Earlier this week, GHF provided a summary of the recommendations from several Senate study committees and how their findings may affect the health care system and consumers in the state. The Georgia House of Representatives also convened study committees to examine issues directly related to health care, and two of these committees recently released their final recommendations.

The House Study Committee on Georgians’ Barriers to Access to Adequate Health Care (HR 240) examined a broad array of health care issues with a focus on the burden of chronic disease in Georgia. The committee, chaired by Representative Sharon Cooper, issued an exhaustive final report that included several legislative recommendations that could impact consumers. The most pertinent recommendations include:

Increasing access to immunizations: Allow schools to require the second dose of the meningitis vaccination in 12^th grade; require hospitals and nursing homes to offer shingles and flu vaccinations; allocate an additional $1 million to the Department of Public Health for additional staff and screenings for the viral hepatitis program; require the Department of Juvenile Justice to check vaccination records and offer vaccinations for juveniles in their care.

Improving testing and treatment for HIV/AIDS: Rewrite state laws to focus criminalization on intention to transmit HIV, as opposed to knowledge of HIV infection; ensure access to HIV treatment regimens for sexual assault victims; increase funding to the Department of Public Health to expand their ability to test for HIV; encourage state-funded health care programs such as Medicaid to expand their outreach for HIV testing.

Facilitating continued enrollment in Medicaid: Engender a policy shift that would allow for the suspension of Medicaid benefits, as opposed to outright termination, for people entering incarceration in the state.

Addressing respiratory diseases: Build upon the existing state asthma plan, which expires in 2018, to include a broader scope of chronic respiratory diseases; expand the screening process for people at risk of COPD to help confirm additional diagnoses.

Expanding access to mental health services: Expand funding for the Department of Behavioral Health and Development Disability’s community service boards; allocate funding for psychiatric residents who specialize in mental health treatment; encourage the use of e-prescriptions for opioid medications in an effort to curb opioid abuse.

You can read the full committee report here.

The House Rural Development Council (HR 389) closely examined a variety of issues that impact rural communities in Georgia and a recurring theme across the state was a need for increased access to quality health care. After 18 meetings in all parts of rural Georgia, the council released several recommendations that could have a significant impact on rural health care consumers.

One of the most noteworthy recommendations encouraged the Department of Community Health to apply for an 1115 Medicaid waiver that would allow participating hospitals and community providers to form a closed network in order to provide care to a set number of uninsured community residents. This waiver would allow Georgia to pull down additional federal funds to provide health care to some of the state’s uninsured population and to test out new ways to deliver high quality care at a lower cost. Unfortunately this idea falls far short of expanding Medicaid, which would provide health coverage to low-income, uninsured Georgians statewide and is the most significant step our state could take in improving access to care for rural Georgians. (Note: the council report refers to this capitated, value-based delivery model as a “block grant,” but this waiver would differ from a block grant in some nuanced, but important ways.)

Like the Senate Study Committee on Barriers to Georgians’ Access to Adequate Healthcare, the council heard a significant amount of testimony on the dearth of practicing medical professionals in rural counties and, as a result, their final recommendations mirror those of the Senate committee. They suggest expanding the scope of practice for mid-level practitioners to allow them to perform certain medial services not currently allowed and implementing a preceptor tax credit program to incentivize medical practitioners to train future healthcare professionals in rural areas.

Finally, the council recommended establishing a Rural Center for Health Care Innovation and Sustainability, which will be responsible for promoting a curriculum of best practices for rural health care. The center will also be used to provide mandatory training for the executive leadership and boards of rural hospitals.

You can read the full committee report here.

As always, you count on GHF to keep you up-to-date on how these recommendations may turn into legislative action when the General Assembly convenes in January. Stay tuned!

As the year winds to an end, the General Assembly’s 2017 study committees have largely completed their work and are releasing final reports, complete with notable findings and recommendations for the legislature to consider when it convenes in January. GHF monitored the activities of several Senate study committees this year as they considered changes to Georgia’s health care system that may impact consumers. (We will issue a blog later this week to provide an overview of similar House committees.)

