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Your health coverage, health care, and well-being during the COVID-19 pandemic

Updated: December 18, 2020

The Georgians for a Healthy Future team is continuing to monitor the COVID-19 (coronavirus) outbreak closely. As always, GHF strives to be a resource for Georgia consumers. While things continue to change quickly during this health care pandemic, we will share practical advice and actionable information to help you navigate a confusing time and find the answers you need. Here we present information about how to access health care services and what to expect from your health insurance coverage when you do. We will keep the corresponding blog post updated as things change and with links to helpful resources as they become available.

Georgia’s statewide shelter in place ended on April 30, 2020 for most Georgians. Vulnerable populations including those who are medically fragile and elderly should continue to shelter in place until June 12, 2020.

Governor Kemp also extended Georgia’s public health state of emergency through January 08, 2020. He also issued executive orders requiring businesses to operate by strict social distancing and sanitation rules through May 13, 2020. As of June 1, 2020 restaurants are still required to abide by 39 restrictions to open their dining rooms.

We encourage all of you to continue to help prevent the spread of the virus by taking the necessary steps to “flatten the curve” including staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.

If you are experiencing symptoms of COVID-19 or may need a test

If you believe that you are experiencing symptoms of COVID-19 or have been exposed to the novel coronavirus, call your primary care doctor or an urgent care clinic. Let them know you think you may have COVID-19, so they can take the proper precautions and direct you to available testing sites. You may also call the Georgia Department of Public Health on their COVID-19 hotline at 844-442-2681. Public health officials are urging people not show up unannounced at a doctor’s office, emergency room or other health care facility.

The Centers for Disease Control and Prevention have a Coronavirus Self-Checker which may be a helpful tool if you think you are experiencing symptoms of the virus.

You can find out more about COVID-19, its symptoms, what to do if you think you are sick, and other COVID-19 information at dph.georgia.gov/novelcoronavirus.

COVID-19 testing is available for all Georgians, regardless of whether you have coronavirus symptoms. Anyone can call their local health department to get scheduled for testing. They can also download the Augusta University ExpressCare app, visit augustahealth.org, or call (706) 721-1852.

Effective May 7, 2020, COVID-19 testing is available to all Georgians who request it, whether they have symptoms or not. Call your local health department to schedule an appointment at a location near you and to inquire if testing is free.

What to expect from your health insurance

If you have insurance, make sure to use it for any testing and medical exams related to COVID-19 and any other medical services you may need during this time.

The COVID-19 crisis has caused many Georgians to lose their jobs and also lose their employer-sponsored health care coverage. If you have lost your coverage or have had a drop in your income, you may be eligible for Medicaid or financial assistance to buy health insurance through the Affordable Care Act. Please read the If You Lose Your Job section below.

If you have Medicaid or PeachCare for Kids

If you and your family have lost your source of income in this crisis, or are in lower-income work with no health coverage, enrolling in Medicaid may be an option for you.

Medicaid provides all “medically-necessary” services to its members. During the national public health emergency period, your Medicaid coverage will cover the cost of a COVID-19 test.  If you are diagnosed with COVID-19 and need medical treatment, Medicaid should also cover those costs. 

Check with your Medicaid insurance company for more information and guidance. Click the name of your Medicaid company to find out more: Amerigroup, CareSource, PeachState Health Plan, and WellCare.

If you need other health care services during this time, check with your Medicaid insurance company and doctor to see if you can have a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person.

Georgia’s Department of Community Health (DCH) has announced that Medicaid & PeachCare members will not owe any co-payments for any health service from May 1, 2020 until the end of the national public health emergency.

No one can willingly lose their Medicaid coverage during the public health emergency. If you lose your Medicaid coverage during this time, contact your Medicaid insurance company.

If you have private insurance

If you have insurance through your job, the State Health Benefit Plan, or the Affordable Care Act marketplace (also called healthcare.gov), use it for any testing or medical exams related to COVID-19. The Families First Act requires that health plans and insurers cover testing for COVID-19 so your test should be free. If someone wants to charge you for a test, call the DPH’s COVID-19 hotline.

If you are diagnosed with COVID-19 and require medical treatment, you should expect to pay some out-of-pocket costs like your deductible.

As of March 21, 2020 Cigna, Humana, Aetna, and UnitedHealthcare have waived cost-sharing for COVID-19 treatment. Aetna and Cigna have pledged to waive COVID-19 treatment costs for qualified medical bills until June 1, 2020. Humana has not announced an end date to their COVID-19 cost-sharing policy.

If you purchased coverage outside of the ACA marketplace or you have a short-term plan or health-sharing ministry, call your insurance company to find out how they are covering COVID-19 testing and treatment. The cost-sharing requirement under the Families First Act does not apply to people who are enrolled in non-ACA compliant plans (ex: short-term plans).

If you need other health care services during this time, check with your insurance company and doctor to see if you can have a “virtual appointment” using the internet, a video call, or a telephone call instead of going in-person.

