“This has been moving at lightning speed, and it makes really big changes to our healthcare system,” said Cindy Zeldin, executive director of Georgians for a Healthy Future.
The November elections have energized people of all political leanings to get more involved in advocacy, and many are doing so for the first time. Learning how each level of government works and how to effectively advocate for your interests can be difficult. GHF’s legislative health policy intern, Hayley Hamilton, has learned the ropes at Georgia’s Capitol and has some advice for people who are new to the Gold Dome:
Walking into the Gold Dome for the first time can be intimidating. Once you pass through the metal detectors and show your ID to the state trooper on duty, you find a sea of people all of whom seem to know each other. If you feel a bit overwhelmed walking in, know that you are not alone, but it gets easier with practice. The Capitol is a congenial place and you will find that everyone is happy to talk to you.
There is a rhythm of
daily events at the Capitol and each part of the days present a different opportunity for you to interact with your legislators. The chambers (House of Representatives and Senate) meet in the mornings to vote on bills and take care of other business. This part of the day is your best opportunity to speak with your legislator. If you want to meet with your legislator “on the ropes” (called this because of the red velvet rope line outside of each chamber) you fill out a short slip of paper outside the House or Senate to let your legislator know that you would like to speak with them. A page (usually a middle school aged student) will deliver the note inside the chamber, and if available, your legislator will come out to speak with you. When you speak to your legislator, it’s important to remember that they are representing you and your community, but they are also short on time. Be compelling and brief with what you have to say, but don’t underestimate the power of your story.
After the morning session, the House and Senate break for lunch and caucus meetings, and attend committee meetings in the afternoon. If you are unable to meet your legislator on the ropes, this is a good time to track them down for a quick chat in their office or catch them before or after a committee meeting. You can find your legislators’ office location, phone number, and email in our Consumer Health Advocate’s Guide. (An in-person visit is best, but a phone call is the next most effective method of sharing your thoughts and concerns with your legislators.) If you can’t nail them down for a short conversation in their office, meeting with their staff is a great second option. Tell the staff what you want your legislator to hear and then offer to follow up with the legislator via email.
Your legislator may be in committee meetings for much of the afternoon. These meetings are open to the public, and you can find committee schedules, locations, and agendas on the websites for the House and Senate respectively. During committee meetings, legislators will hear testimony and vote on bills. You may want to sign up to testify for a bill, just observe a meeting, or speak with a legislator before or after a meeting about a bill on the meeting agenda.
The old cliché of “practice makes perfect” applies to the Georgia’s Capitol and legislative session. The more you are at the Capitol or the more you contact your legislators, the easier it gets. Plus, GHF is here to help with our legislation tracker and weekly legislative updates during the session.
MPH Candidate, 2017
Georgia State University
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.
It is a time of uncertainty for health care. Congressional leaders have already begun the process to repeal the Affordable Care Act, landmark legislation that established a framework for coverage that has resulted in the lowest uninsured rate ever recorded, rights and protections for health care consumers, and provisions to advance health equity. With the 2017 Georgia legislative session underway, state leaders have acknowledged that something must be done about Georgia’s high number of uninsured, the state’s struggling rural health care system, and the impending funding cuts to hospitals. With so much uncertainty and change, it may be hard to keep track of what’s going on in health policy.
Join us for a webinar to learn about and discuss expected and proposed changes at the both the state and national levels. We will provide you with the most recent information about “repeal & replace” efforts and #ProtectOurCare advocacy, and how that will impact Georgia. We will also preview health care in Georgia’s 2017 state legislative session and tell you how you can get involved in the health care issues that you care about through advocacy and public engagement. Join us for a look ahead at health care policy in 2017. Register here to join us!
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.
The Senate Opioid Abuse study committee has begun to flesh out key issues and considerations to draft recommendations for an omnibus bill that includes prevention, treatment, regulatory and enforcement and budgetary provisions to address Georgia’s opioid crisis GHF is encouraged by the committee’s focus on prevention as we have been raising awareness of the need to view substance use disorders as a public health issue that warrants prevention through our Somebody Finally Asked Me campaign. More specifically, we have been advocating for wider use of screening tools such as Screening, Brief Intervention and Referral to Treatment (SBIRT) for youth.
While the committee did not discuss SBIRT, over the past two meetings, the committee heard from hospital systems, pharmacists, the Georgia Division of Family & Child Services (DFCS) and substance abuse research experts on other steps the state could take.
