Health insurance navigators play a vital role by educating consumers, increasing health insurance literacy, and facilitating enrollment, said Cindy Zeldin of Georgians for a Healthy Future.
I am a graduate student in the Public Health program at Georgia State University. As a part of my coursework, I completed a semester-long practicum with Georgians for a Healthy Future as the Legislative Health Policy Intern.
In my academic program, I have spent extensive time learning about health policy, the legislative process, and the healthcare landscape in the United States. While covering those topics in a classroom setting was informative, seeing the legislative process first hand was invaluable. During my time with Georgians for a Healthy Future, I had the privilege of experiencing the legislative process by visiting the Capitol for committee and advocacy meetings, tracking legislation, and meeting policy makers and advocates.
Some of what I learned in the classroom applied to my work at GHF, but I found that there are some things you can only learn through experience. I was surprised by the length of time that legislators spend discussing some bills. Minutia in bill language could be debated for a whole two-hour meeting, while some key details might be voted on within minutes. I often felt a rollercoaster of emotions as a passionate hearing drew my sympathy for a given issue, while opposition pushed back on the bill. Spending time in committee hearings solidified my understanding that health policy often lies in gray areas, despite initially appearing to be black and white.
In my time at Georgians for a Healthy Future, I have learned a great deal about the organization and working in advocacy. Something that surprised me about GHF is the great value of the small things they do, such as encouraging constituents to call their legislators, sharing facts and resources with partner organizations, and talking to consumers. Their efforts often go unseen by the general public but have significant implications for the citizens of Georgia. I have seen the fruits of their labors, and it excites me to know there is an organization working so hard to protect and give a voice to our most vulnerable Georgians. Their partner organizations are equally inspiring in working to better the health of people in the state.
look forward to taking my GHF experience and knowledge with me into the public health field. I have gained a greater understanding of health policy and how bills get passed. I have learned the importance of advocacy and that every person can have a voice. I have learned that there are so many deeply passionate, caring, and hard-working individuals working towards health equity in Georgia. I have learned that the road to policy is often long, but the payoff is worth the time and effort. I will take these lessons with me as I move into my career, and work towards the goal of creating a healthier state and nation for everyone.
MPH Candidate 2017
Georgia State University
Last week, GHF was on the road again traveling to Athens for UGA’s annual State of Public Health conference. The SOPH conference is a chance for public health researchers, practitioners, and students to share and learn about the newest public health initiatives and research happening across Georgia. We were excited to be featured as a presenter among other experts, advocates, and leaders in Georgia’s public health domain.
In a workshop dedicated to the Affordable Care Act, GHF teamed up with Georgia Watch to talk about Marketplace enrollment efforts in Georgia. The presentation was based on GHF’s “Getting Georgia Covered” report, which explored the successes and barriers to outreach and enrollment efforts in Open Enrollment 2. We also previewed the upcoming open enrollment period, which starts on Sunday, Nov. 1, 2015, and advocated for closing Georgia’s coverage gap.
The other presenters in the workshop, including another presentation from our partner Georgia Watch, comprehensively covered the new ACA requirement for hospitals to complete a community health needs assessment (CHNA) of their service area every 2-3 years and how that is being implemented in Georgia. The workshop generated some excellent questions and constructive conversation about these two very different aspects of the ACA.
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Commentary from Cindy Zeldin, Georgians for a Healthy Future’s Executive Director
The nation’s uninsured rate has plummeted over the past year and a half. Here in Georgia, more than 400,000 people have enrolled in health insurance, bringing our state’s uninsured rate down to 15 percent. While there is still much work to be done to ensure that all Georgians have a pathway to coverage (like expanding Medicaid), it’s also important to make sure that those who are newly covered are able to access needed health care services.
Are newly insured Georgians accessing the care they need? For the most part, the answer seems to be yes. The early evidence shows that most people who signed up for health insurance have been able to find a doctor with relative ease and get an appointment for primary care within a week or two.