The Senate Study Committee on Barriers to Georgians’ Access to Adequate Healthcare (SR 188) chaired by Senator Renee Unterman focused heavily on provider shortages that impact Georgians’ ability to receive health care when and where they need it. These shortages are felt most heavily in rural areas of the state, including the 79 counties that have no practicing OB/GYN physicians, 63 counties with no pediatric physicians, and 9 counties with no practicing physicians at all. In its final report, the committee issued several specific recommendations to remedy the provider shortages and increase access to care. Most prominently, the committee recommended expanding the scope of practice for Advance Practice Registered Nurses (APRNs) in areas of the state with the worst health outcomes and largest provider shortages. The committee noted that Georgia has among the strictest practice environments for APRNs and expanding the scope of practice for these nurses would allow rural Georgians to access quality care despite a lack of physicians. The committee also recommended expanding the practice of telemedicine in the state by training more telemedicine presenters, loosening restrictive rules, and providing more funding to telemedicine initiatives. Lastly, the committee addressed the rash of rural hospital closures around the state, suggesting that the closures could be prevented by providing more specific training for hospital board members on healthcare finance and supporting ongoing education for hospital board members and executive staff. You can read the committee’s full report here.

Senator Unterman also chaired the Senate Study Committee on Homelessness (SR 352). The committee examined the integral link between mental health and housing stability, and discussed housing status as a social determinant of behavioral health. The committee recommended that the Department of Community Health identify ways in which the state could use Medicaid funds to support people who are at risk of becoming homeless, and they recommended increased funding to expand the Georgia Housing Voucher and Bridge Program to ensure that more people who live with behavioral health conditions are connected with supportive housing programs. During the committee’s proceedings, several health care providers testified about the health care needs of people experiencing homelessness, including the need to have health insurance coverage. The committee did not issue a recommendation about how to better provide health care services for the homeless population; however, data shows that expanding Medicaid would be a meaningful and significant step to ensuring access to care and treatment for this group of Georgians. You can read the committee’s full report here.

Finally, GHF has also been following the work of Lt. Governor Casey Cagle’s Health Care Reform Task Force, which has met throughout the year at locations across the state. The task force has held meetings about the best practices to combat the opioid crisis and treat addiction, expanding access to health care in rural areas, and strengthening preventative care across the state. The task force convened for their final meeting in October, and they will issue their formal recommendations to the state legislature in January.

It is unclear which of these recommendations will be acted on by the General Assembly during the 2018 legislative session. However, you can count on GHF to keep you updated on any resultant legislation and any other legislative decisions that will impact Georgia’s health care consumers.

GHF is proud to welcome Zach Nikonovich-Kahn to our staff. Zach will serve as GHF’s Communications & Special Projects Manager. In this role, he will manage GHF’s external communications, utilize communications strategies to mobilize Georgians in support of GHF’s mission, and provide research & policy support.

Zach Nikonovich-Kahn is a communications and community engagement professional, specializing in the nonprofit sector. Prior to joining Georgians for a Healthy Future, Zach worked as the Public Policy Advocate for Families First, where he was responsible for leading the agency’s government affairs and advocacy initiatives.

Zach is an extremely proud Atlanta native, and he lives in Midtown. He currently serves on the BeltLine Affordable Housing Advisory Board, as well as the Atlanta BeltLine Young Leaders Council. Zach has also served on the board of the Midtown Neighbors Association, the Board of Ambassadors at the Georgia Museum of Contemporary Art, and the board of the Atlanta chapter of the New Leaders Council.

Zach graduated from the Honors College at the University of Georgia with a B.A. in History, and he has a Master’s degree from Cambridge University.

A subcommittee of the Georgia House of Representatives’ Insurance committee convened last Monday, November 13^th to evaluate the use, costs, and effectiveness of the state’s mandated insurance benefits. Before the Affordable Care Act’s ten essential health benefits, states required insurers to cover certain health care services in the health plans sold in and regulated by the state, and many of those benefit coverage mandates remain in effect today. (CMS has a list of Georgia’s coverage mandates.) Because benefit coverage mandates have a principally positive impact on consumers’ access to, cost of, and quality of health coverage, GHF’s Executive Director Laura Colbert testified at the committee hearing.

In her testimony, Laura focused on the benefits of coverage mandates to consumers:

