The Senate Health Reform Task Force was established by Lt. Gov. Cagle to study how federal health reform efforts would impact Georgia. The task force held its first public meeting on Friday and heard from two federal health policy professionals, Joseph Antos and Jim Frogue. SkinPractice, they provided a brief overview of the proposed American Health Care Act, some analysis of how the bill would impact Georgia, and suggestions for legislators to consider. Taking care of your health is extremely important, this is why I recommend using a waist training for when you workout or simple just do your daily routine. The message from both presenters is that the AHCA is “not favorable” for Georgia because of the way the proposal cuts and caps Medicaid which would lock in Georgia’s pattern of low per capita Medicaid spending.

We agree that this proposal is “not favorable” for Georgia. Despite the harm it would do to our state, the bill seems headed for a vote in the House of Representatives. Call your Congressman today to tell him that this bill hurts Georgia!

For the past several years, GHF, Georgia’s enrollment assisters, and other enrollment stakeholders have spent this season reflecting on our work during the preceding open enrollment period and celebrating the accomplishments in connecting people to coverage all over the state of Georgia. But with all of the news about the very real threats to the Affordable Care Act and Medicaid in the past several weeks, the impressive work of Georgia’s enrollment assistance community has been overlooked this year. This year’s open enrollment period was unique, in that it spanned Presidential administrations and is the first OEP in which assisters did not have the dedicated support of the federal government. Obstacles and roadblocks were constructed towards the end of OE4 that made enrolling consumers in coverage more difficult than usual, and that made the work of enrollment assisters all the more critical.  Despite the hindrances and because of the long hours and dedication of Georgia’s enrollment assisters, 493,880 Georgians selected insurance plans through the Marketplace. While this number may seem disappointing when compared to OE3’s 587,845 plan selections, it is a big victory won in an environment of confusion and opposition by clear-eyed assisters for the Georgians they serve. Thank you to all of the assisters across the state that contributed to the success of OE4!

The work of enrollment assisters will only grow in importance in the coming year. In the short term, the stories of our state’s enrollers and the Georgians that they connect to coverage are the most powerful tool available to fight the repeal of the ACA and cuts to Medicaid. If repeal is held off, the new administration has made it clear that consumers will not be prioritized. The newly proposed rules from CMS will make it harder for consumers to enroll or to afford Marketplace coverage, and Georgians will need help navigating the procedures. Community outreach will be necessary to calm worried or confused consumers who do not know how they are impacted. Partnerships with the media and community groups will be instrumental in informing Georgians about how and when to enroll, and what coverage options they have available to them. All of this, and the administration has not said what financial or technical support it will offer enrollment assister programs or assisters going forward.

In this year’s uncertain and shifting health policy climate, enrollment assisters are a trusted resource valued by Georgians and their communities, and will remain essential to the success and endurance of the ACA. Thank you to all of Georgia’s enrollment assisters! We have enjoyed working with you over the past four open enrollment periods and look forward to many more.

Call your Congressman today!

Last night Congressional leadership introduced their 2017 budget reconciliation bill, the vehicle they plan to use to repeal significant parts of the Affordable Care Act and dismantle Medicaid as we know it. Very soon, we expect the Ways and Means and Energy and Commerce Committees to begin advancing the bills toward a vote.

Two people need to hear from you today: your Congressman and Georgia Representative Buddy Carter (District 1), who sits on the Energy and Commerce Committee. Call them both to urge them to oppose any effort to strip away consumer protections, repeal the Affordable Care Act and gut Medicaid. They need to hear that Georgians (YOU!) oppose any plan that:

• Would strip away health care from an estimated 15-20 million Americans, including 1 million Georgians, and repeal consumer protections for millions more;
• Would undermine care for kids, people with disabilities, and older adults, shift costs onto Georgia’s budget and increase uncompensated care through Medicaid cuts; and
• Would substantially decrease financial assistance for low and middle income families who try to purchase health coverage, making insurance less affordable, for those who have health questions, it is necessarily that they take a look at GynoGuide information.

