Moms need Medicaid

Valerie is a mother of three children living in Lamar County. Medicaid covers all three of Valerie’s children, and they rely on the health coverage it provides for their varying health needs. Valerie sometimes has difficulty accessing the care and information the family needs because they live in a rural area, but acknowledges that Medicaid is a lifeline that makes it possible for her to focus on her family’s other needs. Without health insurance through Medicaid, Valerie would have to pay hefty medical bills to ensure her children receive the care they require.

 

Susie is the sole caretaker of her young granddaughter, but she has a hard time caring for herself because she is stuck in Georgia’s coverage gap. She makes more than $6300 annually, so she doesn’t qualify for Medicaid coverage as a caregiver, and she doesn’t make enough to receive financial help to buy health insurance through the Marketplace. Susie is currently undergoing treatment for cancer but because she lacks health coverage, Susie is only able to receive cancer treatments from a doctor that allows her to make low monthly payments. Susie has other chronic health issues that need to be managed but finds it difficult to receive consistent care without insurance. Because Georgia’s elected officials have not extended Medicaid to cover caregivers like Susie, she struggles to care for herself while working to ensure her young granddaughter receives the care and support she needs to grow up healthy and thrive.

Medicaid provides access to needed health care services for low-income soon-to-be-moms, new mothers, and very low-income parents of minor children. For moms like Valerie, Medicaid makes being a mom a little easier by ensuring that their children have access to the health care services they need to grow and stay healthy. For others, Medicaid would help them get or stay healthy so they can best fulfill the responsibilities of being a mothers or caregivers. Over 150,000 uninsured women like Susie would gain health insurance if Georgia’s decision makers extended Medicaid to cover low-income adults (those making less than $16,000 annually for an individual or $20,780 for a family of three).


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GHF and Step Up Savannah partner to host health advocacy training

Georgians for a Healthy future partnered with Step Up Savannah to host a health advocacy training on Tuesday, April 3rd.  Advocates learned how they could participate and lead health advocacy efforts in their own community and received information about pressing health advocacy issues in Georgia. Representatives from Healthy Savannah and the Chatham County Safety Net Planning Council were also in attendance to share local resources.

The significance of Medicaid was highlighted throughout the event. Participants learned that Medicaid primarily covers low-income children, people with disabilities, seniors, and pregnant women, including 40,000 of Chatham County residents. Alyssa Green, GHF’s Outreach & Education Manager, discussed Georgia’s opportunity close the coverage gap so that 240,000 more Georgians would have access to health insurance coverage. Alyssa shared the story of a Georgia woman who works part-time at DisabilityLINK but is stuck in the coverage gap and, as a result, has trouble managing her high blood pressure.

GHF’s Executive Director Laura Colbert introduced ways that people can advocate for the health care issues that matter most to them, like increased access to healthcare, bringing down health care costs, and protecting the Medicaid program. She explained how to build a relationship with legislator, communicate support or opposition for significant bills, and other forms of advocacy.

The training concluded with presentations from the Chatham County Safety Net Planning Council and Healthy Savannah. The two Savannah-based organizations provided participants with information and resources to promote and build a healthy local community.

 

If you are interested in hosting a training like this in your community, please contact Alyssa Green at agreen@healthyfuturega.org or 404-567-5016 x 2 for more information.


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New tool available to Georgia health care providers to address the opioid crisis

Laura Colbert, MPH, MCHES

 

Every day four Georgians die from opioid overdose and recent data from the Centers for Disease Control and Prevention confirm that the epidemic shows no signs of slowing. Health care providers, public health professionals, community leaders, and families are all searching for effective strategies to slow and stop this growing public health crisis. Some initial steps have been taken by Georgia policy makers and others to increase access to life-saving drugs like naloxone, improve and expand the prescription drug monitoring program (PDMP) to prevent over-prescribing, and raise public awareness about the risks of opioids and other substances, but more is needed. Solutions must include evidence-based strategies that emphasize prevention and early intervention, as well as timely treatment and support for recovery.

An exciting development within Georgia’s Medicaid program gives health care providers an additional tool to aid in the fight against substance use disorders, especially among adolescents and young adults. Georgia’s Medicaid agency has activated the reimbursement codes for a tool called SBIRT, which stands for Screening, Brief Intervention and Referral to Treatment. SBIRT is a set of tools that identifies people who use alcohol or other drugs at harmful levels and guides follow-up counseling and referral to treatment before serious long-term consequences occur.

