More than a year after the state launched the Pathways to Coverage program, offering Medicaid in exchange for work or other state-approved activities, advocates say the program is too difficult…
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Year: 2020
Legislative Update: Week 10
The 2020 legislative session has resumed
Yesterday Georgia’s General Assembly resumed the 2020 legislative session after being suspended in March due to safety concerns over COVID-19. Legislators returned to the Capitol on Monday to pick up their work on the state budget and key pieces of legislation. The last ten days of legislative session will be dedicated primarily to the FY 2021 state budget to which Governor Kemp has proposed 11% cuts. Read the State Budget Cuts Are Not Inevitable section below to find out how you can take action for a state budget that supports the health and wellness of Georgians.
Senate committee approves surprise billing legislation
Critical surprise billing legislation heads toward finish line
Earlier this year, companion bills (SB 359 and HB 888) were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. In a rare Sunday meeting, HB 888 was approved by the Senate Health & Human Services Committee. The Senate Rules Committee acted quickly today and approved the bill for a vote on the Senate floor tomorrow, Wednesday, June 17th. Please call your state senator today and encourage their support for this important piece of legislation!
New revenue can improve health in Georgia
State budget cuts are not inevitable
Because of the economic slow-down caused by COVID-19, Georgia’s revenues from sales taxes and other sources have dropped substantially. This has prompted the Governor to call for an 11% cut in state spending. Deep cuts to already-skeletal services and programs will disproportionately harm communities of color and rural communities, weaken Georgia’s health care system as it continues to respond to the pandemic, and curb the state’s ability to recover economically. GHF was one of 37 groups to send a letter to Governor Kemp and state lawmakers last week calling on them to raise new revenues rather than slash spending. New sources of revenue that can also improve health for Georgians include:
- Raising Georgia’s tobacco tax — an increase of $1 per pack would bring in $400 million each year and reduce smoking rates in Georgia
- Expanding Medicaid— in addition to providing health coverage to 500,000 Georgians, Georgia would draw down $3 billion in federal funds each year
- Re-claiming the health insurance assessment—by collecting the revenue from this existing tax, Georgia could bring in $360 million each year to make health insurance more affordable for consumers and small businesses
Georgia Can’t Wait!
Thank you for a successful Virtual Day of Action!
GHF and Cover Georgia welcomed legislators back on to work yesterday by urging them to take action to expand Medicaid. During yesterday’s virtual Day of Action, participants like you sent 500 messages to Governor Kemp and your legislators encouraging them to act immediately to protect the health and financial well-being of 560,000 Georgians by closing Georgia’s coverage gap! Thank you for your advocacy!
If you didn’t get a chance to contact your lawmakers yesterday, call or email today and ask them to act now to close Georgia’s coverage gap!
GHF has you covered
Stay up-to-date with the legislative session and COVID-19
GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.
- Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- GHF’s 2019-2020 legislative priorities
GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.
- COVID-19 Policy priorities for a healthy Georgia — updated weekly
- Your health coverage, care, and well-being — updated weekl
- Mental health & addiction recovery in the time of COVID-19 — updated as new information becomes available
- NEW! Health insurance options for Georgians during COVID-19
Long-standing systemic and structural racism has led to the deep health disparities that as health advocates we regularly reference:
Rates of COVID-19 among Black Georgians outpace their share of the state’s population.
Black mothers in Georgia are twice as likely to give birth to a low-birthweight baby as white Georgians.
Rates of HIV diagnosis are among Black Georgians are six times higher than among white Georgians and more than twice the state’s overall rate.
Black Georgians report higher rates of asthma, diabetes, and other chronic diseases compared to Georgians of other races and ethnicities.
Black Georgians experience higher levels of poverty, food insecurity, and joblessness, all of which impact their health.
The same racist systems & structures that have produced these health outcomes have led to the murders of black people in Georgia and across the country.
This reality and the systems that allow it to persist are not new. Both are unacceptable.
Georgians for a Healthy Future stands with its Black staff, board members, and partners to affirm that Black lives matter. Through our policy advocacy, coalition building and community engagement, GHF is committed to dismantling the racist structures that threaten the health and well-being of Black Georgians and their communities. GHF is also committed to examining our own organizational structures and practices for ways in which we can more fully embody equity, a process which we began earlier this year.
As GHF continues our imperfect work in pursuit of racial justice and health equity, we invite you to join us:
- Contact your elected officials, including your mayor, city council members, and district attorney to advocate for accountability and change, such as the policy changes recommended by the American Public Health Association and PolicyLink
- Want more advocacy? Contact Governor Kemp and your state legislators and ask them to expand Medicaid when they return to the state Capitol this month. More than one-third of uninsured, low-income Georgians who could gain health coverage through Medicaid are Black and more than half are people of color
- Donate to Black-led health advocacy and service organizations like the Black Mamas Matter, Black Women’s Health Imperative, Center for Black Women’s Wellness, Feminist Women’s Health Center, SisterSong, SOWEGA Rising, and other groups serving your community
- Vote, volunteer and seek other ways to be active in your community
- Build power in marginalized, predominantly Black communities: Support BVM Capacity Building Institute and help provide training and support for community‑based organizations
- For non-black allies: deepen your understanding of how racism affects all of us by reading anti‑racism resources and having conversations with your family and friends
- Take care of yourself and your loved ones
More than 1 million Georgians have lost their health coverage due to job loss during the COVID-19 pandemic. If this is your situation, you can keep yourself and your family covered during this health crisis.
