Laura Colbert, the executive director of the patient-advocacy group Georgians for a Healthy Future, is especially concerned about rural patients. Ninety percent of Georgia’s Obamacare customers would be protected from…
Just like any actor is no more than 6 degrees of separation from Kevin Bacon, you
are probably no more than 1 degree of separation from someone who would be impacted by Congress’s ongoing attempts to gut Georgia’s Medicaid program and repeal the Affordable Care Act. Are you or do you know any of these people?
- A child—half of Georgia’s children are covered by Medicaid, so even if the child in your life has some other kind of coverage, her best friend or classmates probably have Medicaid coverage
- A senior who already does or may soon need long term care or supports—Medicaid is the primary payer for 75% of nursing home stays in Georgia. For seniors aging in their homes, Medicaid provides home health aides and supports home modifications that allow older Georgians to age in the homes they know and love.
- A person who runs their own business—you may know a graphic designer, general contractor, photographer, or farmer who runs their own business. These entrepreneurs generally must purchase their own health insurance and many do through the health insurance Marketplace. For those just starting out, they probably receive financial assistance to help lower their premiums and reduce out of pocket costs. The AHCA proposes to significantly
reduce the amount of financial assistance available for those buying insurance on their own.
- A child or adult with a developmental or physical disability, you are able to get what you want no matter the circumstances,—for Georgia’s children and adults living with disabilities, Medicaid is a lifeline that provides them with access to life-sustaining health services. It also supports home and community-based careso that they can live, study, and work with or near family, friends, and neighbors.
- A person of color—African Americans and Hispanics have seen historic declines in their uninsured rates since the ACA went into effect, helping to close historic disparities in insurance coverage. The proposed rollback of financial assistance for private insurance and Medicaid eligibility would have a disproportionate impact on people of color, especially children. The Medicaid changes alone are estimated to leave 70,000 black children and 40,000 Hispanic children in Georgia without coverage.
- A person with a chronic condition like diabetes, HIV, depression, or cancer—
under the ACA, people with pre-existing conditions are protected from being charged more or rejected when seeking health coverage. And insurance companies have to cover the essential health benefits meaning that the services people need for pre-existing conditions are covered too. The AHCA would allow states to waive this requirement under certain circumstances, sending people back to a time they could be priced out of coverage entirely.
- A veteran—50,000 Georgia veterans rely on Medicaid for access to health care, a 29% increase since 2013. Not all veterans qualify for care through the Veterans Administration (VA). Medicaid helps to fill the gap so that all of these brave men and women can access the care they need.
The American Health Care Act would dismantle Georgia’s Medicaid program and repeal the Affordable Care Act, threatening the coverage, protections, and supports that all of these people rely on every day. Think of the people in your life that fit into these categories–is it you? A parent or child? A close friend or colleague? Then take action to protect their health care.
Call Senator Isakson today and tell him about your friends, family, and neighbors who would be hurt because of the AHCA. Ask him to oppose any measure that 1) cuts and caps Medicaid, or 2) reduces coverage for Georgians. Call 202-224-3643 today!
Your member of Congress needs to hear from you today!
They are at it again. Leaders in the U.S. House of Representatives are getting closer to having the votes they need to pass the American Health Care Act, legislation that would dismantle Medicaid and threaten the coverage of millions of Americans. They may vote as early as tomorrow! Call your Member of Congress today at 866-426-2631 and tell him to vote “NO” on the bill.
The latest proposal keeps all of the bad features of AHCA such as the $4 billion cut to Georgia’s Medicaid program and plans to strip more than 560,000 Georgians of their health insurance. Added to that it would allow states to gut the main consumer protections of the ACA and return to a time when insurers could discriminate against those living with preexisting conditions – charging them higher premiums and selling them plans that don’t meet their health needs by limiting benefits and increasing out-of-pocket costs.
Now is the time for your member of Congress to hear from you. Demand that our lawmakers put the best interests of Georgians and our state ahead of partisan politics. Call your member of Congress today to tell him to vote “NO” on the AHCA. Call 866-426-2631 now!