In order to ensure people affected by COVID-19 have access to health care Georgia’s Insurance Commissioner issued a directive on March 20, 2020, that instructed health insurers to refrain from canceling health policies due to non-payment. That directive expires on May 31st. If you are behind on your premium payments or expect to be, call your insurance company right away to see if they can offer a payment plan, financial assistance, or other help to keep you enrolled.

If you have Medicare

Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs. All necessary hospitalizations are also covered by Medicare, including hospitalizations for quarantine. More information about Medicare’s coverage and services is available here.

If you are uninsured
If you need a COVID-19 test, contact your local public health department to find a testing site and to ask whether the test will be free. Request that they waive any testing costs.

If you need other health care services during this time, find a local community clinic, or apply for financial assistance through a hospital charity care program. Georgians should not let their insurance status get in the way of getting needed testing or treatment.

If you lose your job

Many Georgians across the economy have lost their jobs and may be at risk of losing their coverage. If this is your situation, you can keep yourself and your family covered during this health crisis. You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. When you begin the enrollment process, healthcare.gov will ask you about your estimated income for 2020 and will let you know if you qualify for financial help to lower your premiums and other cost-sharing. 

For free help with the enrollment process, contact these organizations:

Coverage through the ACA marketplace (healthcare.gov) covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Call your insurance company for more information.

If you are unable to enroll in a health insurance plan, you may have other options through services such as a community clinic, which can connect you with the care you need.

Resources for you and your loved ones

During this uncertain time, many of our partner organizations are doing the hard work of finding and centralizing the information that you and your loved ones may need. Here are a few that we think are most helpful. We will continue to update this list with actionable resources and information so you can stay healthy, safe, and well. 

  • COVID-19 guidance and information
    • Information from public health experts: Visit the Georgia Department of Public Health’s website for the latest guidance and updates about COVID-19 in Georgia.
    • Coronavirus resources for people who are not strong readers: Georgia State University has published a library coronavirus materials for people who may not have strong reading or literacy skills. They have included materials up to a 9th-grade reading level.
  • COVID-19 guidance and information for people who do not speak English as a first language: 
    • The GSU School of Public Health’s Prevention Research Center has compiled COVID-19 information sheets (from CDC & the International Rescue Committee) in 25 languages
  • Make sure your basic needs and finances are taken care of:
    • If you need help finding food:
    • Food Bank of Northeast Georgia: Visit www.foodbanknega.org, click “Need Help”. Call the office at (706) 354 8191
    • Atlanta Community Food Bank: Text the word FINDFOOD to 888-976-2232 with your ZIP code and street address and you will be sent a list of the three closest distribution centers.
      Text service also available in Spanish, using the word COMIDA
    • Georgia Mountain Food Bank: uses the same system as Atlanta Community Food Bank
    • Golden Harvest Food Bank Visit www.goldenharvest.org, click on ‘Find Help’ at the top of the page, you will be taken to a map where you can enter your zip code to find the nearest food distributor
    • Middle Georgia Community Food Bank–Call 211 and you will be connected with an associate who will be able to tell you where you can find food
    • Feeding the Valley Food Bank: Visit feedingthevalley.org, on the front page, enter your zip code into the ‘Need Food’ box and you will be shown the closest food pantries to your location
    • America’s Second Harvest of Coastal Georgia: Visit helpendhunger.org, select ‘Find Food’ on the homepage, you will be taken to a map where you can enter your zip code or county to be shown the nearest food distribution centers
    • Second Harvest of South Georgia: Visit feedingsga.org, select ‘Find Help’ in the ‘Learn’ section at the top of the page, you will be taken to a map where you can find the closest distributors to you

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Legislative Update: Crossover & COVID-19 edition 2020

A statement from Georgians for a Healthy Future regarding COVID-19


Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times. 

We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.

Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.
 

We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.

Legislative Update: Week 9

Crossover Day brings action before suspension of legislative session

Last Thursday, March 12th was the 28th day of the Georgia legislative session, which is also referred to as Crossover Day. Crossover Day is the final day for a bill to cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. The General Assembly finalized changes to the current state budget (FY2020) before suspending the legislative session on Friday, March 13th due to safety concerns about COVID-19. Lieutenant Governor Geoff Duncan and House Speaker David Ralston have committed to resuming the 2020 legislative session when public health concerns subside.
In the sections below, you will find a rundown of consumer health legislation and their statuses following Crossover Day. Those that “crossed over” remain viable and those that “did not cross over” are considered dead for this year. You can see a list of all the bills we’re tracking here. 

The General Assembly convened this morning for a one-day special session. They are expected to pass a resolution approving Governor Kemp’s declaration of a public health emergency. With this action, Governor Kemp will have additional power and authority to manage the state’s response to COVID-19.

Our priorities

Surprise billing legislation companion bills cross over

Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a fair payment resolution process that takes consumers out of fights between insurers and health care providers. Both bills have crossed over from their chambers of origin to the opposite chamber. 

Legislation to extend postpartum Medicaid coverage crosses over

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured. HB 1114 was approved by the House last Tuesday.