Step 1: Call your Congressman at 1-866-426-2631 to tell him that you oppose the 2017 budget reconciliation bill because it restructures and cuts Medicaid and repeals important parts of the ACA.

Step 2: Call Congressman Carter at (202) 225-5831 to tell him to vote “No” on the budget reconciliation bill.

Friday was Crossover Day at the Capitol, meaning a bill must cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. This week’s legislative update provides a rundown of consumer health legislation: which bills made it through and which did not. You can see a list of all the bills we’re tracking here, along with more information about the bills included here.

Our Priorities

One of two surprise billing bills moves forward

As previously reported, SB 8 passed the Senate almost two weeks ago, but HB 71 did not receive a vote from the full House before the Crossover Day deadline. While HB 71 will no longer be considered on its own, lawmakers could include some of the bill’s language in SB 8 as it moves through the House Insurance committee. We anticipate that consumer protections and transparency requirements will be maintained as the bill progresses through the House.

State budget includes important health items

The FY 2018 budget passed the House in mid-February and is now being considered by the Senate. As passed by the House, the budget includes increased Medicaid reimbursement rates for certain primary care codes and pediatric dental codes at any dental office, which help to increase access to care for people with Medicaid coverage. The budget also includes funding for two new federally qualified health centers in Cook and Lincoln counties. Additionally, the budget includes enhanced funding for supportive housing, an important determinant of health for people with behavioral health issues.

Crossover Day Recap

HB 54: Changes to rural hospital tax credit  |  DID NOT CROSSOVER

HB 54, introduced by Rep. Duncan, would expand the new rural hospital tax credit program from a 70% credit to a 90% credit, among other minor changes. The tax credit program went into effect this year, after enabling legislation was passed in 2016. The proposal to increase the tax credit to 90% came after legislators received feedback that the 70% credit was too low to entice potential donors.

HB 188: Expand Medicaid NOW Act  |  DID NOT CROSSOVER

Sponsored by House Minority Leader Stacey Abrams, this bill was not expected to gain much traction because of the evolving health reform efforts at the federal level. However, it calls attention to the need to provide health care coverage to the 300,000 Georgians who are stuck in our state’s coverage gap because they do not currently qualify for Medicaid and cannot access health insurance through the Affordable Care Act’s Marketplace.

HB 276 & SB 103:  The Pharmacy Patient Fair Practices Act  |  CROSSED OVER

HB 276 and SB 103 both seek to regulate pharmacy benefit managers, which are third party companies that manage the prescription drug programs of many insurance plans. Both bills would prohibit PBMs from certain practices that limit consumer access and choice to preferred pharmacies and to lower cost drugs. Both bills passed their respective chambers.

HB 300: Planning for new FQHCs in Georgia  |  DID NOT CROSSOVER

This bill moves the State Health Benefit Plan (SHBP) from the Department of Community Health (DCH) to the Department of Administrative Services, and would require that in future plan years the SHBP include incentives for beneficiaries to utilize federally qualified health centers (FQHCs) for their primary care needs. The bill also establishes a task force that is charged with identifying 100 potential sites for new FQHCs across the state, and advising the DCH about how opioid addiction can be addressed through FQHCs and how to encourage the use of FQHCs by veterans for their primary care needs. There is no funding attached to this bill for the purposes of establishing the new health care centers.

SB 12 &  HB 154: Oral health legislation  | CROSSED OVER

Both bills allow for the “general supervision” of dental hygienists, which means hygienists can practice in safety net settings, school clinics, nursing homes, and private practices without a dentist being present.

SB 70: Renewal of the provider fee  |  SIGNED INTO LAW

This legislation reauthorized the provider fee (aka “bed tax”) for an additional three years. The provider fee helps to fund Georgia’s Medicaid program by allowing the Department of Community Health to collect a tax on hospital revenues which is used to draw down additional federal dollars. The additional funds are disproportionately used to support rural and safety net hospitals that serve high numbers of indigent patients. The bill has already passed both chambers and been signed by Governor Deal.