You have three main pathways to coverage:
- Affordable Care Act
- With financial assistance—half of Georgians who lose their insurance will qualify for ACA coverage with financial help to lower the premium they pay each month. In some cases, you may see lower deductibles & co-pays too.
- Without financial assistance—some Georgians, despite a job loss, will still make too much for financial help but you should still shop for coverage to see if there’s a plan that fits your new budget.
- Medicaid & PeachCare for Kids—About 25% of Georgians losing their health coverage may qualify for Medicaid. Georgians most likely to qualify for Medicaid coverage include children, low-income pregnant women, and very low-income parents. Other Georgians who qualify for Medicaid are people with disabilities, seniors, and low-income women with breast or cervical cancer.
- COBRA—in most cases, you will be able to find less expensive coverage from the ACA marketplace. COBRA may be the best option for you if it is important that you maintain a consistent provider (pregnant women, people with chronic or complex conditions).
Some Georgians who have lost their health coverage due to job loss will fall in Georgia’s coverage gap because the state has not expanded Medicaid. That means they can’t get financial help through the ACA and they also don’t qualify for Medicaid.
If you are in the coverage gap because you lost your job, please read the If you are uninsured section (click to go directly there). Then contact Georgians for a Healthy Future at 404-567-5016 x 4 to learn how you can share your story and help fix the problem!
Affordable Care Act (ACA) coverage
You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. You only qualify for coverage for 60 days after you lose your health coverage, so shop and enroll as soon as possible. Visit healthcare.gov to shop and enroll.
Financial assistance is available!
When you begin the shopping/enrollment process, healthcare.gov will ask you about your estimated income for 2020. With that information healthcare.gov will let you know if you qualify for financial help to lower your premiums and other costs. Most Georgians qualify for financial help!
When you estimate your income, include the money you made from your job before you were laid off, any unemployment checks that you expect to receive, and any money that you expect to make from getting re-hired/a new job later in the year. Do not count your stimulus check as income!
For free help with the enrollment process, contact Insure Georgia at insurega.org or 866-988-8246.
Coverage through the ACA marketplace covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Contact your insurance company for more information.
Medicaid & PeachCare for Kids
You can enroll yourself, your family, or your children in Medicaid or PeachCare for Kids at any time, if you qualify. Enroll at gateway.ga.gov.
Children are most likely to quality for Medicaid and PeachCare. Pregnant women and some parents may be eligible for Medicaid coverage depending on your monthly income. (The amount of unemployment you get from Georgia counts as income but the additional $600 per week from the federal government does not.)
Click here to see if you can qualify as a parent and to see if your kids qualify. If you are pregnant, you must make less than these amounts to qualify for Medicaid:
Medicaid is required to cover COVID-19 testing and treatment for free. In addition, you do not have to pay any Medicaid or PeachCare premiums or co-pays during the COVID-19 national emergency.
If you have or enroll in Medicaid coverage, you cannot be disenrolled (kicked off) during the COVID-19 national emergency.
If you have questions about Medicaid and whether you qualify, call the Georgia Division for Family & Children Services at 877-423-4746.
You may also contact Atlanta Legal Aid (find the phone number for your county here) or Georgia Legal Services Program at 1-800-498-9469 with questions or concerns.
If you are uninsured/unable to get health coverage
Do not skip or avoid health care just because you are uninsured! You can get free or low-cost health services at:
- Community Health Centers—find the clinics closest to you here
- Charity Care Clinics—find the clinic closest to you here
- Health care over the phone/online (telehealth)—Giving Health offers free telehealth services to people who are uninsured. Visit givinghealth.org/how-it-works or call 866-662-1923.
- Check with your local hospital to see what financial assistance programs you may qualify for
References & resources
COVID-19 Town Hall PowerPoint slides by Center on Budget & Policy Priorities
Frequently Asked Questions by Center on Budget & Policy Priorities
A recent poll from the Kaiser Family Foundation found that 45% of Americans reported that the COVID-19 crisis has harmed their mental health. Anxiety and fear are common with people concerned about contracting the virus, a loved one getting sick, and the economic impact of the crisis, including job loss, lost income, and loss of health care coverage.
Georgia non-profits and state agencies have come together to ensure resources and supports are available for Georgians who need help with their mental health. The following list provides information and links to resources to help get all of us through these difficult times.
If you need to talk to someone:
- National Suicide Prevention Lifeline
Call 1-800-273-8255 or use the chat option on their webpage
en Espanol: 888-628-9454
Deaf and hard-of-hearing: 1-800-799-4889
Open 24/7. We can all help prevent suicide. The Lifeline provides free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
- Georgia Mental Health Consumer Network’s Peer2Peer Warm Line
Call 888-945-1414
Open 24/7/365 providing peer support over the phone. Support is available to all Georgians experiencing anxiety or stress, or who need support through the pandemic. Please call any time.
- Georgia Council on Substance Abuse’s CARES Warm Line
Call or text 844-326-5400
Open every day, 8:30 am to 11 pm. FREE, confidential, and available to anyone who has questions about addiction and recovery, needs someone to listen to them or wants to talk with someone who is also in recovery from substance use disorders.
- Georgia COVID-19 Emotional support line
Call 866-399-8938
Open 24/7. This confidential line offers assistance for those needing emotional support or resource information as a result of the COVID-19 pandemic. The support line is staffed by volunteers, including mental health professionals and others who have been trained in crisis counseling. This is part of a partnership between the Georgia Department of Behavioral Health & Developmental Disabilities, Beacon Health Options, and Behavioral Health Link.