This is a development worth celebrating, but there are also some warning signs on the horizon that policymakers should heed: according to a recent study by the University of Pennsylvania, Georgia had the highest percentage of health plans utilizing “narrow networks” of providers. In addition, reports of provider directory inaccuracies and networks too skinny to deliver all of the services in a plan’s benefit package have started to emerge.
Narrow networks offer a limited choice of providers in exchange for a lower premium. While many Georgians are willing to make this trade-off, others need a broader network to meet their health needs. And everyone deserves the tools and information to make that choice and to know that they can access services for all covered benefits.
Health care consumers now have access to standardized information about premiums, benefits, deductibles, and other health plan features that make it easier to pick the right plan. Yet provider network size and composition remain a black box for consumers, holding them back from making the best, most informed decision they can. Combined with a rapid trend toward narrow networks, this could put some consumers at risk of not being able to access all of the providers and services they need (or at risk for high medical bills if they have to go out-of-network).
These trends are being examined as part of the Senate Study Committee on the Consumer and Provider Protection Act (SR 561). I was honored to be appointed to this committee to represent Georgians for a Healthy Future and to bring the consumer perspective to the committee. The committee’s third meeting, slated for the morning of November 9th at the State Capitol, will focus on network adequacy, or whether there are adequate standards in place to ensure that consumers enrolled in a health plan have reasonable access to all covered services in the plan.
As a committee member, it is my goal to make sure the voices and needs of consumers are heard and considered. It is becoming clear that consumers don’t yet have 1) access to all of the information they need to select a health plan that best meets their needs and 2) protections that ensure their health plan will provide timely and meaningful access to all covered services. Fortunately, these are problems we can address.
I will be supporting enhancements to provider directories that give consumers the information they need and deserve (such as enhanced search functionality and a simple way to report inaccuracies) as well as network adequacy standards for Georgia that ensure no insured Georgian has to travel an unreasonably long distance or wait an excessive amount of time to access the care they need. I’ve also learned a great deal about this issue by watching the National Association of Insurance Commissioner’s work in this area, and was happy to sign on in support of the policy recommendations around network adequacy that the NAIC’s consumer representatives issued last year.
I am excited about this opportunity to make our health system work better, and GHF will keep you posted on new developments. If you’re interested in providing testimony to the committee, please let us know and we can forward your request to Senator Burke, who chairs the study committee.
Did you know that thanks to the Affordable Care Act, you can receive certain preventive services at absolutely no cost? It’s true! One of the key requirements of the ACA is that insurance companies must cover recommended preventive services at no cost to the consumer – even if you haven’t met your deductible. These include services such as mammograms, annual physicals, colonoscopies, well-woman exams, cholesterol screenings, tobacco cessation, and many more. Click here for a full list of the preventive services that must be covered by all insurance companies. There is also an additional list of required services for women and a separate one for children. It’s important to take advantage of these no-cost preventive services to keep you and your family healthy. Evidence shows that preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they become complicated and debilitating conditions.
If you have any questions about your insurance, please contact our Consumer Education Specialist, Whitney Griggs by email or at 404-567-5016 x 5
With the holiday season upon us and the 2015 Legislative Session just around the corner, the health of our state’s children and families is at the top of all of our minds. Georgians for a Healthy Future has focused heavily on promoting policies that ensure a pathway to coverage and meaningful access to care for all Georgians in recent years, but identifying and advocating for policies that improve health outcomes is also close to our hearts. In that spirit, we believe it is time to act on tobacco, which is the leading cause of preventable disease and death.
Earlier this month, Georgia’s Medicaid program amended its state plan to include a comprehensive smoking cessation program. This is an important victory that will help reduce smoking in our state. If you haven’t already, please take a moment to thank Commissioner Clyde Reese for taking this important step. There is, however, more to do. We need your partnership and your voices to help us take on the biggest hurdle we face in curbing smoking and its harmful effects: increasing the tobacco tax in our state.
According to the American Lung Association’s annual state report card, Georgia scores an “F” on tobacco taxes. Georgia currently ranks as the 48th lowest tobacco tax in the country at just 37 cents per pack. Not only does this make tobacco much more accessible to youth (and all Georgians), but it takes much needed revenue off the table for Georgia as the state tries to find funding for transportation infrastructure, education, and health care coverage for Georgians.