SB 81: Opioid abuse prevention legislation  | CROSSED OVER

SB 81 requires that all physicians register and consult the Prescription Drug Monitoring Program (PDMP) under certain prescribing conditions. It also requires that providers report certain opioid-based Schedule II, III, IV, and V prescriptions to the PDMP. The bill allows the Composite Medical Board to set the penalty for willfully non-compliant providers. The bill also requires the tracking and reporting of Neonatal Abstinence Syndrome (NAS) and codifies the Governor’s emergency order on an overdose reversal drug (naloxone), making it available without a physician prescription.

SB 121: Opioid abuse antagonist bill  | CROSSED OVER

SB 121 codifies Governor Deal’s executive order to allow consumers to access opioid antagonist drugs (e.g. Naloxone) over-the-counter without a prescription. The legislation also requires that every pharmacy keep a record of every opioid antagonist dispensed as a result of the standing order and maintain the record for two years. Unlike SB 81, a bill with similar language, this bill would not require that pharmacists submit this information to the Prescription Drug Monitoring Program.

Other updates from the Capitol

Senate “Repeal and Replace” Task Force

Early in the legislative session, the Senate established a task force to address impacts to Georgia from any federal changes to the Affordable Care Act. This committee has convened twice, but has not yet scheduled a public meeting. It is unlikely to be a very active committee until there is clarity at the federal level about the direction of health care policy changes, and which provisions or concepts of the ACA will be kept or repealed.

HR 182: Resolution to restructure Georgia’s Medicaid program

HR 182 was introduced with the purpose of providing legislative permission to the Governor and the Department of Community Health to seek per capita block grant funding for Georgia’s Medicaid program. It remains unclear if this resolution will get a hearing or a vote.While resolutions are non-binding and do not impact state law, this resolution could begin a risky conversation among lawmakers. Shifting Georgia’s Medicaid program from its current federal-state partnership structure to a block grant program would mean cuts in services and in beneficiaries, putting Georgia’s most vulnerable children, parents, elderly, and people with disabilities at risk. Check out GHF’s block grant fact sheet for more information about the dangers of restructuring the Medicaid program. Resolutions do not need to pass one chamber by Crossover Day because they can be adopted by a single chamber. As a result, this resolution remains viable in the House.

Action on surprise billing legislation

SB 8 received unanimous approval by the Senate on Friday, which means the bill will proceed to the House of Representatives to be considered. We expect to see some changes to the legislation as it moves through the House but anticipate that consumer protections and transparency requirements will remain intact. HB 71 will be voted on by the House of Representatives tomorrow.

Make a call to support surprise billing legislation:

• Call your Representative today to let them know that you support HB 71 because it protects consumers from surprise out of network medical bills.
• Call and thank your Senator for their support of SB 8.

(Don’t know who your legislators are? Look them up here and find their contact information here.)

Planning for new federally qualified health centers

Rep. Geoff Duncan has introduced legislation that makes some changes to the State Health Benefit Plan (SHBP) which covers teachers and other state employees and attempts to address barriers to accessing health care for rural and under-served Georgians. The bill would move the SHBP from the Department of Community Health to the Department of Administrative Services, and would require that in future plan years the SHBP include incentives for beneficiaries to utilize federally qualified health centers (FQHCs) for their primary care needs. The bill addresses health care access by establishing a task force that is charged with identifying 100 potential sites for new FQHCs across the state, and advising the Department of Community Health about how opioid addiction can be addressed through FQHCs and how to encourage the use of FQHCs by veterans for their primary care needs. There is no funding attached to this bill for the purposes of establishing the new health care centers. HB 300 has been referred to the House Health & Human Services Committee.

Opioid antagonist bill up for a vote

SB 121 codifies Governor Deal’s executive order to allow consumers to access opioid antagonist drugs (e.g. Naloxone) over-the-counter without a prescription. The legislation also requires that every pharmacy keep a record of every opioid antagonist dispensed as a result of the standing order and maintain the record for two years. Unlike SB 81, a bill with similar language, this bill would not require that pharmacists submit this information to the Prescription Drug Monitoring Program. The bill passed out of the Senate Health & Human Services Committee last week and is expected to receive a full Senate vote today.