- Increasing funding and wider promotion of substance abuse education with a focus on opioid use in schools and restoring some public health funds.
- Improving provider education and training around prescribing, especially for pregnant women, and educating patients on prescription drug use.
- Increasing access to drug treatment programs for pregnant women, allowing the sale of narcan over the counter, and adding buprenorphine to the Medicaid formulary.
- Promising protocols and programs that hospitals and emergency departments could implement to improve care delivery for chronic pain management, and children with neonatal abstinence syndrome and their mothers.
- Current initiatives and ways to improve state and agency-level policies to improve response systems for law enforcement and child welfare services.
Presentations from Northside Hospital, Augusta University, DFCS, Tanner Health System, and the Georgia Substance Abuse Research Alliance are available upon request. The committee plans to dive deeper into analysis of law enforcement policies, therapeutic services and recommendations for budget appropriations during the upcoming meetings. GHF will continue to advocate for the committee to consider additional prevention methods in its recommendations. We have requested to present recommendations to activate Medicaid codes to promote the use of a substance use screening tool called SBIRT (Screening, Brief Intervention, and Referral to treatment) at the next committee meeting and are awaiting a response. The next committee meeting is scheduled for November 9, 2016 at 1:00 PM at the Capitol. Stay tuned for more updates and information!
Some of the most pressing and contentious health and insurance issues facing Georgians will be front and center during anticipated legislative study committee meetings this fall. Study committees meet during the off-session to take a closer look into specific policy issues and develop recommendations for the upcoming legislative session. Check out a full listing of House and Senate study committees. Below is a summary of the committees GHF will be actively engaged on the advocacy and policy fronts:
Senate Study Committee on Surprise Billing Practices (SR 974)
This study committee is charged with assessing laws to protect consumers against surprise billing. Surprise billing can occur when an insured consumer receives care from an out-of-network provider and is charged for the amount the insurance did not pay. In some cases consumers seek care knowing the risk. In other cases consumers end up with bills despite making appropriate efforts to stay in-network or because inadequate provider networks require them to go out-of-network to receive care they need. Surprise billing was a hot button issue during the 2016 legislative session as more consumers reported receiving a surprise bill and experiencing financial repercussions. This led to the introduction of legislation (SB 382). This legislation included a wide range of provisions for consumer notifications, network adequacy standards, independent dispute resolutions and regulatory oversight. Although SB 382 did not pass it served as a starting point for discussion and preparation for this study committee. GHF has identified surprise billing and the need for legislation that holds consumers harmless in surprise billing scenarios as a policy priority. GHF, in partnership with Georgia Watch, has been actively engaged on this issue and will present recommendation to the committee. If you are interested in providing testimony or input to this committee, please contact Senator Renee Unterman, the study committee chair. The meeting schedule has not been announced but stay tuned for updates.
Senate Study Committee on Premium Assistance (SR 1056)
This committee will closely examine models and policies for premium assistance programs as an alternative to Medicaid expansion and is anticipated to be a forum for a robust discussion about policy options to close the coverage gap. Because Georgia has not yet accepted federal funds to cover low-income Georgians through Medicaid or a Medicaid waiver, approximately 300,000 Georgians remain stuck in a coverage gap. These Georgians do not qualify for Medicaid under current rules and do not earn enough money to qualify for financial help through the Marketplace. Closing the coverage gap by opening up coverage through Medicaid to all Georgians with incomes up to 138 percent of the federal poverty level is a policy priority GHF champions. During the last legislative session SB 368 was introduced and policymakers took a first step toward conversation on ways to close the coverage gap. Although SB 368 did not pass, it sparked a process that led to the upcoming study committee. GHF will present recommendations to the committee and amplify our campaign to close the coverage through our Cover Georgia Coalition. Cover Georgia is a coalition of more than 70 organizations that have come together to educate the public, engage Georgia’s policymakers, and advocate to close the coverage gap by expanding Medicaid. To learn more about Cover Georgia click here and to join please contact Laura Colbert at email@example.com or 404-567-5016 ext. 2. Study committee appointments and meeting schedule have not been announced. If you are interested in providing testimony or input to this committee stay tuned for updates.