In fact, Georgia is so far below the national average for tobacco taxes that we could raise our tax by over a dollar per pack and still just be at the national average. That is why this year GHF and a coalition of supporters will propose raising Georgia’s cigarette tax by $1.23 per pack. It’s as easy as 1-2-3!
One – for the kids who we can prevent from ever starting
Two – for the improved health outcomes that smoking reductions will bring
Three – for the revenue the tobacco tax will bring to our state that can be invested in coverage, access, and prevention.
Please check your upcoming editions of the Peach Pulse for updates on this issue and opportunities to take action!
Georgians for a Healthy Future and more than 40 organizations launched an education and advocacy campaign this week is support of expanding Medicaid in Georgia. Below is our announcement about Cover Georgia’s launch. Please contact us if you’d like to join the coalition.
COVER GEORGIA COALITION LAUNCHES EFFORT TO ENSURE THAT THE STATE MOVES FORWARD WITH THE MEDICAID EXPANSION
ATLANTA, Ga., January 10, 2013 – More than 40 organizations – including healthcare providers, hospitals and healthcare advocates – announced today the creation of a coalition in support of expanding Medicaid to Georgians with incomes below 133 percent of the federal poverty level as authorized by the federal health care reform law, the Affordable Care Act (ACA).
Called Cover Georgia, the coalition is spearheaded by Georgians for a Healthy Future and is comprised of a wide range of healthcare stakeholders, including the Georgia Rural Health Association, the Georgia Academy of Family Physicians, AARP Georgia, the American Cancer Society, among many others.
Enacted by Congress in 2010, the Affordable Care Act included the Medicaid Expansion provision, which would provide the states with billions of dollars in new federal funds to enroll currently uninsured citizens in their Medicaid programs. In Georgia, expanding the program is projected to cover approximately 650,000 Georgians and to bring approximately $33 billion in federal funds into the state over ten years. For the first three years of the expansion, the federal government will fund 100 percent of the new cost; after that, the states would be required to cover no more than 10 percent of the total cost from 2020 onward.
Cover Georgia will make the case that expanding Georgia’s Medicaid program and leveraging the billions of dollars in federal resources will improve access to care, strengthen the state’s health care delivery system, and bolster Georgia’s economy. “This is an unprecedented opportunity to impact the lives of hundreds of thousands of Georgians and we simply cannot pass up this opportunity,” said Amanda Ptashkin, outreach and advocacy director for Georgians for a Healthy Future, the organization spearheading the coalition work.
When the U.S. Supreme Court decided the constitutionality of the ACA in 2012, it ruled that states could not be compelled to participate in the Medicaid Expansion. So far, Governor Deal has said he does not plan to move forward with the expansion in Georgia, expressing concerns about the state budget and the long-term fiscal outlook at the federal level.
“Cover Georgia is a statewide education and advocacy campaign focused on spotlighting both the critical role that Medicaid plays within Georgia today and the opportunity that implementing an expansion of the program presents for consumers, the health care system, and our state’s economy,” said Cindy Zeldin, executive director of Georgians for a Healthy Future. “Covering the lowest-income uninsured through Medicaid will provide access to the basic prevention and treatment services that uninsured Georgians lack today and will pump an infusion of federal dollars into our state’s health care economy.”
“Other states across the country are saying yes to the Medicaid expansion and are investing in their state’s health care delivery systems with federal taxpayer dollars paid by Georgians. Georgia cannot afford to maintain the status quo while other states invest heavily in their health systems. Doing so will further compound regional health disparities and limit Georgia’s ability to compete in the long-run.”
Matt Caseman, of the Georgia Rural Health Association, agrees that in addition to the overall economy, the expansion will help rural Georgia. “Expanding Medicaid will provide thousands of rural Georgians, who don’t have health insurance, access to a primary care doctor and preventative medicine. It will help reduce the burden of uncompensated care and keep the doors open for our safety net providers. This initiative is critical to not only the health of Georgia’s rural communities, but our state’s overall economic success as well.”