If you need a support group:
- The Georgia Council on Substance Abuse is offering a FREE and confidential series of virtual All Recovery Meetings for those who want to stay connected during COVID-19. To learn more about GCSA and find the most up-to-date meeting times, visit their FaceBook page.
- NAMI Georgia and their local chapters around the state offer virtual support meetings for people with mental illness and family members. To get more information about the meetings, call (770) 408-0625 or email programs@namiga.org.
If you want to learn skills or information about mental health:
COVID-19 and your mental health:
- Learn self-care strategies and get the care you need to help you cope with resources and tips from the Mayo Clinic.
- Mental Health and COVID-19 information and resources, Mental Health America
- Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life
If you have health coverage:
- Medicaid – If you need mental health or substance use recovery services during this time, check with your Medicaid insurance company and doctor to see if you can schedule a safe, socially distanced in-person appointment or a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person. The contact information for your Medicaid insurance company is on the back of your insurance card.
- Private insurance – If you need mental health or substance use recovery services during this time, call your insurance company using the number on the back of your insurance card or visit their website to search for an in-network health care provider near you who offers the services that you need.
- Uninsured – If you need mental health care services during this time, call the Georgia Crisis & Access Line at 800-715-4225, visit the GCAL website, or download the MyGCAL app to find free or low-cost, local mental health & substance abuse services. Georgians should not let their insurance status get in the way of getting needed support or treatment.
- You can find more insurance information and resources (including how your insurance will cover COVID-19 testing & treatment) on our COVID-19: Your health coverage, health care, & well-being blog.
If you want to help:
- If you have completed Mental Health First Aid training and are interested in volunteering to provide support via the Georgia COVID-19 Emotional Support Line please email your name and contact info to MHFAvolunteer@dbhdd.ga.gov
April is Medicaid Awareness Month!
Four ways to celebrate Medicaid Awareness Month with GHF
April is Medicaid Awareness Month and GHF is celebrating!
Medicaid covers half of Georgia kids, half of births in the state, and three out of four Georgians in long-term care (like nursing homes). Without Medicaid, low-income Georgia families would have almost no way to enroll in health coverage. Now, Medicaid is proving even more important to Georgia’s health as our state battles the coronavirus. Medicaid is expanding the number of providers available to treat Georgians during the pandemic and keeping Georgians covered when they may have lost their coverage otherwise.
GHF is celebrating Medicaid Awareness Month and we want you to join us! Here are four ways you can celebrate:
- Contact Governor Kemp and state legislators and encourage them to expand Medicaid
- Schedule a virtual Georgia Voices for Medicaid session by contacting Alyssa Green at agreen@healthyfuturega.org for more information.
- Use and share GHF’s updated fact sheets and resources! Check them out below.
- Share your Medicaid story!
Medicaid as Part of the COVID-19 Response
Medicaid is meant for this moment
Medicaid is key to Georgia’s COVID-19 response efforts. Not only is it providing coverage for 2 million Georgians in the midst of this pandemic, but Medicaid is also one of the fastest ways for the federal government to send money to Georgia and health care providers struggling to meet the needs of Georgia patients and families. Medicaid’s flexibility has allowed more doctors and other providers to step up and make themselves available to treat Georgians with and without COVID-19. Medicaid’s flexibility has also allowed new mothers, children, and many other Georgians to keep their coverage for the duration of the public health emergency when otherwise they may have lost it.
Our partners at Voices for Georgia’s Children are tracking the ways that Medicaid is meeting this moment for Georgians. Check out their weekly tracking sheet to keep up!
Even as Medicaid is helping Georgia respond to COVID-19, it could be doing even more! Before the pandemic, an estimated 500,000 low-income Georgians were uninsured because Georgia has not expanded Medicaid to provide them with health insurance. One million Georgians lost their jobs in the last month, so that number is surely higher now. Governor Kemp and Georgia’s state legislators can easily provide these Georgians with the same health benefits that are available to people in similar situations in 37 other states. Tell Governor Kemp and state legislators to expand Medicaid now.
Need information about Georgia Medicaid? GHF has you covered!
As thousands of Georgians lose their jobs each week, many are also losing their health coverage. Some may qualify for Medicaid as a result. If you, your loved ones, or your patients or clients need information about how to qualify, enroll, and use Medicaid, GHF has the information and resources to get you started:
- Affordable Health Care for Your Children: This fact sheet is written for parents and provides information about the coverage options available to their children.
- For Uninsured Parents: Because parents need health care too, this fact sheet helps parents understand how they can access health care services or find coverage. (The information is also applicable to any uninsured adult.)
- Medicaid in Georgia: Part of GHF’s Get Enrolled. Stay Enrolled toolkit, this fact sheet is meant for individuals and families who may be eligible for Medicaid. It tells you how to apply, what happens after you apply, how to find a doctor, and what health services are covered by Medicaid.
- Medicaid Income Guidelines for Parents, Caregivers, and Kids: Developed for social workers, nurses, counselors, and other professionals who help people meet their basic needs, this fact sheet lays out the income eligibility guidelines for Medicaid for Georgia children and parent/caregivers. Find out if your patients and clients may qualify for coverage.