“The Pharmacy Patient Fair Practices Act” approved by both House & Senate committees

HB 276 and SB 103 both seek to regulate pharmacy benefit managers, which are third party companies that manage the prescription drug programs of many insurance plans. Both bills would prohibit PBMs from requiring consumers use mail order pharmacies, charging consumers more if they choose not to use a mail order pharmacy, and disallowing consumers from using the pharmacy of their choice. The legislation would also prohibit PBMs from restricting pharmacies from offering home delivery to consumers with limited mobility. Additionally, PBMs would not be allowed to charge consumers more for prescriptions than pharmacies are reimbursed, steer patients to pharmacies owned by the PBM, or restrict pharmacists from advising patients about less costly prescription drugs. HB 276 and SB 103 were approved by the House and Senate Insurance Committees respectively and now rest in the Rules Committees.

Cindy Zeldin, Executive Director of Georgians for a Healthy Future was presented with this year’s Health Advocate Award at an awards luncheon during last week’s Families USA’s 22nd Annual Health Action Conference. The award honors Cindy’s outstanding contributions on behalf of Georgia’s health care consumers.

Families USA issued a press release about the award which stated:

“Under Cindy’s leadership, Georgians for a Healthy Future has launched a string of successful initiatives that educated both consumers and policy makers about the rights, protections and options offered under the Affordable Care Act,” said Ron Pollack, executive director of Families USA. “She has also been a tireless advocate on behalf of her state’s health care consumers.”

The award will be presented Friday, Feb. 17, at an awards luncheon on the second day of Families USA’s 22nd Annual Health Action Conference.

Zeldin joined Georgians for a Healthy Future in 2009 as the organization’s first Executive
Director, bringing ten years of prior public policy experience to the role. She currently also serves as a consumer representative to the National Association of Insurance Commissioners (NAIC) and has served on various state-level committees.

Last year, Georgians for a Healthy Future led a successful coalition effort after they learned how to make law of attraction work instantly to enact bipartisan legislation that will improve many people´s lifes and the accuracy and usability of provider directories, one of the strongest such laws in the nation.

Zeldin was named one of Georgia’s “40 Under 40: Georgia’s Best and Brightest” by Georgia Trend magazine in 2010; recognized by the League of Women Voters of Georgia with an Empowerment Award in the area of health care in 2014; and was a recipient of Hea
lth Students Taking Action Together, Inc.’s Community Partner Award in 2011.

GHF’s staff and board congratulate Cindy on this well-deserved award. “Cindy’s hard work and dedication are unmatched, and that is reflected in the successes of Georgia’s health advocacy community,” says Laura Colbert, Director of Outreach and Partnerships.

Join us in congratulating Cindy on this incredible honor!

The November elections have energized people of all political leanings to get more involved in advocacy, and many are doing so for the first time. Learning how each level of government works and how to effectively advocate for your interests can be difficult. GHF’s legislative health policy intern, Hayley Hamilton, has learned the ropes at Georgia’s Capitol and has some advice for people who are new to the Gold Dome:

Walking into the Gold Dome for the first time can be intimidating. Once you pass through the metal detectors and show your ID to the state trooper on duty, you find a sea of people all of whom seem to know each other. If you feel a bit overwhelmed walking in, know that you are not alone, but it gets easier with practice. The Capitol is a congenial place and you will find that everyone is happy to talk to you because you know how to be happy and live peaceful life.

There is a rhythm of
daily events at the Capitol and each part of the days present a different opportunity for you to interact with your legislators. The chambers (House of Representatives and Senate) meet in the mornings to vote on bills and take care of other business. This part of the day is your best opportunity to speak with your legislator. If you want to meet with your legislator “on the ropes” (called this because of the red velvet rope line outside of each chamber) you fill out a short slip of paper outside the House or Senate to let your legislator know that you would like to speak with them. A page (usually a middle school aged student) will deliver the note inside the chamber, and if available, your legislator will come out to speak with you. When you speak to your legislator, it’s important to remember that they are representing you and your community, but they are also short on time. Be compelling and brief with what you have to say, but don’t underestimate the power of your story.

