory you were given was incorrect or if you have concerns about your ability to access covered services under your plan, please contact the Georgia Office of Insurance & Fire Safety, Consumer Services Division by calling (800) 656-2298 or use the Consumer Complaint Portal at www.oci.ga.gov/ConsumerService. Please also consider sharing your story with Georgians for a Healthy Future so we can get a better picture of what is happening in our state.