The new plans are skimpier and sometimes financially insolvent so consumers who are considering enrolling in AHPs should be very cautious when shopping around to make the best choice for…
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).
Travis suffered from a series of strokes when he was 11 years old that left him with several physical disabilities. He is one of the approximately 250,000 Georgians with disabilities to be covered by Medicaid.
Several years ago, Travis started volunteering with DisabilityLINK because he believes in the power of community and he likes being able to help others. Since then, he was hired as a Independent Living Specialist at the organization, where he connects people with disabilities to community-based resources and assists in coordinating various events at the DisabilityLINK office. He also works alongside other activists on issues such as housing, accessibility and self advocacy.
Travis recognizes that Medicaid is the reason he is able to financially support himself and work for an advocacy organization. Without the support Medicaid provides, Travis explains, he would not be able to help others the way he has been able to through his work at DisabilityLINK. When asked what he wanted others to know about him being able to receive affordable health insurance he replied, “With me working I am able to be a tax paying citizen.”
Medicaid is essential to ensuring that people with disabilities, like Travis, are able to lead fulfilling, independent lives as active participants in their communities. Georgia’s Medicaid program provides almost 2 million low-income children, people with disabilities, seniors, pregnant women, and very low-income parents with access to the health care services that they wouldn’t have otherwise.
Your story is powerful! Stories help to put a human face to health care issues in Georgia. When you share your story, you help others understand the issue, its impact on Georgia, and its importance.
Your health care story is valuable because the reader may be your neighbor, friend, someone in your congregation, or your legislator. It may inspire others to share their stories or to become advocates. It is an opportunity for individuals who receive Medicaid or fall into the coverage gap, their family members, their physicians and concerned Georgia citizens to show that there are real people with real needs who will be impacted by the health policy decisions made by Congress and Georgia’s state leaders.
Share your story here!
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 firstname.lastname@example.org or 404-567-5016 x 2 for more information.
On February 15th, the Cover Georgia coalition, including Georgians for a Healthy Future, hosted Cover Georgia Day at the Capitol in order to ask state law makers to close Georgia’s coverage gap by extending health insurance to low-income Georgians.
The event began at Atlanta City Hall where GHF welcomed participants including advocates, nurses, medical students and community members. During the morning welcome Representatives Sam Park and Kim Schofield spoke to participants encouraging them to continue working to close Georgia’s coverage gap and Rep. Park shared a personal account of how Medicaid helped to save his mother’s life. Following that, GHF provided a short briefing about the need to close Georgia’s coverage gap and how to be an effective advocate.
At the end of the morning session, participants joined more than 100 advocates from the American Cancer Society at the Georgia Capitol where participants lobbied “on the ropes”. When speaking with their legislators, advocates emphasized the urgency of the issue and the need for every person in Georgia to have health care coverage. They also provided state lawmakers with a new tool called An Insurance Card for Every Georgian.
After talking with their legislators, advocates attended a large press conference in the South Rotunda featuring Neil Campbell of Georgia Council on Substance Abuse; Dr. Mitzi Rubin, a family physician and leader at the Georgia Association of Family Physicians; and Andy Freeman of the American Cancer Society. Ms. Campbell pointed out that providing more Georgians with health insurance is the most significant step our state could take towards addressing the opioid crisis. Dr. Rubin described how a lack of access to health insurance impacts her patients and their health. Mr. Freeman discussed the dual benefits of increasing Georgia’s tobacco tax: 1) reduced numbers of people smoking; 2) the increase in revenue from a tobacco tax would provide more than enough funding to pay for health insurance for low-income Georgians.
Cover Georgia Day was incredibly successful due to the partnership of Cover Georgia coalition partners, health care providers, and grassroots advocates, all of whom are committed to closing Georgia’s coverage gap. Thanks to all who participated.
If you missed Cover Georgia Day at the Capitol, it’s not too late to contact your state legislators to ask them to put a health insurance card in the wallet of every Georgian. Take action today!