Medicaid Matters: Coverage saves lives
Queenesther is the mother of five children living in Albany, GA. She and her children, all under the age of 10, receive health care coverage and care through Medicaid. Last year, Queenesther underwent surgery to remove an ectopic pregnancy that was causing severe health issues and could have been fatal.
“Had it not been for Medicaid I wouldn’t have been able to get it removed and who knows what would have happened,” she said, reflecting on the importance of Medicaid for herself and her family.
Queenesther is fortunate to have Medicaid coverage because Georgia makes it very difficult for parents to qualify. Read more of Queenesther’s story on our blog or in GHF’s Medicaid storybook, Medicaid Matters to Georgia.
Your story is powerful. Share it with us! Stories put a face to health care issues in Georgia and inform state leaders about what their constituents need as they make policy decisions. When you share your story, you help others understand the issue and you influence how our state responds to this unprecedented moment.
As Georgia faces the public health emergency of COVID-19, it can be hard to be optimistic about our health and our futures. However, Georgians for a Healthy Future believes that our state can successfully overcome this tremendous challenge if Georgians adhere to the advice of public health experts and our state’s leaders swiftly adopt evidence-based policies that protect the health and safety of all Georgians. At the same time, Georgia leaders must look ahead to ways they can promote the health and well-being of all Georgians in the economically challenging months to come. Georgians for a Healthy Future has identified policy priorities that we believe are necessary for success in addressing the immediate public health emergency and the emerging economic consequences. These are the policies that we will fight for as we continue our fight for the health and wellness of all Georgians.
Our recommendations are shaped by feedback from GHF’s board of directors, partner advocacy organizations, local groups helping Georgians in their communities, and stories from Georgians just like you. You can share your COVID-19 experiences with GHF here. Thank you for your generous input.
As the status of this crisis changes and we gather more information, you can find updates to these policy recommendations and actionable information here.
Health system capacity and public safety
GHF supports:
- Statewide and local shelter-in-place orders and other aggressive social distancing practices to slow the spread of the COVID-19 virus
- Funding to quickly expand the capacity of Georgia’s Department of Public Health to test and monitor the spread of COVID-19
- Funding to purchase personal protective equipment for health care workers
- Funding to purchase equipment for patient care like ventilators and respirators
- Maximizing the scope of practice for all qualified and licensed health care providers (e.g. physicians assistants, advanced practice registered nurses, registered nurses)
- Expanding options and health coverage of telehealth and virtual visits in all medically appropriate circumstances
Access to quality, affordable health care for all Georgians
GHF supports:
- Maximizing Medicaid flexibility and funding to increase access to care by:
- Expanding Medicaid to all poor and near-poor Georgians (those making less than 138 percent of the federal poverty line)
- Taking advantage of emergency 1135 waivers to increase the number of providers who can see Georgians with Medicaid coverage
- Adopting administrative changes to preserve coverage for current Medicaid members and to enroll Georgians who are already eligible but unenrolled, including the expansion of presumptive and retroactive eligibility and a halt on the annual renewal process
- Expanding coverage of home- and community-based services and long-term services and supports
- Expanding access and protections in comprehensive private health coverage
- Promoting enrollment for people who qualify for private insurance, especially among those who are eligible for financial assistance through the Affordable Care Act (ACA) by:
- Establishing a new Special Enrollment Period for people who wish to purchase health insurance now
- Easing the enrollment and paperwork requirements for people enrolling in coverage due to job loss or income changes
- Prohibiting health insurers from canceling a consumer’s coverage, even if they fall behind on premium payments
- Eliminating cost-sharing for COVID-19 testing (and related tests) and treatment
- Limiting the sale of plans that do not offer comprehensive benefits or follow the standards set by the ACA
- Establishing comprehensive surprise billing protections
- Promoting enrollment for people who qualify for private insurance, especially among those who are eligible for financial assistance through the Affordable Care Act (ACA) by:
- Promoting access to mental health services and substance use recovery supports for all Georgians
- Easing limits on prescription drugs so that consumers can more easily access 90-day supplies of medications
Equity at the center of the response
This pandemic will hit some Georgia communities harder than others. All federal and state policy remedies should endure to offer the most help to those who are disadvantaged due to income, race or ethnicity, disability or health status, age, geography, and other factors. Georgia’s response must proactively address health equity concerns. Among other strategies, this should include disseminating public health messages that include information about affected groups and communities in languages and contexts they understand and directing additional funding to community health centers and other providers that serve disproportionately impacted communities.
Meeting the basic needs of Georgians and their families
As evidenced by yesterday’s job loss statistics, it is imperative that the public health response to the COVID-19 crisis be followed by an ambitious economic response. GHF supports policies that provide equitable opportunities for stability, dignity, and well-being for all Georgia families. While not an exhaustive list, these policies include:
- Expanded access to Georgia’s unemployment insurance system, including 26 weeks of benefits and the easing of eligibility requirements and activities.
- A moratorium on foreclosures and evictions, the provision of rental assistance and mortgage forbearance, and other supports that keep Georgians in their homes
- Improved access to nutritious foods through SNAP, WIC, school system food programs, and other public programs
- Universal paid family leave that allows workers regardless of income to take time off to care for themselves and their loved ones in times of sickness and crisis
- A moratorium on utility shut offs, including internet access so that families can keep the lights on and children can continue to learn remotely
GHF will support partner organizations in their efforts to advocate for these policies and supports for Georgia families and individuals.