Tim Sweeney, of the Georgia Budget & Policy Institute, believes that access to affordable health coverage is one of the most pressing health care issues facing the state. “Expanding Medicaid to cover hundreds of thousands of low-income Georgians is one of the most cost-effective ways to address the issue. Implementing the expansion will enable more Georgians to access needed health care, while boosting Georgia’s economy by bringing billions in new federal funding for doctors, hospitals, pharmacies and other health care providers throughout the state.”
The consequences of this decision will affect hundreds of thousands of Georgians. AARP Georgia State Director, Greg Tanner, points out that, “there are 127,000 Georgians in their 50s or early 60s who make less than $15,000 a year and have no health insurance. Expanding Medicaid to cover them would make them more productive and in the first three years pump $8 billion into Georgia. That money will go directly to doctors, hospitals, clinics and other health care providers. We can’t afford not to expand coverage.”
If the state decides to forgo expanding the Medicaid Expansion, those individuals who earn more than our current eligibility levels but less than 100% FPL (Federal Poverty Level) will have no options for coverage and would not qualify for subsidized coverage in the state’s health insurance exchanges. Those individuals will fall into a coverage gap.
The Cover Georgia coalition will continue to work on educating the public, key decision-makers and others on the importance of the expansion and what it means for our citizens. Individual consumers, health care professionals, policy-makers and others can learn more about Georgia’s Medicaid program and what the expansion would mean for thousands of Georgians by visiting Cover Georgia’s website at www.coverga.org.
The 2012 Legislative Session continues today as legislators meet for Day 27 of the 40-day Session. Crossover Day (Day 30), when a bill must pass at least one chamber to remain viable for the Session, will be March 7th. Here is what health care advocates are watching:
- The House and Senate have both passed versions of the Amended FY 2012 Budget (HB 741); since there are minor differences, HB 741 now heads to conference committee. Notably, the Senate version added $1.2 million in the Department of Public Health budget for the Children 1st program to replace the loss of Supplemental TANF funds. This program provides screenings for newborns. Also in the Senate version, funds were added to the Department of Community Health budget to reflect projected need in Medicaid but there were also cuts to reflect the rounding down of co-payments to the nearest dollar. Meanwhile, work continues on the FY 2013 budget. Click here for the Georgia Budget & Policy Institute’s analyses of the implications for the state’s health care agencies on the governor’s proposed 2013 budget recommendations.
- HB 1166, sponsored by Representative Atwood, would restore child-only health insurance policies to Georgia’s individual market. Georgians for a Healthy Future, along with a range of child health advocacy groups, is in strong support of this measure to provide this option for families who need coverage for their kids. The bill is expected to be before the House Insurance Committee on Wednesday. You can learn more about this issue by downloading our fact sheet.
- HB 801 and SB 418 were introduced by Representative Gardner and Senator Orrock, respectively, as companion bills to establish a health insurance exchange in Georgia. While leadership in the House and Senate have indicated that there will not be movement on an exchange this year, please thank Representative Gardner and Senator Orrock for their leadership on this important issue. You can learn more about how a Georgia exchange could work by downloading our issue brief here. All information from the Governor’s Health Insurance Exchange Advisory Committee, which met throughout the second half of 2011 to develop recommendations on this issue, is available here.
- HB 1159, sponsored by Representative Pruett, is known as the New Parent Information Bill and would create a Joint Study Commission on Education for Parents with Newborn Children to determine how best to gather information, raise funds and create a comprehensive informational video. The video would include but not be limited to information on the prevention of childhood obesity; how to prevent SIDS, shaken baby syndrome, and other forms of child abuse; how to prevent death and injury and additional information which would assist parents to raise safe and healthy children. The bill is expected to be before the House Health and Human Services Committee this week.
Don’t forget to download our Consumer Health Advocate’s Guide to the 2012 Georgia Legislative Session to help you navigate the Capitol! A limited number of hard copy guides are available. Please contact us if you’d like a copy.