Surprise medical billing emerges as prominent issue at the Capitol
Surprise out-of-network medical billing is emerging as a prominent issue within the Georgia General Assembly. A surprise medical bill can occur when a consumer encounters an out-of-network (OON) provider at an in-network facility or in other circumstances. Three pieces of legislation have been introduced to address surprise billing and each attempts to resolve the issue in its own way. In this week’s legislative update, we will provide a broad look at each bill and its provisions. (If you would like more information about any of the bills, click on the provided links to read the full legislation.) All three bills seek to protect patients, and we will monitor and weigh in on the bills as they undergo the inevitable amendment process in committee. We appreciate all of the bill sponsors for remaining vigilant towards protecting patients from unexpected medical bills.
HB 678: Increased network and billing transparency by health care providers and insurers
HB 678 is sponsored by Rep. Richard Smith, chairman of the House Insurance Committee, and has the backing of several powerful House lawmakers. The bill improves transparency for consumers by outlining the information that must be provided to consumers by health care providers and practices and by insurers. Providers must inform consumers about their participation in the patient’s insurance network and about how to check the network status of other providers with which the primary provider has coordinated services (e.g. laboratory or radiology services). It also requires insurers to provide consumers with information about when and how to receive approval for services from an out of network provider. Insurers must also communicate to a consumer ahead of a planned procedure if the provider is out of network (OON), and if so, the estimated amount the insurer will cover for the OON services. Lastly, HB 678 provides consumers with 90 days from the time of receiving a medical bill to pay the bill, negotiate payment or initiate arbitration through the Georgia Department of Insurance. After that time period, providers would be allowed to initiate collection proceedings to secure their payment.
HB 799: Out of network care in emergency situations
While HB 678 applies only to non-emergency situations, HB 799 applies solely to emergency care and medically necessary follow-up care. The legislation, sponsored by Rep. Sharon Cooper, Chairperson of the House Health & Human Services Committee, disallows managed care plans from denying payment for emergency services and disallows hospitals from billing patients for medically necessary care following an emergency situation except for their standard co-pays, co-insurance, and deductibles. For a patient receiving emergency care at an OON hospital and who is covered by a plan that requires prior authorization for post-stabilization care, the legislation outlines how the OON hospital and insurer must coordinate the patient’s transfer to an in-network facility and defines which entities are responsible for specific costs. Under this bill, if a patient (or their representative) does not consent to be transferred to an in-network hospital, the OON hospital must provide verbal notice to the patient that they may be financially responsible for any further post-stabilization care provided.
SB 359: Consumer Coverage & Out of Network Medical Care Act
SB 359 is the only Senate-side legislation introduced thus far to address surprise out-of-network billing and is sponsored by Senator Chuck Hufstetler, Chairman of the Senate Finance and member of HHS committees. The legislation contains many of the same transparency provisions for non-emergency care as HB 678 with regard to information that health care providers and hospitals must supply to consumers, but provides for more robust disclosure by insurers to consumers about possible OON costs. It also contains provisions similar to that of HB 799 with respect to emergency situations, but goes farther to stipulate that insurers must treat OON emergency care as if it were in-network by applying a consumer’s cost-sharing towards their in-network deductible and out-of-pocket maximum. The legislation also makes mediation available to consumers who receive elective medical care during which an unexpected event arises resulting in surprise bill greater than $1000. SB 359 is expected to be more controversial than the other two bills because it sets a payment resolution process that sank previous legislative attempts.
RSVP today for Cover Georgia Day at the Capitol!
Join us next Thursday, February 15th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of low-income Georgians. This is the most important step that our elected officials can take to slow the growing opioid crisis, strengthen our state’s struggling rural health care system, and improve the health & finances of hard-working, low-income Georgia families. Take advantage of this opportunity to talk with your elected officials about closing Georgia’s coverage gap! RSVP today!
Can’t make it? Send an email to your state legislators asking them to put an insurance card in the pockets of all low-income Georgians.