Crossover Day recap

HB 792: Amended FY 2020 Budget | SENT TO GOVERNOR
 

HB 792 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2020. The “little budget” has passed both chambers of the General Assembly and has been sent to the Governor.
 


HB 793: FY 2021 Budget | CROSSED OVER
 

HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. For more information on the health care highlights in the proposed FY 2021 budget, read the Community Health, Behavioral Health, and Public Health budget overviews from the Georgia Budget & Policy Institute. 


HB 511: Rural transit bill | CROSSED OVER
 

HB 511, sponsored by Representative Kevin Tanner, would create a new division within the Georgia Department of Transportation (GDOT) that would, among other things, oversee rural transit programs including Medicaid’s non-emergency medical transportation (NEMT) services. The bill would divide the state (except for 13 metro-Atlanta counties) into eight regions in which counties could collaborate to raise revenue for and coordinate rural transit services. 
 


HB 544: Mental health emergency involuntary treatment | DID NOT CROSS OVER
 

HB 544, sponsored by Rep. Chuck Efstration, would make changes to how people in mental health or SUD crises can be committed to emergency involuntary treatment. This legislation could have negative consequences for people with substance use disorders who could be involuntarily committed to treatment under certain circumstances.
 

HB 719:  Effort to modernize HIV laws | CROSSED OVER
 

HB 719, sponsored by Rep. Deborah Silcox, would modernize Georgia’s HIV-related laws and make progress towards decriminalizing HIV. Current Georgia law deems it a felony for people living with HIV to have sex or donate blood without disclosing their status, or for spitting at or using bodily fluids on a law enforcement officer. Under HB 719 only the act of having sex without disclosing a person’s HIV status would remain illegal.
 

HB 731: | Tobacco tax increase | DID NOT CROSS OVER
 

HB 731, sponsored by Rep. Ron Stephens, would raise Georgia’s tobacco tax to $1.87 from its current level of $0.37.

HB 760: Mental health; peace officer authorization  | DID NOT CROSS OVER

HB 760, sponsored by Rep. Sharon Cooper, would give peace officers the authority to take a person to a physician or emergency department for emergency examination under certain circumstances.

HB 842: Gracie’s Law – organ transplant discrimination| CROSSED OVER

HB 842, sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities.

HB 864: | Excise tax on vaping products | DID NOT CROSS OVER

HB 864, sponsored by Rep. Bonnie Rich would add a 7% excise tax to vaping products and would require businesses that sell vaping products to register with the state for a $250 fee. 


HB 918: Restricts onerous PBM audits of pharmacies | CROSSED OVER

HB 918, sponsored by Rep. Sharon Cooper, puts in place limits on the practices of PBMs within these audits so that pharmacies can more easily meet audit requests and the benefit of the doubt is given to pharmacies when small or innocuous mistakes are discovered.


HB 946: Increases accountability for PBMs | CROSSED OVER
 

HB 946, sponsored by Rep. Matt Knight, would increase fines on PBMs when they “steer” consumers to specific pharmacies and would prohibit PBMs from paying affiliated pharmacies more than independent ones. The bill would require PBMs to pass along rebates to insurers (who would presumably pass those savings on to consumers) and would ban programs called “co-pay accumulators.” Co-pay accumulators increase out-of-pocket costs for consumers who need prescription drugs, especially those with expensive medications and those with high deductibles and other cost-sharing.


HB 947: Examining the costs of PBMs in Medicaid | CROSSED OVER
 

HB 947, sponsored by Rep. Matt Knight, would require Georgia’s Department of Community Health to complete an independent study to find out if Georgia would save money by removing the current PBM structure from its Medicaid plans. If the estimated savings are more than $20 million annually, Georgia would eliminate PBMs from most of the state’s Medicaid plans.

HB 1079: Authorizes full Medicaid expansion through an 1115 waiver  | DID NOT CROSS OVER

HB 1079, sponsored by Rep. Kim Schofield, would allow the state to submit a new 1115 waiver that would expand Medicaid to all Georgians making less than 138% of the federal poverty line.

HB 1114: Extending postpartum Medicaid coverage | CROSSED OVER
 

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured.
 

HB 1151: Network adequacy | DID NOT CROSS OVER

HB 1151, sponsored by Rep. Kim Schofield, would increase consumer access to health care by imposing quantitative standards on insurance companies’ provider networks. Georgia has the narrowest provider networks in the country, forcing people to pay more to find care outside of their insurance plan’s approved providers. Network adequacy standards would ensure that consumers can access a provider in their insurance  network for all covered benefits.

HB 1153: Short-term limited duration plans | DID NOT CROSS OVER


HB 1153, sponsored by Rep. Kim Schofield, would limit short-term health plans to 3 months and provide consumer protections like protections for people with pre-existing conditions.

HR 1280: Addressing childhood lead exposure | DID NOT CROSS OVER
 

HR 1280, introduced by Rep. Katie Dempsey, establishes a Joint Study Committee on Childhood Lead Exposure to address the issue of thousands of Georgia children under six years of age who were found to have lead poisoning, which is irreversible and can cause speech, language, and behavioral problems, lower IQ levels, and nervous system damage.