Want to do more?
If you or a family member benefit from Georgia’s Medicaid program, join the #IamMedicaidGA campaign! Policymakers need to know that real Georgians will be impacted by their vote on the AHCA. Get started here!
Georgians for a Healthy Future’s Executive Director Cindy Zeldin attended the Spring Meeting of the National Association of Insurance Commissioners (NAIC) in her role as a consumer representative to the NAIC. At the meeting, a group of health-focused consumer representatives presented an overview of a new report authored by a diverse group of patient and consumer advocates highlighting the need to ensure that any changes to the health care system do no harm to consumers, minimize market disruption, and maintain common-sense consumer protections. The report, The Need for Continued Consumer Protections and Stability in State Insurance Markets in a Climate of Federal Uncertainty, conveys the perspective of consumer advocates on the need for continued access to high-quality health insurance products—regardless of whether and how changes are made at the federal level—and the likely impact that some proposed Affordable Care Act replacement policies will have on consumers and state insurance markets. The report discusses:
• What consumers want when it comes to private health insurance;
• The progress that has been made in reducing the uninsured rate since 2010 and the risks of full or partial repeal of the Affordable Care Act;
• Key principles—such as insuring the same number of consumers with the same quality of coverage and minimizing market disruption—that we urge policymakers to apply when considering further changes to the market; and
• Concerns about the impact of potential changes on consumers and state markets, with an emphasis on high-risk pools, continuous coverage requirements, high-deductible health insurance products, association health plans, the sale of insurance across state lines, the loss of essential health benefits protections, and the need for continued nondiscrimination protections.
An overview of the report was provided to state insurance commissioners during the NAIC/Consumer Liaison Committee meeting on Monday, April 10th during the National Association of Insurance Commissioners (NAIC) Spring 2017 National Meeting in Denver, Colorado. The authors of the report serve as appointed consumer representatives to the NAIC and members come from national organizations such as the American Cancer Society Cancer Action Network, the American Heart Association, Consumers Union, and the National Alliance on Mental Illness; state-based advocacy organizations such as the Colorado Consumer Health Initiative, Georgians for a Healthy Future, and the North Carolina Justice Center; and academic centers such as Georgetown University and Washington & Lee School of Law.
The full report is available here.
Surprise billing legislation passed by committee
SB 8 was heard by the House Insurance committee this morning and passed unanimously. Among other transparency and notification requirements, this version of the surprise billing legislation requires that providers and hospitals must provide consumers with information about the plans in which they participate, and that upon the request of consumers, providers give an estimated cost of non-emergency services before they are provided. Insurers must inform consumers whether a provider scheduled to deliver a service is in-network, and if not, an estimation of how much the insurer will pay for the services, among other notification requirements. SB 8 will now go to the House Rules committee.
WHAT HAPPENED LAST WEEK
Senate passed the FY2018 budget
Last week, the Senate approved the FY 2018 budget. The budgets approved by the Senate and House differ slightly, so a conference committee will be appointed to meet and work out the differences. You can check the Differences Report for specifics on the variance between the House and Senate budgets, and we will provide a brief overview of the final version once the conference committee finishes its work.
Insurance coverage for children’s hearing aids passed
SB 206 was approved by the House of Representatives today, and will require private health insurance plans to cover hearing aids for children under 19 years old. The legislation stipulates that the costs cannot exceed $3000 per hearing aid and that the plans cover replacement hearing aids every four years or when the hearing aid fails before that time. Medicaid already covers hearing aids for children who qualify for coverage.
Pharmacy Patients Fair Practices Act passed by both chambers
Both HB 276 and SB 103 were approved by the Senate and House respectively last week and will get sent to the Governor for his signature. This legislation (which we previously covered here) will regulate practices of pharmacy benefit managers so as to allow consumers access to their pharmacy of choice, provide the opportunity for home delivery of medications, and prevent consumers from over-paying for prescriptions. It is really important to find a pharmacy that you can trust, I suggest to check Canadian pharmacies which have been very reliable for me.