Senate Study Committee on Opioid Abuse (SR 1165)
In light of the rise of opioid addiction and related overdose deaths, this study committee was created to examine legislative approaches Georgia could take to curb the opioid epidemic and save lives. Committee members have been appointed and include the commissioner of public health, Director of Georgia Drugs and Narcotics agency, a pharmacist, medical doctor and citizen with personal experience with opioid overdose. The first committee meeting is scheduled for September 30th in Gainesville and the second meeting will be held October 27th at the Capitol. Save the dates and we will provide more information soon. GHF in partnership with the Georgia Council on Substance Abuse will present recommendations on activating Medicaid codes to promote the use of an evidence-based substance use screening and prevention tool known as SBIRT (screening, brief intervention, and referral to treatment) statewide and a fiscal analysis of the costs and benefits of implementing SBIRT through Medicaid to the committee. To find out more about SBIRT and our Preventing Youth Substance Use Disorders coalition visit our website. If you are interested in providing testimony or input to this committee please contact Senator Renee Unterman, the study committee chair.
Other Study Committees to Watch
- Senate Study Committee on Hearing Aids for Children (SR 1091)
- Senate Study Committee on Emergency Cardiac Centers (SR 1154)
- Senate Study Committee on State Sponsored Self-Insured Group Health Insurance Plan (SR 1166)
- House Study Committee on Mental Illness Initiative (HR 1093)
- House Study Committee on Professional Employer Organizations (HR 1341)
Moving the conversation forward
Yesterday marked the start of a new chapter in the campaign to close the coverage gap. The Georgia Chamber of Commerce Health Access Task Force unveiled a set of proposals to expand coverage. We are heartened that business leaders and health care industry stakeholders recognize the important role that coverage plays in a healthy and productive Georgia. You can read the news coverage in the AJC, WABE, Georgia Health News, and Atlanta Business Chronicle.
Is it a good plan?
We believe a coverage solution is one that extends coverage to all those Georgians caught in the coverage gap, does not erect unnecessary barriers to care, and maximizes the federal dollars set aside for Georgia. The Chamber’s proposal is a big step in this direction. While we have concerns about how some of the proposed provisions will impact consumers, we look forward to working with the Chamber, legislators, our Cover Georgia partners, and other stakeholders to find a solution that best serves individuals and families, our state’s health system, and our state’s economy.
What can I do to build on the momentum?
Be a part of the conversation! Your legislators need to know that this is an important issue for their constituents. Here you’ll find a quick and easy way to enter in your address and directly email both your state house and senate member. Let them know it’s time we close the coverage gap!
At Georgians for a Healthy Future, we’ve been fighting for expanded access to care since our doors first opened. We’ve developed videos and graphics to help simplify this complicated issue. We’ve created in-depth tools to explain the nuance and dispel myths. Our postcard and petition project has helped lift up this issue at the Gold Dome where we regularly testify and provide research to lawmakers.
As we get closer to closing the coverage gap we hope you’ll continue to stand with us. By signing up for the Georgia Health Action Network you’ll receive timely updates as the debate unfolds and easy ways for you to stay engaged. And, of course, we’re here for you! If you have questions about what’s going on, please ask!
Tremendous progress has been made over the past three years in increasing enrollment into health insurance that facilitates access to care and provides financial protection for individuals and families across the state of Georgia. However, too many Georgians are still uninsured, the trends toward narrow networks and consolidation within the health industry threaten to negatively impact access to care, and consumers express concerns about affordability. Addressing these issues will require collaboration between enrollment and health care stakeholders, advocates, and policymakers. Here are three things Georgia lawmakers can do to ensure that all Georgians have access to the quality of care they need.
- Close the coverage gap – Despite robust Marketplace enrollment in Georgia, we still have one of the highest uninsured rates in the nation, largely because our state policymakers have not yet closed the coverage gap. Georgia’s enrollment assisters have repeatedly expressed to advocates that this is the biggest barrier to enrollment that their consumers face.
- Addressing Affordability – Rate review is an annual process during which insurance companies submit their proposed plan rates for the coming year to be reviewed by state and federal regulators. We encourage state regulators to scrutinize these rates closely to ensure they are justified and to request adjustments if they are not. We also encourage policymakers to explore emerging approaches in health care payment and delivery reform that hold the potential to enhance value for consumers.
- Ensuring Access to Care – We encourage policymakers to build on the progress made by SB 302 by enacting comprehensive network adequacy standards in 2017.
For more details on policy and advocacy opportunities and our findings from research around the third open enrollment period, download our new report, Getting Georgia Covered: What We Can Learn from Consumer and Assister Experiences During the Third Open Enrollment Period.