Members of the Bump It Up a Buck coalition (including Georgians for a Healthy Future) are working together to maintain the momentum needed to secure an increase in the consumption tax on cigarettes by $1. Experts say the measure would reduce smoking levels in the state, improve the health of all Georgians and conservatively generate more than $340 million in new tax revenue for the state each year. As part of our efforts to increase awareness of the issue, members of the coalition will participate in the first celebration of national Kick Butts Day to be held in Atlanta since 2008. The event will be held on Wednesday, March 21, 2012, and will include a rally on the steps of the Capitol and online activities as well. Georgia currently has the 48th lowest per pack tax in the nation at only 37 cents (national average: $1.46). You can show your support for the initiative by joining the hundreds who Like the idea at http://www.facebook.com/BumpItUpaBuck.
Georgians for a Healthy Future is a non-profit, non-partisan health policy and advocacy organization that addresses health care issues through a consumer lens. Our 2012 policy priorities were developed with broad input from community stakeholders. We will work collaboratively with our community partners to advance these priorities.
Maximize opportunities and benefits presented by the Affordable Care Act for Georgia health care consumers. Georgians for a Healthy Future will continue to monitor legislation and agency-level activity to implement the ACA and support Georgia laws and regulations that establish structures and systems that maximize benefits for consumers in this process.
Preserve consumer protections for Georgians in private health insurance plans. State laws and regulations provide a basic level of protections and benefits to consumers who buy private health insurance plans. These protections ensure that consumers who purchase these plans obtain meaningful health insurance that covers essential medical services in the event they get sick. Georgians for a Healthy Future will continue to support efforts to preserve and strengthen consumer protections and oppose legislation that would place consumer protections at risk.
Modernize Medicaid and PeachCare by utilizing best practices to improve coverage rates, access to care, and health outcomes. The Medicaid and PeachCare for Kids programs provide health insurance for our state’s most vulnerable citizens. The Georgia Department of Community Health is currently weighing options to redesign these programs. Georgians for a Healthy Future will monitor this process as well as legislative activity and will support policy changes that facilitate continuous coverage and enrollment, preserve and expand access to care, and improve health outcomes. Georgians for a Healthy Future will oppose policy changes that restrict access to vital health care services for Medicaid and PeachCare beneficiaries.
Establish a consumer-friendly health insurance exchange. A well-designed health insurance exchange can add transparency to the health insurance marketplace, spur competition and choice, help make insurance more affordable and available, and give consumers the information they need to make optimal purchasing decisions. Georgians for a Healthy Future will support a health insurance exchange compatible with the American Health Benefit Exchanges (AHBE) authorized by the Affordable Care Act that provides consumers with the appropriate information, tools, and navigation assistance to make optimal purchasing decisions and a governance structure that can effectively and transparently oversee the exchange without conflicts of interest.
Restore child-only health insurance plans to the private health insurance market. Due to a recent change in federal law, insurance carriers in the individual market can no longer deny coverage to a child with a pre-existing condition. Even though insurers may still medically underwrite these policies, insurance carriers in Georgia stopped issuing these policies altogether. Georgians for a Healthy Future will support legislation to restore these plans to Georgia’s health insurance marketplace.
Strengthen Georgia’s public health system. Our public health system plays a critical role by vaccinating children, monitoring and preventing epidemics, ensuring safe food and water, and providing both clinical and community-based preventive services. Despite an increasing need for services, Georgia’s per capita public health spending is among the lowest in the nation. The establishment in 2011 of the new Department of Public Health presents an opportunity to rebuild our public health infrastructure and to place renewed focus on the critical role of public health. Georgians for a Healthy Future supports a robust, adequately funded public health system to meet the critical needs of our state.
Increase the tobacco tax. The current funding environment demands evidence-based policy solutions that both advance the health of our state and generate needed revenue. In recent years, even the most basic, vital, and cost-effective programs have been subject to deep budget cuts. Georgians for a Healthy Future opposes further cuts to these vital programs and supports budget solutions such as a substantial increase in the state’s tobacco tax. Tobacco taxes are a proven strategy with the dual benefit of bringing in additional state revenue and increasing the health of Georgians by reducing adult and youth smoking.