Legislation to synchronize multiple medications passed
SB 200 will make it easier for people to synchronize their prescriptions so that they can pick up multiple prescriptions at the same time. The bill requires that insurance plans pro-rate medication co-pays for partial prescription fills so that the schedules for medications can be synced if requested by a patient. Under current law, a person may have to pay a full co-pay even if a pharmacist is providing only a part of their 30-day medication in order to synchronize multiple prescriptions. SB 200 passed the House Insurance committee last week and was approved unanimously by the House this morning.
Surprise billing legislation progresses in both chambers
Both SB 8 and HB 71 were passed out of their respective Senate and House committees late last week. SB 8 has been held up because of a dispute between insurers and health care providers about reimbursement. The bill was amended to establish out of network payment for disputed charges at the 80th percentile of the “Fair Health” metric and was subsequently passed by the Senate Health & Human Services committee. HB 71 seeks to compel physicians who are credentialed at hospitals to accept an in-network rate when the patient is in-network at the hospital, even if the physician is not. It was passed unamended by the House Insurance Committee. Both bills await approval in the Rules Committees to receive floor debates and votes.
House passes FY2018 budget
The House of Representatives passed its version of the FY2018 budget on Friday. The budget includes increased reimbursement rates for certain primary care codes for Medicaid providers. Increased reimbursement rates are also funded for certain dental codes in PeachCare for Kids and Medicaid. The budget includes funds for two new federally qualified health centers in Cook and Lincoln counties, and 97 new primary care residency slots. The FY 2018 budget is now being considered by the Senate, which is expected to make its own changes before issuing its final approval. Check out Georgia Budget and Policy Institute’s blog and budget primer for more detailed information about how Georgia spends its health care dollars.
WHAT HAPPENED LAST WEEK
Changes to rural hospital tax credits
HB 54, introduced by Rep. Duncan, would expand the new rural hospital tax credit program from a 70% credit to a 90% credit, among other minor changes. The tax credit program went into effect this year, after enabling legislation was passed in 2016. The proposal to increase the tax credit to 90% came after legislators received feedback that the 70% credit was too low to entice potential donors. HB 54 was approved by the House Ways & Means committee on Feb. 9, and now awaits passage in the House Rules Committee.
Opioid abuse prevention bill
SB 81 remains in the Senate Rules Committee waiting for approval for floor debate and passage after committee approval late last week. The current version of the bill requires that all physicians register and consult the Prescription Drug Monitoring Program (PDMP) under certain prescribing conditions. It also requires that providers report certain opioid-based Schedule II, III, IV, and V prescriptions to the PDMP. The bill sets the penalty for willfully non-compliant providers on a continuum that ranges from a warning to a felony and fine for a fourth offense and beyond. The bill also requires the tracking and reporting of Neonatal Abstinence Syndrome (NAS) and codifies the Governor’s emergency order on an overdose reversal drug (naloxone), making it available without a physician prescription.
MARCH WITH US!
This Saturday: Atlanta March for Healthcare
Yesterday, we rallied at the Save My Care bus stop, and Saturday we will march at the Atlanta March for Healthcare! Join us as we fight to preserve the Affordable Care Act and the protections that it provides for Georgians. Hosted by the Georgia Alliance for Social Justice, the march will cap Congress’s week of recess and send them back to D.C. with the charge to #ProtectOurCare!
Saturday, Feb. 25, 3-5 pm
Gather at St. Mark’s United Methodist Church
Re-authorization of provider fee successfully passes through legislature
On Friday Georgia’s House of Representatives voted to approve the hospital “provider fee” for another three years, and Governor Deal says he will sign the legislation tomorrow. The provider fee helps to fund Georgia’s Medicaid program by allowing the Department of Community Health to collect a tax on hospital revenues which is used to draw down additional federal dollars. The additional funds are disproportionately used to support rural and safety net hospitals that serve high numbers of indigent patients.
Oral health bills approved
Also on Friday, the Senate passed SB 12 and the House passed HB 154, both of which allow dental hygienists to practice in safety net settings, school clinics, nursing homes, and private practices without a dentist being present. While the bills are overwhelmingly similar, the differences between them will need to be worked out between the chambers.