Some of these policies have been adopted or partially adopted by federal officials, Governor Kemp, and state agency officials. GHF thanks Georgia leaders for the actions they have already taken. In the coming weeks, GHF will track which policies are fully implemented, partially adopted, or not taken up at all, and will provide updates accordingly.
Thank you for your support and advocacy. We wish you health and safety!
Updated: December 18, 2020
The Georgians for a Healthy Future team is continuing to monitor the COVID-19 (coronavirus) outbreak closely. As always, GHF strives to be a resource for Georgia consumers. While things continue to change quickly during this health care pandemic, we will share practical advice and actionable information to help you navigate a confusing time and find the answers you need. Here we present information about how to access health care services and what to expect from your health insurance coverage when you do. We will keep the corresponding blog post updated as things change and with links to helpful resources as they become available.
Georgia’s statewide shelter in place ended on April 30, 2020 for most Georgians. Vulnerable populations including those who are medically fragile and elderly should continue to shelter in place until June 12, 2020.
Governor Kemp also extended Georgia’s public health state of emergency through January 08, 2020. He also issued executive orders requiring businesses to operate by strict social distancing and sanitation rules through May 13, 2020. As of June 1, 2020 restaurants are still required to abide by 39 restrictions to open their dining rooms.
We encourage all of you to continue to help prevent the spread of the virus by taking the necessary steps to “flatten the curve” including staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
If you are experiencing symptoms of COVID-19 or may need a test
If you believe that you are experiencing symptoms of COVID-19 or have been exposed to the novel coronavirus, call your primary care doctor or an urgent care clinic. Let them know you think you may have COVID-19, so they can take the proper precautions and direct you to available testing sites. You may also call the Georgia Department of Public Health on their COVID-19 hotline at 844-442-2681. Public health officials are urging people not show up unannounced at a doctor’s office, emergency room or other health care facility.
The Centers for Disease Control and Prevention have a Coronavirus Self-Checker which may be a helpful tool if you think you are experiencing symptoms of the virus.
You can find out more about COVID-19, its symptoms, what to do if you think you are sick, and other COVID-19 information at dph.georgia.gov/novelcoronavirus.
COVID-19 testing is available for all Georgians, regardless of whether you have coronavirus symptoms. Anyone can call their local health department to get scheduled for testing. They can also download the Augusta University ExpressCare app, visit augustahealth.org, or call (706) 721-1852.
Effective May 7, 2020, COVID-19 testing is available to all Georgians who request it, whether they have symptoms or not. Call your local health department to schedule an appointment at a location near you and to inquire if testing is free.
What to expect from your health insurance
If you have insurance, make sure to use it for any testing and medical exams related to COVID-19 and any other medical services you may need during this time.
The COVID-19 crisis has caused many Georgians to lose their jobs and also lose their employer-sponsored health care coverage. If you have lost your coverage or have had a drop in your income, you may be eligible for Medicaid or financial assistance to buy health insurance through the Affordable Care Act. Please read the If You Lose Your Job section below.
If you have Medicaid or PeachCare for Kids
If you and your family have lost your source of income in this crisis, or are in lower-income work with no health coverage, enrolling in Medicaid may be an option for you.
Medicaid provides all “medically-necessary” services to its members. During the national public health emergency period, your Medicaid coverage will cover the cost of a COVID-19 test. If you are diagnosed with COVID-19 and need medical treatment, Medicaid should also cover those costs.
Check with your Medicaid insurance company for more information and guidance. Click the name of your Medicaid company to find out more: Amerigroup, CareSource, PeachState Health Plan, and WellCare.
If you need other health care services during this time, check with your Medicaid insurance company and doctor to see if you can have a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person.
Georgia’s Department of Community Health (DCH) has announced that Medicaid & PeachCare members will not owe any co-payments for any health service from May 1, 2020 until the end of the national public health emergency.
No one can willingly lose their Medicaid coverage during the public health emergency. If you lose your Medicaid coverage during this time, contact your Medicaid insurance company.
If you have private insurance
If you have insurance through your job, the State Health Benefit Plan, or the Affordable Care Act marketplace (also called healthcare.gov), use it for any testing or medical exams related to COVID-19. The Families First Act requires that health plans and insurers cover testing for COVID-19 so your test should be free. If someone wants to charge you for a test, call the DPH’s COVID-19 hotline.
If you are diagnosed with COVID-19 and require medical treatment, you should expect to pay some out-of-pocket costs like your deductible.
As of March 21, 2020 Cigna, Humana, Aetna, and UnitedHealthcare have waived cost-sharing for COVID-19 treatment. Aetna and Cigna have pledged to waive COVID-19 treatment costs for qualified medical bills until June 1, 2020. Humana has not announced an end date to their COVID-19 cost-sharing policy.
If you purchased coverage outside of the ACA marketplace or you have a short-term plan or health-sharing ministry, call your insurance company to find out how they are covering COVID-19 testing and treatment. The cost-sharing requirement under the Families First Act does not apply to people who are enrolled in non-ACA compliant plans (ex: short-term plans).
If you need other health care services during this time, check with your insurance company and doctor to see if you can have a “virtual appointment” using the internet, a video call, or a telephone call instead of going in-person.
In order to ensure people affected by COVID-19 have access to health care Georgia’s Insurance Commissioner issued a directive on March 20, 2020, that instructed health insurers to refrain from canceling health policies due to non-payment. That directive expires on May 31st. If you are behind on your premium payments or expect to be, call your insurance company right away to see if they can offer a payment plan, financial assistance, or other help to keep you enrolled.
