The effort was a collaboration between Physicians for a National Health Program, a group of doctors that advocates for Medicare for All, elected officials, community members, patients and advocacy groups…
By Cindy Zeldin
This column originally appeared in the Bryan County News.
Sept. 23 marked the six-month anniversary of the enactment of the Affordable Care Act, the new federal health care law. The bulk of the changes go into effect in 2014, giving state and local governments, insurers, providers and other key stakeholders time to translate and implement the new policies.
While the health reform legislation is complex and the politics contentious, the new health law is our best shot here in Georgia to expand insurance coverage, improve access to care and ultimately move the needle on many of our state’s lagging health outcome indicators.
Implementing the new health care law won’t necessarily be easy and doesn’t lend itself to a bumper sticker slogan. But with a coordinated effort and a collaborative spirit, we can leverage the new health law to build a healthier Georgia.
The new law is complex: a major reason for this is that our current health system is fragmented and complicated, and Congress made a concerted effort to preserve what was working well for most Americans while filling in the intractable gaps that simply left too many hard-working citizens without access to affordable, quality health care.
At the same time, insurers and the federal government are clashing over the details of how to carry out some of the provisions in the new law, and this back-and-forth has dominated the headlines. Add in a dose of pre-election politics, and it is no wonder consumers have some confusion.
Rather than use this confusion to impede the effectiveness of the new law, here in Georgia we should embrace the opportunity it presents, particularly since we have so much to gain.
Currently, nearly 2 million Georgians are uninsured. Despite the popular perception that the uninsured still get the medical care they need, the evidence is clear that they do not. The uninsured are nearly four times more likely than the insured to have gone without a recent routine check-up, and clinical outcomes are worse for uninsured patients across a range of health conditions.
If implemented properly, the new health law will cover the majority of Georgia’s uninsured by extending coverage to those who are denied, ineligible or for whom insurance is priced out of reach today.
The insured will benefit, too. While consumers in employment-based plans report high levels of satisfaction with their plans, the individual health insurance marketplace is a minefield, fraught with pre-existing condition exclusions and rescission policies that allow insurers to retroactively deny benefits to consumers who have purchased insurance in good faith, only to discover that it is pulled out from underneath them when they get sick. The new health care law will put a stop to these practices.
Perhaps most importantly for Georgia policymakers and consumers, however, is that while the basic architecture and the bulk of the financing for the new law are put into place federally, there is significant opportunity for the states to implement key policies in a way that is tailored to each state’s needs.
For example, the state of Georgia recently applied for and received a grant from the Department of Health and Human Services to begin planning for a Georgia health insurance exchange, which will serve as a one-stop shop for individual private health insurance policies and must coordinate with other state agencies to navigate consumers to programs like Medicaid for which they may be eligible.
The new health law also authorizes a $15 billion Prevention and Public Health Fund, and some of these dollars will be available for Georgia to draw down to implement wellness and prevention programs in communities throughout the state. There is also a significant investment in community health centers and grants to expand the provider workforce, all opportunities for Georgia.
Between now and 2014, if we put politics aside and instead thoughtfully and carefully develop a Georgia-specific implementation plan for the new law, the health of our state and its citizens could benefit for generations to come.