The GHF team loves bringing you these weekly legislative updates, and you have told us that you enjoy reading them! Our team works hard to deliver this service to you in a complete and accurate way every week of Georgia’s legislative session. If you rely on these updates to keep you connected to the health happenings under the Gold Dome, please consider supporting our work with a donation today. Thank you very much!
In this week’s update:
New bill on network adequacy!
Budget updates
New legislation on tobacco, vaping, and moving to a state-run ACA marketplace
Advocacy events for your calendar
GHF’s got you covered this session!
ENSURING GEORGIANS ACCESS TO QUALITY HEALTH CARE!
The CATCH Act aims to protect Georgians from high health care costs
SB 20 has been introduced by Sen. Kay Kirkpatrick and is titled the Consumer Access to Contracted Healthcare (CATCH) Act. The CATCH Act revises Georgia’s Surprise Billing legislation to set network adequacy standards for insurers and provides protections for when consumers are forced to go out of a health plan’s network of providers for care.
Network adequacy measures a health plan’s ability to deliver reasonable and timely access to the health care services needed by their members. This includes primary care, specialty, and mental health providers. In order for health plans to have adequate provider networks, they must have enough in-network providers and benefits to offer access to all medically necessary services within a reasonable time.
When health plans do not have adequate networks, they do not have a sufficient number of contracted health care providers. That forces members to wait or travel long distances for critical health care services. In many cases, they are forced to see out-of-network providers and pay more for their care. When consumers face these kinds of barriers, they may delay or skip necessary medical care.
The CATCH Act aims to address this issue by updating Georgia’s network adequacy standards. Georgia’s current standards are almost 30 years old and give health insurers a lot of flexibility. The CATCH Act would require insurers to meet specific requirements for network adequacy, including maximum wait times for appointments. The CATCH Act also creates a number of consumer protections for instances when health plans do not meet the new requirements and consumers are forced to go out of network for care. For example, insurers would have to cover out-of-network services at in-network prices when the plan does not have the needed type of provider available in-network.
Budget check: The Georgia House of Representatives passed the amended FY23 budget on Thursday. The amended budget updates the current state budget, which runs through the end of June. It now goes to the Senate for consideration. The Senate Appropriations Health & Human Development Subcommittee already has a meeting scheduled for tomorrow (2/7) at 1 pm to review the amended budget. d
The House Appropriations committee and its subcommittees will turn their attention to the FY24 budget, which will go into effect on July 1st. We will keep you updated as both budgets complete the legislative process.
Here are a few bills that we believe deserve your attention and the attention of legislators.
Increase in tobacco tax
HB 191, introduced by Rep. Ron Stephens, would raise the tobacco tax by 20 cents. This would increase the current tax from 37 cents to 57 cents. The revenue from this increase will be appropriated for health care purposes throughout Georgia.
Tobacco taxes are one of the most effective policies to reduce smoking rates. To see Georgians quit smoking or vaping, our state would need to raise the tobacco tax by more than the proposed 20 cents. GHF supports an increase of at least $1. Read more about the importance of a tobacco tax increase here.
HB 192, introduced by Rep. Ron Stephens, would increase the tax for vaping products. Vaping products are currently taxed at 7% and HB 192 would increase the tax to 15%.
GHF is excited to see the increase in this tax introduced alongside an increase in the tobacco tax. By increasing the cost of both products, we would hope that consumers do not simply switch between one product and another when the price goes up.
SB 47, sponsored by Sen. Chuck Hufstetler, would update the Indoor Air Quality Act.The changes would prohibit vaping in the same areas that smoking is currently banned in Georgia. Georgia’s smoking ban was put in place in 2005, well before vaping became popular.
Seventeen percent (17%) of Georgia high schoolers report vaping. Because vaping products include nicotine, vaping can lead to addiction (just like cigarettes). It may also lead to lung disease.
Bill would allow Georgia to set up a state ACA marketplace
Introduced by Sen. Ben Watson, SB 65, would allow Georgia to establish its own state-based marketplace (SBM) for health insurance. The bill also allows the Commissioner of Insurance to create an advisory committee to provide recommendations for establishing an SBM. Lastly, it removes the ban on state entities, including the University of Georgia, from operating health insurance navigator programs.
When the Affordable Care Act’s health insurance marketplace went in effect in 2014, states had the option to create their own health insurance marketplace (state-based marketplace) or use the federally-facilitated marketplace (FFM) – i.e. healthcare.gov. Eighteen (18) states have set up SBMs, which gives them more control over their health insurance marketplaces. SBMs are a state-federal partnership and are developed with oversight from the Centers from Medicare and Medicaid Services (CMS). While SBMs allow states to innovate in ways that can cut health insurance costs and improve quality, they are time and cost-intensive to set-up and maintain with no guarantee of good results.
It may help to think of the current federally facilitated marketplace (healthcare.gov) as a reliable car with automatic shifting and a GPS that generally gets passengers to the right destination. A state-based marketplace is like a stick-shift car that needs a skilled driver with a strong sense of direction and a good map.
If SB 65 is approved by the legislature, the Governor has indicated that his goal is to run Georgia’s SBM as a part of his Access Model proposal. This move would side-step the federal hold on his attempt to separate Georgians from healthcare.gov. We will continue to monitor the bill and provide updates as we know more.
GET INVOLVED!
Check out these advocacy events:
Each week during the legislative session, we’ll highlight legislative advocacy days from partner groups. These are great opportunities for you to participate in the lawmaking process by meeting your legislators and speaking up about important issues. Upcoming:
If you have an upcoming advocacy event that you’d like included, please contact Alex McDoniel at amcdoniel@healthyfuturega.org.
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, here are tools to help you 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
Georgia Pathways to Coverage Medicaid program too limited, too costly, analysis finds
Jess Mador
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…