Ninety percent of adults who meet the medical criteria for addiction started smoking, drinking, or using other drugs before they were 18 years old. Because Medicaid and PeachCare for Kids cover half of all Georgia children, the activation of the Medicaid reimbursement codes for SBIRT is a powerful opportunity to identify youth substance use and intervene early. Studies show that simply asking young people about drugs and alcohol use can lead to positive behavior changes and that brief interventions reduce the frequency and amount of alcohol or other drug use by adolescents.

This policy change was the product of a sustained advocacy effort by Georgians for a Healthy Future (GHF) and the Georgia Council on Substance Abuse (GCSA). We anticipate it will lead to the screening of an estimated 145,000 Georgia youth annually and that 36,000 of those youth will present substance use behaviors that prompt a brief intervention with a health care provider. Initial data from Georgia’s Medicaid agency demonstrates that some providers are already making use of the SBIRT codes in their practices.

Notwithstanding these exciting results, we have committed to continue our efforts to improve access to screening, early intervention, and recovery services and supports for young people across Georgia. While the Medicaid reimbursement codes allow physicians, physician extenders, and advanced practice registered nurses to provide SBIRT services, we recognize that RNs, LPNs, licensed clinical social workers, and certified peer counselors can and should be able to provide SBIRT to youth and adults. Further, the codes allow SBIRT to be provided primarily in health care settings, but that excludes schools and other community-based settings where most young people spend their time.

We invite you to join our efforts to prevent substance use among young Georgians. Spread the word by giving our new fact sheet to the providers in your clinic, public health department, or hospital. If you are a health care provider, attend a training to develop the skills to implement SBIRT with the people that you care for. Join our on-going advocacy efforts to activate the reimbursement codes for more practitioner levels (including RNs and LPNs) and more settings by contacting us to let us know you are interested.

The opioid and substance use crisis that is sweeping Georgia and impacting communities nationwide will require a full spectrum of solutions that leverage the expertise of health care providers, public and private resources, and community and family supports. SBIRT is an evidence-based tool that can play a significant role in our collective efforts to reduce substance use and create a healthier Georgia for all of us.

To learn more, visit our Keeping Youth on a Healthy Path page.

For health care providers: download our new fact sheet here.

 

 

 


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New policy report: Getting Georgia Covered 2017

With four open enrollment periods completed and a fifth one beginning in the coming weeks, the Health Insurance Marketplace has become established as the avenue for purchasing coverage for thousands of Georgians who do not have access to have insurance at work. The fourth open enrollment period differed from the first three in several important ways, and understanding these variations will be important in ensuring that the Marketplace continues to serve consumers who seek access to affordable comprehensive health insurance. This report examines the characteristics of the consumers enrolled in the Georgia Marketplace, compares open enrollment 4 to the previous three enrollment periods, and provides a preview for open enrollment 5.

Inside you’ll find:

– Key themes in consumer and assister experiences during the 2017 open enrollment period
– A look forward to open enrollment 5
– Policy opportunities to increase enrollment, ensure access to care, address affordability issues, and facilitate continued consumer education and supports

You can find the full report here. 


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1 degree of separation

Just like any actor is no more than 6 degrees of separation from Kevin Bacon, you

Anthony & Nicholas are covered by Medicaid

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
    Katherine is starting her own photography business

    reduce the amount of financial assistance available for those buying insurance on their own.

  • A child or adult with a developmental or physical disability can do anything they put there mind to, 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, they are even taught Self Development Secrets to better themselves as a person. It also supports home and community-based careso that they can live, study, and work with or near family, friends, and neighbors in comfortable houses with bespoke kitchens and all the furniture and kitchen appliances as the hamilton beach 70670 food processor.
  • 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
    Joshua can attend college because of Medicaid’s community-based supports

    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 veteran50,000 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!


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Legislative Update: March 20

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.


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The 2017 Legislative Session is underway!

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:

 

Stay tuned for updates throughout the session.