If you have Medicare
Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs. All necessary hospitalizations are also covered by Medicare, including hospitalizations for quarantine. More information about Medicare’s coverage and services is available here.
If you are uninsured
If you need a COVID-19 test, contact your local public health department to find a testing site and to ask whether the test will be free. Request that they waive any testing costs.
If you need other health care services during this time, find a local community clinic, or apply for financial assistance through a hospital charity care program. Georgians should not let their insurance status get in the way of getting needed testing or treatment.
If you lose your job
Many Georgians across the economy have lost their jobs and may be at risk of losing their coverage. If this is your situation, you can keep yourself and your family covered during this health crisis. You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. When you begin the enrollment process, healthcare.gov will ask you about your estimated income for 2020 and will let you know if you qualify for financial help to lower your premiums and other cost-sharing.
For free help with the enrollment process, contact these organizations:
- Insure Georgia, insurega.org, 866-988-8246
- The Health Initiative, thehealthinitiative.org, 404-688-2524 (leave a voicemail in the general mailbox)
Coverage through the ACA marketplace (healthcare.gov) covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Call your insurance company for more information.
If you are unable to enroll in a health insurance plan, you may have other options through services such as a community clinic, which can connect you with the care you need.
Resources for you and your loved ones
During this uncertain time, many of our partner organizations are doing the hard work of finding and centralizing the information that you and your loved ones may need. Here are a few that we think are most helpful. We will continue to update this list with actionable resources and information so you can stay healthy, safe, and well.
- COVID-19 guidance and information
- Information from public health experts: Visit the Georgia Department of Public Health’s website for the latest guidance and updates about COVID-19 in Georgia.
- Coronavirus resources for people who are not strong readers: Georgia State University has published a library coronavirus materials for people who may not have strong reading or literacy skills. They have included materials up to a 9th-grade reading level.
- COVID-19 guidance and information for people who do not speak English as a first language:
- Google Drive folder with resources in 20 languages, collected and maintained by the Center for Pan Asian Community Services
- The GSU School of Public Health’s Prevention Research Center has compiled COVID-19 information sheets (from CDC & the International Rescue Committee) in 25 languages
- Make sure your basic needs and finances are taken care of:
- If you need help finding food:
- Food Bank of Northeast Georgia: Visit www.foodbanknega.org, click “Need Help”. Call the office at (706) 354 8191
- Atlanta Community Food Bank: Text the word FINDFOOD to 888-976-2232 with your ZIP code and street address and you will be sent a list of the three closest distribution centers.
Text service also available in Spanish, using the word COMIDA - Georgia Mountain Food Bank: uses the same system as Atlanta Community Food Bank
- Golden Harvest Food Bank Visit www.goldenharvest.org, click on ‘Find Help’ at the top of the page, you will be taken to a map where you can enter your zip code to find the nearest food distributor
- Middle Georgia Community Food Bank–Call 211 and you will be connected with an associate who will be able to tell you where you can find food
- Feeding the Valley Food Bank: Visit feedingthevalley.org, on the front page, enter your zip code into the ‘Need Food’ box and you will be shown the closest food pantries to your location
- America’s Second Harvest of Coastal Georgia: Visit helpendhunger.org, select ‘Find Food’ on the homepage, you will be taken to a map where you can enter your zip code or county to be shown the nearest food distribution centers
- Second Harvest of South Georgia: Visit feedingsga.org, select ‘Find Help’ in the ‘Learn’ section at the top of the page, you will be taken to a map where you can find the closest distributors to you
- Housing:
- Georgia Covid-19 Resource List, Atlanta Legal Aid Society, Inc.
- GLSP’S Eviction Prevent Project, Georgia Legal Services Program
- Finances:
- COVID-19 stimulus payments: The IRS has published a way for people to receive their recovery refund (also called COVID-19 stimulus payments) even if you were not required to file taxes in 2019. Details are available here.
- Avoid scams: What Consumers Need to Know About COVID-19 Scams, Georgia Watch
- Direct financial assistance: Patient Advocates Fund’s COVID Care Recovery Fund delivers $500 in direct financial aid to eligible patients who need non-medical, cost-of-living help as a result of their diagnosis of COVID-19.
- Financial health during COVID-19: Financial Resilience Center, National Disability Institute
- Health Care:
- Find a clinic – Georgia Primary Care Association
- Find a clinic – Georgia Charitable Care Network
- Resources for people with developmental disabilities:
- COVID-19 Resources for Georgians with Developmental Disabilities, Georgia Council on Developmental Disabilities
- Staying mentally healthy and keeping your recovery: Behavioral Health in the time of COVID-19 by Georgians for a Healthy Future
- Keeping children healthy and well:
- COVID-19 latest information and resources, Voices for Georgia’s Children and Georgia Statewide Afterschool Network
- Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life
- Transitioning Into Your Family’s New “Normal”, Children’s Healthcare of Atlanta
- Five-Minute Coronavirus Stress Resets, The New York Times
- Resources for pregnant families during COVID-19: Healthy Mothers, Healthy Babies Coalition of Georgia has put together a toolkit for families navigating pregnancy, labor, and the postpartum period in Georgia during COVID-19
- Community Health Workers
- Information and Resources for Community Health Workers: This information kit was created for CHWs serving in Georgia to supplement the robust list of information provided by the National Association of Community Health Workers.
A statement from Georgians for a Healthy Future regarding COVID-19
Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times.