• Protection from insufficient coverage— No one plans on getting in a car crash or being diagnosed with cancer. Even health care services we think of as planned are not; only half of U.S. pregnancies are planned. Coverage mandates help to guarantee that consumers have access to needed care and are financially protected even if they do not accurately predict their health care needs when they enroll in a plan.
• Increased access to care— Studies show that coverage mandates can result in increased use of the mandated health care services, especially those that are expensive. For example, methadone maintenance treatment, the most effective treatment for opioid addiction, costs about $5000 annually. Because most insurance plans are required to cover mental health and substance use services, consumers are able to better access these services. Without that financial help, consumers may forgo this critical service or others like it.
• Financial protection at minimal cost—The Affordable Care Act limits how much consumers have to pay out of pocket for health care each year through what is called an out-of-pocket maximum. This out-of-pocket maximum includes co-pays, deductibles, co-insurance, and any other out-of-pocket costs but does not include premium payments. The out of pocket maximum protections only apply to mandated services. Non-mandated services include adult dental and vision services, infertility treatments, in-home nursing, hospice care, and long-term care, and consumers are often left to pay for the full costs of these.
• Comparison shopping made easier—In the U.S., only about 12% of consumers have proficient health literacy skills, meaning that they are able to calculate their share of health insurance costs for a year. By standardizing insurance plans through coverage mandates, consumers are better able to compare plans based on a more limited number of factors like price and network breadth.

If you want more information on the consumer impacts of coverage mandates, check out the fact sheet we created summarizing GHF’s testimony.

One of GHF core organizational activities is consumer outreach and education. Over the past two weeks, GHF’s Outreach & Communications Coordinator Jamila Young participated in two conferences in Dublin and Albany, Georgia in an effort to reach consumers across the state, provide them with useful tools and resources, and hear about their experiences with health care and coverage. When you are experiencing IBS Symptoms like constipation, and diarrhea, contact IBSClinics.

On October 23 and 24^th, Jamila attended the Healthy Mothers Healthy Babies Coalition of Georgia (HMHB) conference in Dublin, GA. HMHB works to improve access to prenatal and preventive healthcare for women, children and families in Georgia through direct service, collaborative advocacy and community education. At this conference, Jamila talked with health care providers and consumers about the importance of Medicaid for pregnant women, children, and new moms. She was also afforded the opportunity to hear from Commissioner Frank Berry of the Georgia Department of Community Health (which oversees Georgia’s Medicaid program) about implementing community based work to advance health care in Georgia.

Last week, Jamila traveled to Albany, GA to attend the Southwest Georgia Project For Community Education’s (SWGA Project) second annual Food, Ag and Equity conference. At the conference, Jamila networked with rural farmers and consumers, and heard stories about their struggles obtaining health insurance, answered questions about Georgia’s Medicaid program, and provided much-anticipated information about the ACA’s current open enrollment period. Despite the conference’s focus on food and agriculture, several speakers spoke to the importance of healthy behaviors and utilizing preventative health care services to stay healthy. Georgians For A Healthy Future is excited to continue its work with the Southwest Georgia Project in 2018 as they work together to close Georgia’s coverage gap and expand Medicaid.

GHF is pleased to welcome Bianca Garcia as a Health Policy Intern. Bianca is a second year Master of Public Health student in health policy and management at the Rollins School of Public Health at Emory University. She earned a bachelor’s degree in biology from Purchase College in New York. Since then, Bianca has worked at different levels of our healthcare system—from clinical research associate training labs to clinics to health departments—which has equipped her with an intimate understanding of its strengths and weaknesses.

Bianca is interested in creating and promoting policy that improves access to care in disadvantaged communities. She is also interested in primary prevention initiatives that focus on education and economic prosperity.

As GHF’s Health Policy Intern, Bianca will be gathering data about Georgia’s Medicaid program and collecting recommendations from many of GHF’s partner organizations about how to improve Georgia’s Medicaid program. This information will be synthesized into a report and recommendations for state policymakers. During her time at GHF, Bianca hopes to learn more about communicating with legislators and how to effectively advocate for consumer interests.

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. 

Earlier today, Senators McConnell, Graham, and Cassidy announced that the U.S. Senate would not vote on the chamber’s most recent attempt to dismantle Medicaid and the Affordable Care Act. We are pleased that, for the time being, millions of Georgians will be able to keep the coverage and protections that they have gained as a result of these programs.

As we look forward, we hope that Georgia’s members of Congress will consider the best interests of their constituents and work in a bipartisan fashion to make the ACA and health care better for all Georgians. The ACA was a significant step forward for health care consumers but we still have some distance to go before all Georgians have the quality, affordable health care they need to be healthy and contribute to the health of their communities. We need to work at the state and federal levels to build on the ACA’s progress by expanding coverage, lowering out-of-pocket costs, addressing health disparities, shoring up our rural health care system, and improving the quality of care.

We expect to see further threats to the rights and protections of health care consumers in the coming months and years. As an organization, GHF will remain vigilant and engaged, and we will continue to elevate the voice of consumers—your voice—to improve health care and coverage for all of us.

