A consumer health advocates guide to the 2020 elections: Georgia’s General Assembly

This year, no Georgian has been left untouched by the health or economic impacts of COVID-19. The global pandemic has spotlighted the importance of public policy decisions that prioritize the health and wellness of populations, the consequences of underfunding government agencies (like departments of public health) and other essential public infrastructure, and the disparate impact that public policies have had on Black Americans and other people of color.  National, state, and local leaders, many elected by the public, are responsible for the policy decisions made ahead of and in response to COVID-19, its economic fallout, and the movement for racial justice .

Ahead of Election Day on November 6, 2020, Georgians have the opportunity to learn more about these elected positions, the decision-making power each has, and how that may impact their health and the well-being of Georgians. This year, Georgians will cast their votes for the U.S. President, members of Congress,  state legislators, state supreme court judges, and other positions.  Voters’ decisions about the candidates in each race will have an unprecedented impact on consumers health issues in Georgia as we continue to battle through the current health crisis.

Georgia’s General Assembly
Pictures from the Georgia state capitol featuring GHF and health advocates

Georgia’s General Assembly is made up of two chambers: the House of Representatives and the Senate. Georgia has one of the largest state legislatures in the nation with a total of 236 members, compromised of 56 Senators and 180 Representatives. Every Georgia resident has one Georgia Senator and one Georgia House member, both of whom are up for re-election every two years. All of Georgia’s state legislative seats are on the ballot this fall.

Georgia’s state budget

Constitutionally, the General Assembly is only responsible for proposing and passing an annual state budget; however, during the body’s annual 40-day session, legislators also propose, debate, and pass laws for the state of Georgia, including those that regulate health care, health coverage, or that impact health through another sector (like education, housing, or transportation).  

All appropriations bills, which define how state money can be spent, must begin in the House. Each year, after the Governor proposes a state budget, the legislative leaders of the House turn the proposed budget into a bill for consideration by the House’s Appropriations committee and then by all House members. As the House considers the budget, it hears from leaders of state agencies, lobbyists for various interest groups, advocates like GHF, and from members of the public about how the state should spend its budget for the next year.

When the House has approved the budget, the budget goes through the same process in the Senate. Once approved by both chambers, any differences are worked out in a conference committee, before sending the budget back to the Governor to be approved or vetoed.

Due to the on-going coronavirus crisis, this year’s budget considerations by the General Assembly were influenced by falling state revenues. The General Assembly decided against finding new ways for Georgia to bring in money from increased tobacco taxes, taxes on insurance companies, and other revenue-generating ideas. Instead, the Georgia House and Senate passed a state budget that included $2.2 billion in budget cuts for the FY 2021 budget. The approved budget cuts  will have negative consequences for critical health care programs and social services. For example, a $91 million reduction in funds to the Department of Behavioral Health and Developmental Disabilities will make it more difficult for uninsured adults to find treatment for substance use disorders. The $8.2 million cut to the Department of Public Health will severely decrease programs that promote health care access in rural and underserved areas.

State laws

Members of the General Assembly may propose laws to address issues of concern for their constituents. These issues can range from surprise out-of-network medical billing to the opioid crisis to Medicaid expansion to maternal mortality. Many legislators receive ideas for legislation from concerns and complaints brought to them by their constituents (an important reason to get to know your legislators!).

Each year, hundreds of bills are proposed and only a fraction successfully pass both chambers. Health-related bills typically pass through the Health & Human Services and Insurance Committees in each chamber. Legislators can consider bills until Sine Die, the 40th and last day of the legislative session. When approved by both chambers, successful legislation goes to the Governor for approval or veto.

Two of the most impactful pieces of health-related legislation passed by the state legislature this year were HB 888, the Surprise Billing Consumer Protection Act, and HB 1114, postpartum Medicaid coverage. HB 888 will ban surprise billing in emergency situations and for non-emergency health services when a consumer is at an in-network hospital or other facility, beginning January 1, 2021. HB 1114 will allow new mothers to receive Medicaid coverage for six months after giving birth. (Previously, new moms were covered for only 60 days after giving birth.) Both of these bills will improve health and well-being of Georgians. Oppositely, in 2019, the Georgia General Assembly passed HB 481, which would have outlawed most abortions after 6 weeks of pregnancy. This law would have worsened Georgia’s maternal mortality crisis and was deemed illegal by a federal court.

This year’s election

Georgia’s General Assembly will have many new faces after the upcoming election, each of whom will play a role in shaping the state’s health care landscape over the next two years or more. Whether and how the state addresses issues like COVID-19, health care affordability, the opioid crisis, and the sustainability of the rural health care system may be decided by voters at the ballot box this November. Be sure you know the candidates for Georgia’s Senate and House on your ballot and how they plan to act on the health issues that are important to you.


This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2020 election on timely consumer health issues. Please be on the lookout for more blogs in this series.

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.


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Five Years in the Making: Consumer Advocates’ Role in Passing Comprehensive Surprise Billing Legislation

Quote from consumer about surprise billing and summary of blog

Today, Governor Kemp signed the Surprise Billing Consumer Protection Act into law! Georgians for a Healthy Future and our partners at Georgia Watch strongly supported this bipartisan bill to protect consumers from surprise out-of-network medical bills.