*Note: Because this is a resolution (rather than a bill), this resolution is still viable for passage and could be used to establish a House study committee.

SB 298: Raising age to purchase tobacco and vaping products| DID NOT CROSS OVER

SB 298, sponsored by Sen. Renee Unterman, would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age, among other things. 

SB 303: Georgia Right to Shop Act | CROSSED OVER

SB 303, sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee, would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information. 


SB 313: Benchmarking for prescription drug prices | CROSSED OVER
 

SB 313, sponsored by Senator Dean Burke, had its second hearing in the Senate Insurance and Labor committee last Wednesday. This bill would update Georgia’s oversight of pharmacy benefit managers and add important consumer protections.


SB 348: Consumer Right to Access Act | DID NOT CROSS OVER

SB 348, sponsored by Senator Kirkpatrick, is aimed at addressing network adequacy. The bill includes similar language to SB 352 (below) and also directs Georgia’s Insurance Commissioner to set quantitative network adequacy standards to ensure Georgia consumers have adequate access to care within their insurance plans.

SB 352: Online provider directories | CROSSED OVER

SB 352, sponsored by Senator Burke, would allow consumers to see providers at in-network rates for their entire plan year, if the provider is listed as in-network at the time a person enrolls in their health plan. The providers included in a consumer’s insurance plan network changes regularly throughout the year and this bill would assure that the provider network advertised at the time of enrollment is the provider network they are able to access all year long.

GHF has you covered

Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

Tags: • • • • • • • • •

A statement from Georgians for a Healthy Future regarding COVID-19

Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times.

We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.

Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.

We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.

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Legislative Update: More Medicaid for new moms, big & little budgets, and Crossover Day deadlines

Legislative Update: Week 8

General Assembly continues work on budgets ahead of Crossover Day

Last week the Senate passed their version of the FY2020 state budget (the “little budget”). This week the House and Senate will appoint a conference committee to work out the remaining differences in their versions of the little budget before it gets a final approval by both chambers. This morning the House Appropriations committee has passed its version of the FY2021 budget, which will begin July 1st of this year and run through June 30, 2021. The big budget will be considered by the full House chamber later this week.

Committee hearings will continue in earnest as legislators try to move their priority bills ahead of this week’s Crossover Day deadline. (Crossover Day is the 28th day of session and the deadline by which bills must pass the House or the Senate in order to remain viable to become law.) In next week’s legislative update, we will run down which health bills were left on the cutting room floor and which ones remain viable for this year.

Bill introduced to extend postpartum Medicaid coverage

Legislation would allow moms to keep Medicaid coverage up to six months after giving birth

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured. The bill has been referred to the House Health & Human Services committee and has the support of Healthy Mothers Healthy Babies Coalition of Georgia, GHF, and other consumer health advocacy groups.

Learn more about this legislation and maternal health in Georgia in a new blog from the Georgia Budget & Policy Institute.

Surprise billing and Gracie’s Law approved

Surprise billing protections are another step closer to passage

Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. Last week the House passed its version of this important consumer-focused legislation, HB 888. The Senate has already approved SB 359, which closely mirrors the House bill. The Senate bill is expected to be amended in the House Special Committee on Access to Quality Health Care so that it exactly matches the House version and better protects against surprise bills in emergency situations. Both bills are expected to be considered up by their respective committees after Crossover Day.

Gracie’s Law moves on to Senate

Gracie’s Law (HB 842), sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities. Gracie’s Law was approved by the House on February 28th and is now in the Senate Health and Human Services Committee. The bill is supported by The Arc of Georgia, the Georgia Council on Developmental Disabilities, and other disability advocacy organizations.

(For more on this bill, please read our earlier legislative update.)

Pharmacy benefit manager legislation keeps moving

Four bills to reform PBM practices in Georgia move forward ahead of Crossover Day

Georgia’s House and Senate continued their efforts last week to change how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. 

HB 946 and HB 947, both sponsored by Rep. Matt Knight and HB 918, sponsored by Rep. Sharon Cooper, were passed by the House on Wednesday. HB 946 was referred to the Senate Insurance and Labor committee, and HB 918 and HB 947 were referred to the Senate Health and Human Services committee. Similarly, SB 313sponsored by Senator Dean Burke, was approved by the Senate on Thursday.

(For an overview of the bills, please read our March 2nd legislative update.)

GHF has you covered

Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

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Legislative Update: HIV, lead poisoning prevention, & lots of PBMs

Legislative Update: Week 7

Legislative session passes halfway mark

Last week marked the halfway point of the 2020 Georgia legislative session. The General Assembly was busy with legislative hearings and committee votes last week, illustrated well by the flurry of activity in all of the health-related committees. We have your complete updates below.

The Senate is expected to pass their version of the amended FY2020 state budget this week and work continues in the House on the FY2021 budget. Committee hearings will continue in earnest this week ahead of next week’s Crossover Day deadline. (Crossover Day is the 28th day of session and the deadline by which bills must pass the House or the Senate in order to remain viable to become law.)