 


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Action Alert: #ProtectOurCare

The President-Elect and Congressional leadership are already working to repeal the Affordable Care Act, but have not yet communicated what a replacement might be. Repealing the law without an adequate replacement would do great harm to consumers, destabilize Georgia’s health insurance market, and stress our health care delivery system. It´s important to take care of your health in every way possible, if you happen to have issues such as stress or depression, especially Teen Counseling, buy kratom a natural drug that fights these issues immediately as cannabis products which are found in a cannabis store, you can also check Afinil which will help you out as well, read also is CBD good for you. If you want to know our special health care you can visit healthyhempoil.com.
Approximately one million Georgians would lose their health insurance by 2019, bringing the number of uninsured in our state to a staggering 2.4 million people – more than before the ACA was passed. Millions more would lose their basic rights and protections as consumers, and access to care would be at risk. We could lose:

 

  • Protections for people with pre-existing conditions from being charged more or from being barred from coverage. Pre-existing conditions include chronic diseases like diabetes, mental health conditions, asthma, cancer, and more
  • Protections that keep women from being charged more than men
  • Free preventive care
  • The ability to keep young adults on their parent’s plan until age 26
  • Financial protections that limit the amount of money consumers must pay out-of-pocket each year for care and that keep insurers from limiting lifetime benefits
  • Anti-discrimination provisions that protect consumers based on sex, gender identity, language spoken, or country of origin
  • Health insurance navigators who offer free, local, unbiased assistance to help people find the health care coverage that works best for them. It is nice to help people and care for them, encourage them physically, spiritually, and emotionally made by CDPAP services.

 

We need your help!

 

Members of Congress value what their constituents think, and the battleground over repeal will be focused on the United States Senate. Senators Isakson and Perdue need to hear from you today. Please call them at 202-224-3121 and tell them “Repealing the health care law without a replacement will affect everyone, particularly the one million Georgians who will lose coverage. Don’t take away our health care.”
Want to do more?

 

Please also consider sharing your health care story with us or with your Member of Congress or United States Senator. Federal policymakers need to hear the stories of their constituents whose basic access to coverage and care hangs in the balance before they make any decisions that impact your health care.

 

Follow #ProtectOurCare and GHF on Twitter and Facebook for updates and action alerts.

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Policy Forum: Getting Georgia Covered

DSC_0344

Last week, Georgia health advocates, service providers, and enrollment assisters combined forces for a day of learning, sharing, and planning at our second annual Getting Georgia Covered summit. In conjunction with the event, Georgians for a Future released a new publication focusing on key themes in consumer and assister experiences during the 2016 open enrollment period, best practices for outreach, enrollment, and reaching eligible Georgians who remain uninsured, and policy opportunities to increase enrollment, improve access to care, and address affordability issues. The report, Getting Georgia Covered: What We Can Learn From Consumer and Assister Experiences During the Third Open Enrollment Period, is intended to be a resource for health care stakeholders, advocates, and policymakers.

 

In addition to workshops that fostered collaboration between organizations and individuals working on behalf of health care consumers in different ways, we also featured presentations and remarks from Dr. Pamela Roshell, Region IV Director, US Department of Health and Human Services, Dr. Bill Custer, Director of Center for Health Services Research and Associate Professor, J. Mack Robinson College of Business, Georgia State University, Heather Bates, Deputy Director, Enrollment Assister Network, Families USA and Sandy Anh, Associate Research Professor, Georgetown University Center on Health Insurance Reforms. Jemea Dorsey, Chief Executive Officer for the Center for Black Women’s Wellness, and Sarah Sessons, Executive Director of the Insure Georgia Initiative of Community Health Works also offered their expertise and insights in a closing panel. In the coming weeks, we will release a publication highlighting promising opportunities to improve consumer health through collaboration, drawing on the discussions and ideas that came out of the workshops and discussions.


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New Policy Report Released!

EnrollmentBrief2016imageGetting Georgia Covered: What We Can Learn from Consumer and Assister Experiences During the Third Open Enrollment Period

With three annual open enrollment periods completed and a fourth one just around the corner, the Health Insurance Marketplace has become established as the avenue for purchasing coverage for roughly half a million Georgians. This report builds on last year’s Getting Georgia Covered: Best Practices, Lessons Learned, and Policy Recommendations from the Second Open Enrollment Period and focuses on understanding the characteristics of the people who have enrolled in marketplace plans and the experiences of consumers and the enrollment assisters who helped them. Their insights can inform the work of advocates, stakeholders, and policymakers to reach shared goals of reducing the uninsured, improving access to care, and addressing affordability for consumers.

Inside you’ll find:

  • Key themes in consumer and assister experiences during the 2016 open enrollment period
  • Best practices for outreach, enrollment, and reaching eligible Georgians who remain uninsured
  • Policy opportunities to increase enrollment, improve access to care, and address affordability issues

Go to the report.


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GHF In The News
Mar 19, 2018
Bill Would Let ‘Micro-Hospitals’ In Rural Georgia Counties
Elly Yu

Laura Colbert, executive director of Georgians for Healthy Future said there are good provisions in the bill, but there are other things the bill didn’t address. “HB 769 nibbles around…

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