We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.
We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.
Legislative Update: Week 9
Crossover Day brings action before suspension of legislative session
Last Thursday, March 12th was the 28th day of the Georgia legislative session, which is also referred to as Crossover Day. Crossover Day is the final day for a bill to cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. The General Assembly finalized changes to the current state budget (FY2020) before suspending the legislative session on Friday, March 13th due to safety concerns about COVID-19. Lieutenant Governor Geoff Duncan and House Speaker David Ralston have committed to resuming the 2020 legislative session when public health concerns subside.
In the sections below, you will find a rundown of consumer health legislation and their statuses following Crossover Day. Those that “crossed over” remain viable and those that “did not cross over” are considered dead for this year. You can see a list of all the bills we’re tracking here.
The General Assembly convened this morning for a one-day special session. They are expected to pass a resolution approving Governor Kemp’s declaration of a public health emergency. With this action, Governor Kemp will have additional power and authority to manage the state’s response to COVID-19.
Our priorities
Surprise billing legislation companion bills cross over
Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a fair payment resolution process that takes consumers out of fights between insurers and health care providers. Both bills have crossed over from their chambers of origin to the opposite chamber.
Legislation to extend postpartum Medicaid coverage crosses over
HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured. HB 1114 was approved by the House last Tuesday.
Crossover Day recap
HB 792: Amended FY 2020 Budget | SENT TO GOVERNOR
HB 792 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2020. The “little budget” has passed both chambers of the General Assembly and has been sent to the Governor.
HB 793: FY 2021 Budget | CROSSED OVER
HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. For more information on the health care highlights in the proposed FY 2021 budget, read the Community Health, Behavioral Health, and Public Health budget overviews from the Georgia Budget & Policy Institute.
HB 511: Rural transit bill | CROSSED OVER
HB 511, sponsored by Representative Kevin Tanner, would create a new division within the Georgia Department of Transportation (GDOT) that would, among other things, oversee rural transit programs including Medicaid’s non-emergency medical transportation (NEMT) services. The bill would divide the state (except for 13 metro-Atlanta counties) into eight regions in which counties could collaborate to raise revenue for and coordinate rural transit services.
HB 544: Mental health emergency involuntary treatment | DID NOT CROSS OVER
HB 544, sponsored by Rep. Chuck Efstration, would make changes to how people in mental health or SUD crises can be committed to emergency involuntary treatment. This legislation could have negative consequences for people with substance use disorders who could be involuntarily committed to treatment under certain circumstances.
HB 719: Effort to modernize HIV laws | CROSSED OVER
HB 719, sponsored by Rep. Deborah Silcox, would modernize Georgia’s HIV-related laws and make progress towards decriminalizing HIV. Current Georgia law deems it a felony for people living with HIV to have sex or donate blood without disclosing their status, or for spitting at or using bodily fluids on a law enforcement officer. Under HB 719 only the act of having sex without disclosing a person’s HIV status would remain illegal.
HB 731: | Tobacco tax increase | DID NOT CROSS OVER
HB 731, sponsored by Rep. Ron Stephens, would raise Georgia’s tobacco tax to $1.87 from its current level of $0.37.
HB 760: Mental health; peace officer authorization | DID NOT CROSS OVER
HB 760, sponsored by Rep. Sharon Cooper, would give peace officers the authority to take a person to a physician or emergency department for emergency examination under certain circumstances.
HB 842: Gracie’s Law – organ transplant discrimination| CROSSED OVER
HB 842, sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities.
HB 864: | Excise tax on vaping products | DID NOT CROSS OVER
HB 864, sponsored by Rep. Bonnie Rich would add a 7% excise tax to vaping products and would require businesses that sell vaping products to register with the state for a $250 fee.
HB 918: Restricts onerous PBM audits of pharmacies | CROSSED OVER
HB 918, sponsored by Rep. Sharon Cooper, puts in place limits on the practices of PBMs within these audits so that pharmacies can more easily meet audit requests and the benefit of the doubt is given to pharmacies when small or innocuous mistakes are discovered.
HB 946: Increases accountability for PBMs | CROSSED OVER
HB 946, sponsored by Rep. Matt Knight, would increase fines on PBMs when they “steer” consumers to specific pharmacies and would prohibit PBMs from paying affiliated pharmacies more than independent ones. The bill would require PBMs to pass along rebates to insurers (who would presumably pass those savings on to consumers) and would ban programs called “co-pay accumulators.” Co-pay accumulators increase out-of-pocket costs for consumers who need prescription drugs, especially those with expensive medications and those with high deductibles and other cost-sharing.
HB 947: Examining the costs of PBMs in Medicaid | CROSSED OVER
HB 947, sponsored by Rep. Matt Knight, would require Georgia’s Department of Community Health to complete an independent study to find out if Georgia would save money by removing the current PBM structure from its Medicaid plans. If the estimated savings are more than $20 million annually, Georgia would eliminate PBMs from most of the state’s Medicaid plans.
HB 1079: Authorizes full Medicaid expansion through an 1115 waiver | DID NOT CROSS OVER
HB 1079, sponsored by Rep. Kim Schofield, would allow the state to submit a new 1115 waiver that would expand Medicaid to all Georgians making less than 138% of the federal poverty line.
HB 1114: Extending postpartum Medicaid coverage | CROSSED OVER
HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured.