Effort to modernize HIV laws moves forward

HB 719 passed by House Health & Human Services committee

HB 719, sponsored by Rep. Deborah Silcox, would modernize Georgia’s HIV-related laws and make progress towards decriminalizing HIV. Current Georgia law deems it a felony for people living with HIV to have sex or donate blood without disclosing their status, or for spitting at or using bodily fluids on a law enforcement officer by a person living with HIV. Under HB 719 only the act of having sex without disclosing a person’s HIV status would remain illegal and the punishment for that would be downgraded to a misdemeanor. This legislation has the backing of LGBTQ+ advocates and public health professionals. 

The House Health & Human Services committee approved HB 719 on Wednesday. The bill will now be considered by the House Rules committee. 

Addressing childhood lead exposure

Resolution introduced to establish study committee on child lead poisoning

Last year, 2,333 Georgia children under six years of age were found to have lead poisoning, which is irreversible and can cause speech, language, and behavioral problems, lower IQ levels, and nervous system damage. To address this issue, Rep. Katie Dempsey has introduced HR 1280 to establish a Joint Study Committee on Childhood Lead Exposure. The resolution has been referred to the House Health & Human Services committee for its consideration.

For more information on this important public health issue, check out this helpful fact sheet from Voices for Georgia’s Children.  

Pharmacy benefit managers in the spotlight

Georgia’s House and Senate committees have taken a keen interest in legislation to change how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. in order to secure lower prices on medications, PBMs have adopted practices that are seen as to burdensome by pharmacies, restrictive and hard-to-navigate by consumers, and opaque by elected officials. Here are a few of the bills that are moving forward that would reform PBM practices in Georgia.

HB 918: Restricts onerous PBM audits of pharmacies

PBMs may audit the practices of pharmacies as part of their responsibilities for a health insurer. However, these audits can strain independent and small pharmacies with fewer employees. HB 918, sponsored by Rep. Sharon Cooper, puts in place limits on the practices of PBMs within these audits so that pharmacies can more easily meet audit requests and the benefit of the doubt is given to pharmacies when small or innocuous mistakes are discovered.

The House Special Committee on Access to Quality Health Care approved HB 918 on Friday. The bill will now be considered by the House Rules committee.

HB 946: Increases accountability for PBMs

HB 946, sponsored by Rep. Matt Knight, would increase fines on PBMs when they “steer” consumers to specific pharmacies and would prohibit PBMs from paying affiliated pharmacies more than independent ones. The bill would require PBMs to pass along rebates to insurers (who would presumably pass those savings on to consumers) and would ban programs called “co-pay accumulators.” Co-pay accumulators increase out-of-pocket costs for consumers who need prescription drugs, especially those with expensive medications and those with high deductibles and other cost-sharing.

The House Special Committee on Access to Quality Health Care approved HB 946 on Friday. The bill will now be considered by the Hosue Rules committee.

HB 947: Examining the costs of PBMs in Medicaid

HB 947, also sponsored by Rep. Matt Knight, would require Georgia’s Department of Community Health to complete an independent study to find out if Georgia would save money by removing the current PBM structure from its Medicaid plans. If the estimated savings are more than $20 million annually, Georgia would eliminate PBMs from most of the state’s Medicaid plans.

The House Special Committee on Access to Quality Health Care approved HB 946 on Friday. The bill will now be considered by the Hosue Rules committee.

SB 313: Benchmarking for prescription drug prices

SB 313, sponsored by Senator Dean Burke, is expected to receive a vote today in the Senate Insurance & Labor committee.

This bill is consistent with HB 946 in many ways, although not an exact match. SB 313 requires that PBMs use the “national average drug acquisition cost,” as a reference point for reimbursing pharmacies for prescriptions. The bill also includes many of the same patient protections as those in HB 946. 

GHF has you covered

Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.


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Legislative Update: Transportation and movement on surprise billing

Legislative Update: Week 5

Legislative session resumes this week

After a brief pause last week due to budget disagreements the Georgia legislature will resume its normal schedule today, February 18th. Today is day 13 (out of 40) of this year’s legislative session. According to the legislature’s new calendar, Crossover Day (the day by which a bill has to be approved by at least one chamber in order to remain “alive” for this year) is scheduled for March 12th.

Surprise billing legislation set for committee vote

Senate and House action expected on surprise billing legislation this week

Last month, companion pieces of legislation were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a resolution process that allows insurers and health care providers to settle payment disputes while keeping consumers out of the middle.
 

The Senate Health and Human Services committee heard testimony from insurers, advocates, and medical providers at a hearing on SB 359 last Tuesday. GHF’s Executive Director testified on the bill saying, “the consumer protections in this bill are fair and reasonable. For these reasons, we support (SB 359) and hope to see its successful passage by both chambers during this session.”

HB 888 is scheduled to be heard in the House Special Committee on Access to Quality Health Care today at 2pm.