After the morning session, the House and Senate break for lunch and caucus meetings, and attend committee meetings in the afternoon. If you are unable to meet your legislator on the ropes, this is a good time to track them down for a quick chat in their office or catch them before or after a committee meeting. You can find your legislators’ office location, phone number, and email in our Consumer Health Advocate’s Guide. (An in-person visit is best, but a phone call is the next most effective method of sharing your thoughts and concerns with your legislators.) If you can’t nail them down for a short conversation in their office, meeting with their staff is a great second option. Tell the staff what you want your legislator to hear and then offer to follow up with the legislator via email.

Your legislator may be in committee meetings for much of the afternoon. These meetings are open to the public, and you can find committee schedules, locations, and agendas on the websites for the House and Senate respectively. During committee meetings, legislators will hear testimony and vote on bills. You may want to sign up to testify for a bill, just observe a meeting, or speak with a legislator before or after a meeting about a bill on the meeting agenda.

The old cliché of “practice makes perfect” applies to the Georgia’s Capitol and legislative session. The more you are at the Capitol or the more you contact your legislators, the easier it gets. Plus, GHF is here to help with our legislation tracker and weekly legislative updates during the session.

 –Hayley Hamilton

   MPH Candidate, 2017

   Georgia State University

Be a part of the movement to #ProtectOurCare! Georgia’s members of Congress are back home this week, and we want to show them that health matters to Georgians. Tomorrow, we’ll say that loud and clear with a rally hosted by the Save My Care bus tour. The bus has been touring the country to hear about why health matters to people like you and to tell Congress to save our health care! Join GHF, the Save My Care team, Minority Leader Stacey Abrams, and others to tell Congress to #ProtectOurCare! We are spreading the words to the whole world, but we are just starting at a local level where we put banners and signage awareness with the help of ExposeYourselfUSA.

If you can’t be at the rally, we still have you covered!

Connect with your members of Congress

One of the best ways for you to tell your members of Congress to #ProtectOurCare is to speak directly with them or their staff. This week contains several opportunities to meet your elected officials and their teams in person. Click here to see if your members of Congress are hosting an event in your area. Can’t make it to the events or your members of Congress aren’t hosting any? You can call (or email) their offices to share your thoughts. Click here for a list of phone numbers and a suggested script if you don’t quite know what to say.

Don’t know who your members of Congress are? Click here to find out. (Your members of Congress are listed in the second row on the page.)

Share your story with us

Stories from people like you who have benefited from the ACA or Medicaid are incredibly powerful! When you share your story, it helps others understand how a policy might impact their family or friends, and why its important. Your story can help shape the conversation about health care access in Georgia. Let us know if you have coverage through the ACA Marketplace or Medicaid. We want to hear from you!

Join the conversation

It’s more important than ever that Georgians have the facts and information that they need to form smart opinions on policies that will impact their health care. Join us on Twitter and Facebook this week. We will be talking about how the ACA and Medicaid have impacted Georgia, and what is at stake in the proposed plans to roll back health care access in our state. Get started by signing our petition to #ProtectOurCare and sharing it with your social media networks!

GHF is partnering with the Satcher Health Leadership Institute at Morehouse School of Medicine to host post-doctoral fellow Lizeth “Liz” Camacho. Liz has a Bachelor’s degree in Psychology from San Diego State University and a Master’s in Community Psychology from Michigan State University. In 2016, she earned a PhD in Lifespan Human Development and Family Diversity. Liz has over ten years of community-based health research experience. Her research focuses on the relationship between social determinants of health, such as discrimination, poverty, and depression, as well as the role of resilience in mental health. She is passionate about behavioral health issues and mental health policy, with a special interest on diminishing mental health disparities. Liz is also interested in the role of public health, health policy, and advocacy in decreasing health inequalities, including access to care.