HB 1151: Network adequacy | DID NOT CROSS OVER
HB 1151, sponsored by Rep. Kim Schofield, would increase consumer access to health care by imposing quantitative standards on insurance companies’ provider networks. Georgia has the narrowest provider networks in the country, forcing people to pay more to find care outside of their insurance plan’s approved providers. Network adequacy standards would ensure that consumers can access a provider in their insurance network for all covered benefits.
HB 1153: Short-term limited duration plans | DID NOT CROSS OVER
HB 1153, sponsored by Rep. Kim Schofield, would limit short-term health plans to 3 months and provide consumer protections like protections for people with pre-existing conditions.
HR 1280: Addressing childhood lead exposure | DID NOT CROSS OVER
HR 1280, introduced by Rep. Katie Dempsey, establishes a Joint Study Committee on Childhood Lead Exposure to address the issue of thousands of Georgia children under six years of age who were found to have lead poisoning, which is irreversible and can cause speech, language, and behavioral problems, lower IQ levels, and nervous system damage.
*Note: Because this is a resolution (rather than a bill), this resolution is still viable for passage and could be used to establish a House study committee.
SB 298: Raising age to purchase tobacco and vaping products| DID NOT CROSS OVER
SB 298, sponsored by Sen. Renee Unterman, would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age, among other things.
SB 303: Georgia Right to Shop Act | CROSSED OVER
SB 303, sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee, would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information.
SB 313: Benchmarking for prescription drug prices | CROSSED OVER
SB 313, sponsored by Senator Dean Burke, had its second hearing in the Senate Insurance and Labor committee last Wednesday. This bill would update Georgia’s oversight of pharmacy benefit managers and add important consumer protections.
SB 348: Consumer Right to Access Act | DID NOT CROSS OVER
SB 348, sponsored by Senator Kirkpatrick, is aimed at addressing network adequacy. The bill includes similar language to SB 352 (below) and also directs Georgia’s Insurance Commissioner to set quantitative network adequacy standards to ensure Georgia consumers have adequate access to care within their insurance plans.
SB 352: Online provider directories | CROSSED OVER
SB 352, sponsored by Senator Burke, would allow consumers to see providers at in-network rates for their entire plan year, if the provider is listed as in-network at the time a person enrolls in their health plan. The providers included in a consumer’s insurance plan network changes regularly throughout the year and this bill would assure that the provider network advertised at the time of enrollment is the provider network they are able to access all year long.
GHF has you covered
Stay up-to-date with the legislative session
GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.
- Sign up for the Georgia Health ActionNetwork (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- GHF’s 2019-2020 legislative priorities
Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times.
We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.
We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.
Legislative Update: Week 8
General Assembly continues work on budgets ahead of Crossover Day
Last week the Senate passed their version of the FY2020 state budget (the “little budget”). This week the House and Senate will appoint a conference committee to work out the remaining differences in their versions of the little budget before it gets a final approval by both chambers. This morning the House Appropriations committee has passed its version of the FY2021 budget, which will begin July 1st of this year and run through June 30, 2021. The big budget will be considered by the full House chamber later this week.
Committee hearings will continue in earnest as legislators try to move their priority bills ahead of this week’s Crossover Day deadline. (Crossover Day is the 28th day of session and the deadline by which bills must pass the House or the Senate in order to remain viable to become law.) In next week’s legislative update, we will run down which health bills were left on the cutting room floor and which ones remain viable for this year.
Bill introduced to extend postpartum Medicaid coverage
Legislation would allow moms to keep Medicaid coverage up to six months after giving birth
HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured. The bill has been referred to the House Health & Human Services committee and has the support of Healthy Mothers Healthy Babies Coalition of Georgia, GHF, and other consumer health advocacy groups.
Learn more about this legislation and maternal health in Georgia in a new blog from the Georgia Budget & Policy Institute.
Surprise billing and Gracie’s Law approved
Surprise billing protections are another step closer to passage
Companion bills were introduced in the House and Senate last month to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. Last week the House passed its version of this important consumer-focused legislation, HB 888. The Senate has already approved SB 359, which closely mirrors the House bill. The Senate bill is expected to be amended in the House Special Committee on Access to Quality Health Care so that it exactly matches the House version and better protects against surprise bills in emergency situations. Both bills are expected to be considered up by their respective committees after Crossover Day.
Gracie’s Law moves on to Senate
Gracie’s Law (HB 842), sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities. Gracie’s Law was approved by the House on February 28th and is now in the Senate Health and Human Services Committee. The bill is supported by The Arc of Georgia, the Georgia Council on Developmental Disabilities, and other disability advocacy organizations.
(For more on this bill, please read our earlier legislative update.)
Pharmacy benefit manager legislation keeps moving
Four bills to reform PBM practices in Georgia move forward ahead of Crossover Day
Georgia’s House and Senate continued their efforts last week to change how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies.
HB 946 and HB 947, both sponsored by Rep. Matt Knight and HB 918, sponsored by Rep. Sharon Cooper, were passed by the House on Wednesday. HB 946 was referred to the Senate Insurance and Labor committee, and HB 918 and HB 947 were referred to the Senate Health and Human Services committee. Similarly, SB 313sponsored by Senator Dean Burke, was approved by the Senate on Thursday.
(For an overview of the bills, please read our March 2nd legislative update.)
GHF has you covered
Stay up-to-date with the legislative session
GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.
- Sign up for the Georgia Health ActionNetwork (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- GHF’s 2019-2020 legislative priorities
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