Call one or more of these committee leaders to ask for their support of SB 359 and HB 888: 

  • Sen. Ben Watson, Chairman of Senate HHS committee,
    404-656-7880
  • Sen. Dean Burke, Vice Chairman of Senate HHS committee, 404-656-0040
  • Rep. Mark Newton, Chairman of the House Special Committee, 404-656-0254
  • Rep. Sharon Cooper, Vice Chairman of the House Special Committee, 404-656-5069

If your state Senator or Representative is on either committee, please call them as well!

Prescription drug legislation heard by senate committee

SB 313: Pharmacy benefit managers, the middlemen for prescription drugs

SB 313, sponsored by Senator Dean Burke, had its second hearing in the Senate Insurance and Labor committee last Wednesday. This bill would update Georgia’s oversight of pharmacy benefit managers and add important consumer protections. Pharmacy benefit managers (PBMs) are companies that manage prescription drug benefits for health insurance companies and in that role are charged with negotiating lower costs for the company and consumers.

At Wednesday’s hearing, patients, doctors, pharmacists and representatives of pharmacy benefit managers offered detailed testimony on the bill. No further action was taken on the bill last week and it is unclear if the Senate Insurance committee will consider it again this week. GHF will continue to report on the bill through the legislative session. (We provided an overview of the bill in an earlier legislative update.)

Rural transit bill could bring changes to Medicaid transportation

Revisions to transit bill attract support from more stakeholders

Adequate transportation is important to the health of Georgians because in most cases people need to go to a location outside of their homes to receive health care. Without access to reliable, safe transportation, Georgians may be forced to skip health appointments and go without medication, or they may not be able to access other things (like healthy foods or good schools and jobs) that would help them stay healthy.

HB 511, sponsored by Representative Kevin Tanner, would create a new division within the Georgia Department of Transportation (GDOT) that would, among other things, oversee rural transit programs including Medicaid’s non-emergency medical transportation (NEMT) services. The bill would divide the state (except for 13 metro-Atlanta counties) into eight regions in which counties could collaborate to raise revenue for and coordinate rural transit services. The purpose of the proposed “mobility zones” is to eliminate restrictions on crossing county lines for health appointments and other services for seniors, low-income families, and other needy Georgians, and extend transportation services to those who do not have access to local transportation options.

Advocates for Georgia seniors supported earlier versions of the bill and recent revisions to the bill have earned the support of GDOT and Uber. HB 511 has not been scheduled for a hearing but GHF will report on the legislation as the session progresses.

GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

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Legislative Update: Surprise billing, mental health, & Gracie’s law

Legislative Update: Week 4

Legislative session paused amid budget disagreements

The Georgia legislature voted to pause the official legislative calendar last week due to the difficult and sometimes contentious discussions over the state budget. Governor Kemp’s proposed budget cuts for the current and subsequent state budgets have left the legislature to the difficult tasks of finding savings where possible, making cuts to some services and programs, and debating how to bring in sufficient revenue. Speaker of the House David Ralston has instructed the House to hold only budget-related hearings this week. 

The legislature plans to officially reconvene next Tuesday, February 18th for day 13 of this year’s legislative session. According to the legislature’s new calendar, Crossover Day (the day by which a bill has to be approved by at least one chamber in order to remain “alive” for this year) is scheduled for March 12th.

Strong surprise billing legislation introduced

Surprise billing legislation would protect consumers in emergency & non-emergency situations

Last week companion legislation were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a fair payment resolution process that takes consumers out of fights between insurers and health care providers. If passed, these bills would protect 2.6 million Georgians from surprise medical bills.

SB 359 has been read and reffered to the Senate Health and Human Services committee. HB 888 is in House first readers and in the House Special Committee on Access to Quality Health Care.

Call one or more of these committee leaders to ask for their support of SB 359 and HB 888: 

  • Sen. Ben Watson, Chairman of Senate HHS committee,
    404-656-7880
  • Sen. Dean Burke, Vice Chairman of Senate HHS committee, 404-656-0040
  • Rep. Mark Newton, Chairman of the House Special Committee, 404-656-0254
  • Rep. Sharon Cooper, Vice Chairman of the House Special Committee, 404-656-5069

If your state Senator or Representative is on either committee, please call them as well!

House examines mental health and organ transplant issues

Involuntary commitment emerges as theme in mental health legisation

Two pieces of mental health legislation garnered attention from mental health advocates and legislators last week.

HB 544, sponsored by Rep. Chuck Efstration, would make changes to how people in mental health or SUD crises can be committed to emergency involuntary treatment. This legislation could have negative consequences for people with substance use disorders who could be involuntarily committed to treatment under certain circumstances. This bill sits in the House Judiciary committee but the discussions of this issue may instead be moved to a subcommittee of the Behavioral Health Innovation and Reform Commission.

HB 760, sponsored by Rep. Sharon Cooper, would give peace officers the authority to take a person to a physician or emergency department for emergency examination under certain circumstances. This legislation is not supported by mental health advocacy groups because it could lead to involuntary committal for people with mental health issues. The bill now sits in the House Public Safety and Homeland Security committee.