Legislation prioritized by Senate leaders approved by HHS Committee
At Thursday’s Senate Health & Human Services Committee, the two pieces of legislation resulting from the Health Care Reform Task Force were considered. Both SB 357 and SB 352 received strong support from legislators and stakeholders. GHF’s partners at the Georgia Council on Substance Abuse and Mental Health America of Georgia rose in support of SB 352, which would create a 15-member Commission on Substance Abuse & Recovery supported by a director. Both bills were passed by unanimous voice votes. You can find a description of both bills in last week’s legislative update blog.
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.
October is Breast Cancer awareness month and at Georgians for a Healthy Future we are committed to helping women access essential cancer screenings, including mammograms to detect breast cancer, through working to ensure that all Georgia women have access to health insurance. Uninsured, low-income women often face financial barriers to receiving recommended screenings for breast and cervical cancer and in Georgia, minority women face additional breast cancer disparities. However, research has shown that women who live in a state that has expanded Medicaid are more likely to get a mammogram than women that live in a non-expansion state. In 2008, women in every state had the same likelihood of getting a mammogram, but in 2015 a study found that women in expansion states were 25% more likely to get screened. As you can see, expanding Medicaid allows women to get the potentially life-saving preventive care they need. So for all the women in your life, please sign our petition to close the gap here.
But it doesn’t have to be that way.
As we approach the 2017 legislative session, we have the opportunity to close the coverage gap and ensure that some becomes all. Check out our new video about the Georgians stuck in the coverage gap and our opportunity to close it.
Today, we are asking that you be a part of the movement and contribute $25 to our Skincare reviews to close the coverage gap. Your contribution will allow us to travel across the state meeting with and raising up the voices of Georgians in the gap. It will fund our media efforts so that everyone, from Blueridge to Bainbridge, will know that these people can’t wait. The time to close the coverage gap is now.
More of your personal stuff here: https://www.skincare.net/skin-care-products/arbonne-review/
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 best beard trimmer 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!
FOR IMMEDIATE RELEASE – August 31, 2016
Georgians for a Healthy Future – Laura Colbert, email@example.com (404) 567 – 5016 x 2
Georgia Budget & Policy Institute – Laura Harker, firstname.lastname@example.org (404) 420 – 1324 x 103
Mercy Care – Diana Lewis, email@example.com (678) 843 – 8509
Atlanta, GA – August 31, 2016
Today the Georgia Chamber of Commerce released their proposal to address Georgia’s coverage gap, and expand access to health coverage for low-income Georgians.
Leaders of the Cover Georgia coalition responded with the following statements.
Cindy Zeldin, Executive Director of Georgians for a Healthy Future, a health care consumer advocacy organization that heads the Cover Georgia coalition said:
“We are encouraged that business leaders and health care industry stakeholders have prioritized health care coverage as a necessary component of economic vitality. The set of policy options put forth by the Georgia Chamber provides a strong starting point. We look forward to a statewide conversation in the coming months about the best approach to ensure all Georgians have a pathway to coverage and access to care.”
Laura Harker, Policy Analyst for Georgian Budget & Policy Institute, a nonprofit focused on Georgia’s fiscal and economic outlook:
“We are encouraged that Georgia leaders are talking more than ever about the need to expand health care access and give the state’s health care system a timely boost. Closing the coverage gap is a smart investment for Georgia that would bring in billions of federal dollars and reduce uncompensated care costs.”
Tom Andrews, President of Mercy Care, a network of health clinics that provide primary care and support services to those who are homeless and uninsured said:
“On behalf of the 88% of our patients who are uninsured, we cannot adequately express the positive impact any one of these plans would have on the health of the patients we care for.”
Cover Georgia is a coalition of more than 70 organizations that have come together to educate the public, engage Georgia’s policy makers, and advocate to close Georgia’s coverage gap by expanding Medicaid. 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.
More resources about the coverage gap:
- A Chartbook for Understanding Medicaid in Georgia and the Opportunity to Improve It
- Georgia Left Me Out: Coverage Gap Fact Sheet
- Strengthening Georgia’s Rural Hospitals and Increasing Access to Care