WHAT HAPPENED LAST WEEK
Passage of Opioid Abuse Prevention Bill
SB 81 continued to draw a lot of attention last week. The bill was eventually passed by the Senate Health and Human Services committee with several significant changes. The current version of the bill still requires that all physicians register and use the Prescription Drug Monitoring Program (PDMP), but only requires that providers report on Schedule 1 drugs and reduces the penalty for not reporting to a minimum of a misdemeanor. The current version of the bill also changed language that would have required children with ADHD to renew their prescription every five days.
Surprise billing legislation heard in committee
The Senate Health and Human Services committee began its consideration of SB 8, legislation that would protect consumers from surprise out-of-network medical billing. Testimony was heard from insurers, health care providers, hospitals, and the consumer advocacy group, Georgia Watch. While all stakeholders seem to be in agreement that consumers should be held harmless when seeking care at an in-network facility and through no fault of their own encounter an out-of-network provider, there are significant differences on the matter of provider reimbursement for services provided in those situations. No vote was taken on the legislation but is expected to be re-considered by the committee this week. HB 71, legislation that address surprise billing in a different way, is expected to receive its first hearing this week in the House Insurance committee.
Resolution introduced to encourage block grants for state Medicaid program
HR 182 was introduced last week with the purpose of providing legislative permission to the Governor and the Department of Community Health to seek per capita block grant funding for Georgia’s Medicaid program. While resolutions are non-binding and do not impact state law, this resolution could begin a risky conversation among lawmakers. Shifting Georgia’s Medicaid program from its current federal-state partnership structure to a block grant program would mean cuts in services and in beneficiaries, putting Georgia’s most vulnerable children, parents, elderly, and people with disabilities at risk if you’re in one of these cases, you could get in touch with a home care agency. Check out GHF’s block grant fact sheet for more information about the dangers of restructuring the Medicaid program. It is unclear if this resolution will get a hearing or a vote.
Mark Your Calendar!
Save My Care Rally: February 20th
With Congress taking steps to repeal and replace the Affordable Care Act and thus blocking the access to care so many Georgians have gained in the past several years, it is more important than ever to stand up and let them know that Georgians want to #ProtectOurCare.
On February 20th, join the Save My Care bus, GHF, and hundreds of Georgians for a rally in Atlanta. Georgia’s members of Congress will be at home for recess and it’s the perfect time to make sure your elected officials hear you loud and clear.
Hearing on surprise billing legislation scheduled for tomorrow
SB 8, which seeks to protect consumers from surprise out-of-network medical bills, is scheduled to receive a hearing in the Senate Health & Human Services committee on Tuesday at 2 pm. SB 8 would establish a standard payment structure for physicians seeking reimbursement for surprise out-of-network services, and would hold consumers harmless in surprise billing situations. HB 71, the companion bill sponsored by Rep. Richard Smith, is expected to be assigned to a sub committee of the House Insurance committee on Tuesday at 8 am.
You can help!
If you have received a surprise out-of-network medical bill, share your story with our partners at Georgia Watch. Consumer stories help illustrate to legislators why legislation is needed to help protect consumers like you. Click here to share your story!
What Happened Last Week
Senate passes provider fee renewal
On Thursday the Senate passed SB 70 which renews the provider fee (also called the “bed tax”) for another three years in order to fund Georgia’s Medicaid program. This allows the Department of Community Health to collect the 1.45% tax on hospital revenues in order to draw down federal Medicaid dollars. These additional dollars are disproportionately used to support rural and safety net hospitals who serve high numbers of indigent patients. The bill will now move to the House where it expects an easy passage.
“Expand Medicaid NOW Act” reintroduced
House Minority Leader Stacey Abrams introduced HB 188, the Expand Medicaid NOW Act, last week. While we do not expect this bill to gain much traction because of the evolving health reform efforts at the federal level, it calls attention to the need to provide health care coverage to the 300,000 Georgians who are stuck in our state’s coverage gap because they do not currently qualify for Medicaid and cannot access health insurance through the Affordable Care Act’s Marketplace. The bill has been referred to the House Appropriations Committee.