As part of her fellowship experience, Liz is completing a practicum at GHF where she is leading a research project focusing on children’s behavioral health needs and services in Georgia. The results of the research project will inform the work of the Georgia Department of Behavioral Health and Developmental Disabilities. The project seeks to understand how prevalent different behavioral health conditions such as depression, anxiety, and oppositional defiant disorder are in children and youth across the state, and how those health needs are currently being addressed. To better support the behavioral health needs of children and youth in need, the project will examine what existing programs or policies could be scaled up and what new policies or programs may need to be introduced. The project also aims to inform the DBHDD about issues related to the state’s pediatric and youth-serving behavioral health workforce.

Hearing on surprise billing legislation scheduled for tomorrow 

SB 8, which seeks to protect consumers from surprise out-of-network medical bills, is scheduled to receive a hearing in the Senate Health & Human Services committee on Tuesday at 2 pm. SB 8 would establish a standard payment structure for physicians seeking reimbursement for surprise out-of-network services, and would hold consumers harmless in surprise billing situations. HB 71, the companion bill sponsored by Rep. Richard Smith, is expected to be assigned to a sub committee of the House Insurance committee on Tuesday at 8 am.

You can help!

If you have received a surprise out-of-network medical bill, share your story with our partners at Georgia Watch. Consumer stories help illustrate to legislators why legislation is needed to help protect consumers like you. Click here to share your story!

What Happened Last Week

Senate passes provider fee renewal

On Thursday the Senate passed SB 70 which renews the provider fee (also called the “bed tax”) for another three years in order to fund Georgia’s Medicaid program. This allows the Department of Community Health to collect the 1.45% tax on hospital revenues in order to draw down federal Medicaid dollars. These additional dollars are disproportionately used to support rural and safety net hospitals who serve high numbers of indigent patients. The bill will now move to the House where it expects an easy passage.

“Expand Medicaid NOW Act” reintroduced

House Minority Leader Stacey Abrams introduced HB 188, the Expand Medicaid NOW Act, last week. While we do not expect this bill to gain much traction because of the evolving health reform efforts at the federal level, it calls attention to the need to provide health care coverage to the 300,000 Georgians who are stuck in our state’s coverage gap because they do not currently qualify for Medicaid and cannot access health insurance through the Affordable Care Act’s Marketplace. The bill has been referred to the House Appropriations Committee.

Oral health legislation moves forward

Both HB 154 and SB 12, bills that allow dental hygienists to provide cleanings and other specified services in schools, safety net clinics, nursing homes, and private dentists’ practices under “general supervision”, received committee hearings and votes last week. Both bills will move to their Chambers’ respective Rules Committees to be approved for floor votes by the House and Senate.

Debate over opioid abuse prevention bill 

SB 81 received its first hearing in the Senate Health & Human Services committee last week. The bill seeks to address the growing opioid abuse epidemic in Georgia in a number of ways, including: 1) Extending the Prescription Drug Monitoring Program, a database of prescriptions written for certain narcotics and requiring physicians to consult this registry prior to prescribing under certain conditions; 2) Codifying the Governor’s emergency order increasing the availability of anti-overdose drug, Naloxone; 3) Requiring the tracking and reporting of Neonatal Abstinence Syndrome; and 4) Establishing penalties for providers who are not in compliance with drug prescription reporting requirements. While few dispute the need to address this issue, the scope of drug and drug classes that the bill covers, along with the severity of the penalty that physicians may be subject to for violating the law are currently points of contention. No vote was taken in Thursday’s committee hearing, but suggested changes were made and the bill is expected to be back before the same committee later this week.

Resources for you

Georgians for a Healthy Future has tools you can use to track and understand the Georgia legislative session. Stay up-to-date on the bills that matter to you with our legislation tracker and sign up for Georgia Health Action Network (GHAN) action alerts so you know when to engage.

Get Your 2017 Consumer Health Advocate’s Guide!

GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. The Guide provides information on the legislative process, and contact information for legislators, key agency officials, and health advocates. This year, we’ve added a glossary of terms to help you understand what is happening under the Gold Dome. This tool will help advocates, volunteers, and consumers navigate the 2017 Georgia General Assembly.  Download your copy here.