Gracie’s Law would protect organ transplant discrimination for Georgians with disabilities

Rep. Rick Williams has introduced HB 842, titled “Gracie’s Law.” According to the Georgia Council on Developmental Disabilities (GCDD), Gracie’s Law would protect patients with disabilities from being removed from the organ donor waiting list because of their disability. According to an article in GCDD’s Making a Difference magazine, “While the Americans with Disabilities Act (ADA) denies discrimination based on any disability, there is still a lack of federal enforcement,” prompting the need for state action on this issue. This bill has been referred to the House Insurance committee. You can read more about Gracie’s Law here (pg. 12-13).

Thank you!

Cover Georgia logo

Health care heroes like you submitted 1,710 comments!

Before the legislative session began, Governor Kemp filed paperwork with health officials in the federal government to move forward with plans to change Medicaid and private insurance in Georgia. When health officials needed your input on the Medicaid plan, more than 1700 Georgians like you stepped up! 
 

We are incredibly grateful for your advocacy on behalf of Georgians and communities who would benefit from Medicaid expansion in Georgia. Thank you for speaking up for your friends, neighbors, and all Georgians! Now your comments become part of a powerful legal record that health officials must take into acocunt as they decide whether or not to approve Governor Kemp’s Medicaid plan.

Stay tuned! Health officials are still reviewing Governor Kemp’s planned changes for private insurance. When the time comes, we will ask you to speak up again by submitting a comment again! Here and at coverga.org, we will let you know what those changes mean for you and your loved ones and when you can comment.

GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

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Legislative Update: Pharmacy benefit managers, health costs, & vaping

Legislative update: Week 3

Georgia House continues budget considerations 

Last week the Georgia House of Representatives resumed its budget hearings in earnest. The House Appropriations subcommittee on Health met on Tuesday to hear more from state agency leaders about their amended FY2020 budget requests. The FY2020 budget runs through June 30, 2020, and is sometimes called the “little budget”. 

It was clear during last week’s hearings that the House may not simply agree to the budget cuts requested by Governor Kemp. Many Appropriations committee members expressed concerns about how the agencies’ proposed cuts would impact access to health care in rural Georgia, the availability of mental health and substance use services, and other critical health services and supports.

Both chambers will reconvene today, February 3rd, for the tenth day of the legislative session. Before scrolling to the latest news on emerging bills and other happenings under the Gold Dome, don’t forget to tell officials what you think of Governor Kemp’s Medicaid plan. The comment deadline is this Friday.

Less than a week to go!

The comment period ends on Friday! Take action now!

Before the legislative session began, Governor Kemp filed paperwork with health officials in the federal government to move forward with their plans to change Medicaid and private insurance in Georgia. Now those health officials need your input, beginning with the Medicaid plan! 

Governor Kemp’s Medicaid plan will leave thousands of low-income Georgians with no meaningful way to get health insurance. Instead of expanding Medicaid to cover 490,000 Georgians, this plan would cover only 50,000 people and cost three times more per person.

We need you to step up AGAIN and become a health care hero by telling national officials what you think of the Medicaid plan! The deadline for comment is Friday, February 7th. Visit coverGA.org to comment today!

Did you submit a comment in November? Please submit a comment again so federal officials can hear directly from you.

Senate starts with prescription drugs & price transparency

SB 313: Updating how Georgia regulates pharmacy benefit managers

Senator Dean Burke has introduced SB 313, a law that would update Georgia’s oversight of pharmacy benefit managers and add important consumer protections. Pharmacy benefit managers (PBMs) are companies that manage prescription drug benefits on behalf of health insurers, and are a new favorite focus of policy makers who want to address rising health care costs. 

SB 313 requires PBMs to charge health insurers the same price for a drug as it receives from the drug manufacturer and that PBMs pass all rebates from the manufacturer to the health plan. (Ideally, these savings are then passed along to consumers.) The bill also disallows PBMS from building drug formularies (lists of covered medicines) in a way that discriminates against people with prescription drug needs. The bill also strengthens the Insurance Commissioner’s ability to hold PBMs accountable to state laws and regulations.

This bill is complex and GHF will continue to report on it through the legislative session. The bill has been referred to the Senate Insurance Committee.

SB 303: Georgia Right to Shop Act

SB 303 would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information. The legislation is sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee. It has been referred to the Senate Insurance Committee and is expected to be heard this week. 

Focus on nicotine & tobacco continues

Legislation would tax vaping products

Representative Bonnie Rich introduced HB 864 last week, which would add a 7% excise tax to vaping products and would require businesses that sell vaping products to register with the state for a $250 fee. This bill is one of at least three pieces of legislation that would change how Georgia taxes and regulates tobacco or other nicotine products. HB 731, sponsored by Rep. Ron Stephens, would raise Georgia’s tobacco tax to $1.87 from its current level of $0.37. SB 298, sponsored by Sen. Renee Unterman, would increase the age that Georgians are allowed to purchase tobacco products to 21 years of age, among other things.

Both House Bills have been referred to the House Ways & Means committee and SB 298 has been referred to the Senate Regulated Industries committee.

GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

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GHF comments on Governor’s partial Medicaid expansion proposal

On December 23, 2019, the Georgia Department of Community Health (DCH) submitted Governor Kemp’s Medicaid waiver proposal to federal health officials.

The Governor’s proposed 1115 Medicaid waiver, called Georgia Pathways plan, would allow Georgians with incomes below the poverty line to enroll in Medicaid coverage but only if they can meet monthly work requirements (at least 80 hours per month of work, school, training, or volunteering per month). The plan would cover only a fraction of those who could be covered by a full Medicaid expansion.

DCH’s submission of the proposal to the Centers for Medicare & Medicaid Services (CMS) comes after a 30-day public comment period, during nearly 1000 Georgians weighed in with their opinions on the plan. Despite the overwhelming opposition to the plan, Governor Kemp and DCH sent their proposal to federal officials with no meaningful changes.

On January 8, 2020, officials at CMS determined Georgia’s application was complete, which kicked off a second 30-day public comment period. The public comment period allows Georgians impacted by this plan, health advocates, and any other interested party to weigh in.

Along with more than 1700 others, GHF submitted comments to communicating our deep concerns about the plan’s shortcomings. You can read GHF’s full comments here.

Georgia’s 1115 waiver process
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Legislative Update: Surprise billing, vaping, & Georgia’s budget

Legislative Update: Week 1

The 2020 legislative session has begun

Last week, the Georgia General Assembly convened for the first time in 2020. The first four days of the 2020 legislative session were mostly taken up with committee appointments, Governor Kemp’s second State of the State address, and other annual traditions including GHF’s own Health Care Unscrambled. 

This week will be dedicated primarily to budget hearings for the current (FY 2020 Amended) and next year’s (FY 2021) state budgets. The General Assembly will reconvene next Monday, January 27th for the fifth day of legislative session. 

Efforts to address surprise billing gain early momentum

The issue of surprise out-of-network medical billing (sometimes called “surprise billing” or “balance billing”) is already getting a lot of attention early in the 2020 session. At Health Care Unscrambled, Senate Health & Human Services Chairman Ben Watson said, “If we do not pass balanced billing or surprised billing this year, I don’t think it will be a successful session.” Governor Kemp added his support during his State of the State address, saying “Working with patients, providers, and the private sector, we’ll craft a legislative remedy to reduce surprise medical billing. We will demand transparency, embrace empathy, and insist on fairness.” 

GHF and our partners at Georgia Watch have long advocated for a legislative solution that protects Georgia consumers from payment battles between insurers and providers. We are grateful for the support of Governor Kemp, Lieutenant Governor Duncan, and legislative leaders on this important issue. We look forward to working with all parties to ensure that Georgia consumers are no longer stuck with surprise bills when they go to the doctor.

Governor outlines priorities in annual address

Governor Kemp submits his budget recommendations

On Thursday, Governor Kemp addressed the General Assembly in his second annual State of the State address and, per tradition, used the opportunity to introduce his proposed budget. Governor Kemp also laid out his priorities for his second year in office, including education, foster care, and public safety.

The amended budget (an update to the current state budget) includes a 4% cut to cut state spending through the end of the state fiscal year (June 30, 2020).

The Governor’s recommended FY 2021 budget, which will begin on July 1, 2020, includes a 6% cut to state spending. Despite the cut, a $89.6 million increase in the Medicaid budget is proposed to address growing enrollment. The House will now take up and consider the two budgets before passing them to the Senate later in the session.

Action Alert!

Act now, submit your comment today!

Before the legislative session began, Gov. Kemp filed paperwork with health officials in the federal government to move forward with their plans to change Medicaid and private insurance in Georgia. Now those health officials must ask for your input, beginning with the Medicaid plan! 
 

Gov. Kemp’s Medicaid plan will leave thousands of low-income Georgians with no meaningful pathway to coverage. We need you to step up AGAIN and become a health care hero by telling health officials what you think of the Medicaid plan! The deadline for comment is Friday, February 7th. Visit CoverGA.org to comment today! 

Did you submit a comment in November? Please submit a comment again so federal officials can hear directly from you.

Early legislation introduced

Legislation to restrict vaping

SB 298 would raise the minimum age to purchase vaping products from the current age of 18 to 21. It would also set tougher penalties for selling tobacco, nicotine and vaping products to minors and would require schools to include information about the harms of vaping and smoking in their health education curricula. The legislation is sponsored by Senator Renee Unterman. Similar legislation is expected to be introduced in the House in the coming weeks. The bill has been referred to the Senate Regulated Industries and Utilities Committee.

The legislative calendar begins to take shape

The General Assembly set its calendar for the first fourteen days of the 2020 legislative session in HR 879. After this week’s budget hearings, the session will pick up again according to the following schedule:

January 27: Day 5

January 28: Day 6

January 29: Day 7

February 30: Day 8

February 31: Day 9

February 3: Day 10

February 4: Day 11

February 5: Day 12

February 6: Day 13

February 10: Day 14

GHF has you covered

Stay up-to-date with the legislative session
 

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

Tags: • • • • • • • •

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Apr 1, 2024
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