Oral health legislation moves forward
Both HB 154 and SB 12, bills that allow dental hygienists to provide cleanings and other specified services in schools, safety net clinics, nursing homes, and private dentists’ practices under “general supervision”, received committee hearings and votes last week. Both bills will move to their Chambers’ respective Rules Committees to be approved for floor votes by the House and Senate.
Debate over opioid abuse prevention bill
SB 81 received its first hearing in the Senate Health & Human Services committee last week. The bill seeks to address the growing opioid abuse epidemic in Georgia in a number of ways, including: 1) Extending the Prescription Drug Monitoring Program, a database of prescriptions written for certain narcotics and requiring physicians to consult this registry prior to prescribing under certain conditions; 2) Codifying the Governor’s emergency order increasing the availability of anti-overdose drug, Naloxone; 3) Requiring the tracking and reporting of Neonatal Abstinence Syndrome; and 4) Establishing penalties for providers who are not in compliance with drug prescription reporting requirements. While few dispute the need to address this issue, the scope of drug and drug classes that the bill covers, along with the severity of the penalty that physicians may be subject to for violating the law are currently points of contention. No vote was taken in Thursday’s committee hearing, but suggested changes were made and the bill is expected to be back before the same committee later this week.
Resources for you
Georgians for a Healthy Future has tools you can use to track and understand the Georgia legislative session. Stay up-to-date on the bills that matter to you with our legislation tracker and sign up for Georgia Health Action Network (GHAN) action alerts so you know when to engage.
Get Your 2017 Consumer Health Advocate’s Guide!
GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. The Guide provides information on the legislative process, and contact information for legislators, key agency officials, and health advocates. This year, we’ve added a glossary of terms to help you understand what is happening under the Gold Dome. This tool will help advocates, volunteers, and consumers navigate the 2017 Georgia General Assembly. Download your copy here.
Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated as a featured guest at WABE’s A Nation Engaged community forum at the Carter Center in Atlanta on the evening of January 17th. The forum, an initiative of WABE’s A Closer Look radio show, featured a range of thought leaders, community activists, policy experts, and previous guests of the program. The conversation was wide-ranging and incorporated different views and perspectives. Georgians for a Healthy Future was honored to be invited and to be part of the lively event. You can see more details and listen to the entire special broadcast here.
Georgians for a Healthy Future will be at the Capitol throughout the forty-day session to monitor health-related legislation, serve as a voice for health care consumers, and keep you informed about opportunities to engage and take action. For the past four years, our top legislative priority had been closing Georgia’s coverage gap by expanding Medicaid. In the wake of the 2016 election, the national policy landscape has shifted considerably, knocking that off the table this year and placing existing coverage, care, and consumer protections at risk. Despite this backdrop of uncertainty and a critical need for federal advocacy, there will be important decisions made over the next three months at the state level that impact the health of individuals, families, and communities.
While it is early, here are the major health care issues we preliminarily expect legislators to tackle in 2017:
- Renewal of the provider fee commonly known as the “hospital tax” or “bed tax” to help fund Medicaid and keep hospital doors open
- Development of a set of reforms to improve mental health services based on the recommendations of a legislative study committee that has been meeting over the past several months
- Creation of a “repeal” task force to assess the impact of changes to or repeal of the Affordable Care Act on Georgia
- Addressing the practice of surprise medical billing, which can leave insured consumers with unexpected bills when a health care provider is out-of-network
- Increasing reimbursement rates for certain primary care services for health care providers participating in Medicaid
- Improving access to dental care for children, seniors, and people with disabilities
Georgians for a Healthy Future has several ways for you to stay up-to-date on what’s happening under the Gold Dome this year:
- Learn: Download our 2017 policy priorities, read up on how the legislative process works, and track health-related legislation
- Engage: Sign up for our Georgia Health Action Network (GHAN) action alerts
- Participate: Identify and contact your specific legislators on issues you care about
Stay tuned for updates throughout the session.