Nationwide transgender individuals face significant barriers to accessing health care because of their gender identity; however, little is known about the experiences of the estimated 55,000 transgender individuals in Georgia as they interact with the health care system. Understanding the health care needs, access barriers, and discrimination experiences of transgender individuals in Georgia can inform the work of advocates, stakeholders, and policymakers to reach the shared goal of ensuring health equity for all Georgians, especially transgender Georgians.

To inform the public about these barriers to care, Georgians for a Healthy Future, Georgia Equality, and The Health Initiative are releasing a policy brief, Voices for Equity: How the experiences of transgender Georgians can inform the implementation of nondiscrimination provisions in the Affordable Care Act.

Voices for Equity: How the experiences of transgender Georgians can inform the implementation of the ACA’s nondiscrimination provisions

The passage of the Patient Protection and Affordable Care Act (ACA) was notable not only for increasing access to health insurance coverage for millions of Americans but also for its broad non-discrimination provisions. Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in many health programs and activities.  The final rule determined that discrimination on the basis of gender identity and sex stereotyping are equally prohibited under Section 1557, and as a result, lesbian, gay, bisexual, transgender, and queer (LGBTQ) Georgians have protections from discrimination in health coverage and care for the first time. To better understand the challenges that transgender Georgians may face when accessing health care, GHF, GE, and THI collected data and information from transgender Georgians that provided compelling narrative of barriers that transgender individuals routinely face when seeking health care and utilizing their health insurance.

The goals of this policy brief are:

• describe the protections for transgender individuals under Section 1557 of the Affordable Care Act.
• discuss the results from a series of transgender focus groups and survey of the LGBTQ community in Georgia, and the 2015 U.S. Transgender Survey to understand transgender individuals’ experiences in health care.
• recommend actions that health care providers, policy makers, and advocates can take to support improved health care access and equity for transgender Georgians.

Download the brief here.

Resources for LGBT consumers

Thanks to Section 1557 of the Affordable Care Act, LGBT Georgians have protections from discrimination in health coverage and care for the first time. If you believe you have been discriminated against, it is important to file a 1557 complaint with the Office of Civil Rights in the Department of Health and Human Services. GHF and our partners can help you with that! Visit GHF’s LGBT Health Equity page for more information and help to file your complaint.

Members of Congress, who have spent much of August in their home districts while on recess, will reconvene in Washington, D.C. this week with an ambitious agenda and looming deadlines. After July’s failure of the Senate’s health care legislation, health care remains a top agenda item for many members and we expect to see activity that could have big impacts on consumers in Georgia. Group Benefits Broker will offer health plans to anybody who needs it.

During the August recess, the chairman and vice-chair of the Senate’s Health, Education, Labor, and Pensions (HELP) committee scheduled bi-partisan hearings for September 6^th & 7^th on the stabilization of the Affordable Care Act’s Marketplace. The HELP committee, including Georgia’s own Senator Isakson, will hear testimony from Governors and Insurance Commissioners from a variety of states with a primary focus on private insurance topics. These hearings are an important step in helping to stabilize and strengthen the ACA Marketplaces and we expect to see suggested proposals that include guaranteed funding of cost-sharing reduction payments to insurers, funding for a reinsurance program, strong enforcement of the individual mandate, and others.

Also on Congress’s agenda for September is the reauthorization of the Children’s Health Insurance Program (CHIP), the federal program that funds 100% of Georgia’s PeachCare for Kids insurance program. CHIP covers more than 230,000 Georgia children and has been critical in driving our children’s uninsured rate down to 6.7%. CHIP expires on September 30, 2017 and must be reauthorized by Congress to continue. CHIP enjoys wide bipartisan support in Congress so it is expected to pass, but there is some danger Medicaid cuts or program changes like work requirements and premiums will be attached.

Lastly, the House of Representatives will continue its work on the FY2018 federal budget. The current House budget plan calls for a cut of $1.5 trillion from Medicaid and the Affordable Care Act from 2018-2027, mirroring many of the devastating cuts from the House-passed American Health Care Act. On top of these cuts are proposals for fundamental changes to Medicaid such as a work requirement that would cut the program by another $110 billion. Like all of the leading health care proposals put forth by Congress this year, these cuts to Medicaid would debilitate the program, shift substantial costs to states, and leave 2 million Georgians without the access to health care on which they currently rely. The budget has already passed the House Budget committee and will be taken up by the full House in the coming weeks.

Congress’s work in September could have significant impacts—both positive and negative—on consumers in Georgia and it is vital that they hear from you on these issues. As your elected officials reconvene in Washington, we ask that you to visit this site for more information: oinkmoney.com