These exorbitant bills often burden patients with high amounts of medical debt. In fact, over half of debt collection actions contain medical debts, leading to bankruptcy for many consumers. Take George C. of Lilburn, for instance, who had his right foot amputated at an in-network hospital. Even after obtaining assurances from his insurer that the provider was in network, he still found himself stuck with costly medical bills. “I found out they used out-of-network providers when they assured me they would [not]. They would not dismiss the bills and I had no alternative but to file for bankruptcy,” said George, after receiving surprise medical bills totaling $60,000.

With the signing of the Surprise Billing Consumer Protection Act, the state has taken an important step toward protecting consumers from the nightmare scenario George experienced. Georgia is the 16th state to have adopted comprehensive protections against surprise medical bills, covering an estimated 2.5 million Georgia residents when the law goes into effect in 2021.

As a bonus, the legislation also allows Georgia to establish an all payer claims database (APCD), which is a powerful tool used by 19 other states. Georgia’s APCD will inform the surprise billing payment resolution process, but will also be used to help policymakers, stakeholders, and advocates develop better understandings of health care costs, use of services, population health trends, and disparities.

Thank you to all who followed the surprise billing debate and helped bring it across the finish line by contacting your legislators at each stage of the process!

This win was a long time in the making, and a very committed group of state leaders worked tirelessly on surprise medical bill protections for many years. That includes the bill sponsors, Sen. Chuck Hufstetler and Rep. Lee Hawkins, Chairman Richard Smith,  and the Governor and Lieutenant Governor and their staffs. Georgia Watch and Georgians for a Healthy Future (GHF) were fortunate to play meaningful roles as well.


The beginning of the debate

The Georgia General Assembly’s consideration of surprise billing protections stretches back to 2015 when legislators began to look at the inter-related issues of network adequacy and surprise out-of-network medical billing (called surprise billing or balance billing). Following the 2015 legislative session, the Georgia Senate convened the Consumer and Provider Protection Act study committee to look at these issues and to which GHF’s then Executive Director was appointed.

Picture of a speaker at a podium

To buttress the work of the committee and highlight the importance of addressing both surprise billing and network adequacy for consumers, Georgia Watch and GHF held the Getting What You Pay For policy forum in February 2016. As a result of the study committee’s work, the policy forum, and powerful advocacy by Georgia Watch and GHF, the 2016 legislative session saw the successful passage of SB 302, which required health insurers to maintain accurate lists (called “provider directories”) of in-network medical providers.

While the state legislature did not have the appetite to take on surprise billing in all of its complexities in 2016, Georgia Watch and GHF knew this important consumer issue had the attention of policymakers.


Stalemate

We did not want to lose the momentum for surprise billing protections. Using the time between the 2016 legislative session and the start of the 2017 session, Georgia Watch and GHF worked closely with legislative leaders to inform their thinking on the issue and to craft legislation. Unfortunately, the legislative options put forward by state leaders in the 2017 session failed because of disagreements between insurers and providers about how to resolve payment disputes.

Dedicated leadership by legislators and continued partnership with consumer advocates could not overcome the entrenched disagreements between doctors and hospitals, and health insurance companies over the costs of care. This dynamic continued through the 2018 and 2019 legislative sessions, leaving consumers vulnerable to expensive, unfair medical bills through no fault of their own.


“If you want to go fast, go alone. If you want to go far, go together.”

Recognizing the on-going stalemate, Georgia Watch and GHF thought carefully about how to overcome this impasse. After studying surprise billing successes in other states, we agreed that success would require a united front from legislative leaders with a Georgia-specific solution.

Georgia Watch and GHF approached Sen. Hufstetler, Chairman Smith, and Rep. Hawkins about pursuing a “united front” strategy in the summer of 2019, and as a result of the trusting relationships we had built with them over many years, they agreed to participate and guide the process. Through GHF’s relationships at Georgetown University’s Center on Health Insurance Reform, we were able to bring in national experts on surprise billing who shared the latest information on state and federal proposals and discussed how other states tackled major issues, both of which helped bring a few fresh ideas to the table. Sen. Hufstetler and Reps. Smith and Hawkins—as eager as we were to break the stalemate—used that information and input from Georgian Watch and Georgians for a Healthy Future to develop a solution that works for Georgia but that was informed by efforts in other states.

This bi-cameral strategy attracted the support of Gov. Kemp and Lt. Gov. Duncan, both of whom had already expressed interest in passing surprise billing protections. When HB 888 and SB 359 were introduced in January, state leaders showed courage and commitment by sticking with the approach they had collectively developed, even over the objections of some stakeholders.

As the bill moved through the General Assembly, more state legislators, hospitals, and provider groups lent their support to the legislation. Moving this bill across the finish line involved negotiation among multiple parties, support from our partners in the patient and consumer advocacy community, storytelling from consumers who had experienced surprise bills, and a reliance on the trusted relationships that Georgia Watch and GHF had with state leaders.

Our efforts now move to the Georgia Department of Insurance (DOI) and the Office of Health Strategy & Coordination (OHSC). DOI will write the rules that guide the implementation of surprise billing protections which will take effect on January 1, 2021. The OHSC will develop funding for and lead the creation of Georgia’s all payer claims database.


It is rare for a state to go from no protections to comprehensive protections in one fell swoop, especially with the near unanimous support we saw in the Georgia General Assembly. Georgia Watch and GHF believe that this success demonstrates the incredible impact of long-term, sustained consumer advocacy at the Georgia Capitol and in other spaces where decisions are made. This kind of advocacy takes staff time, focus, expertise, and resources, all of which are provided by individual donors and philanthropic funders like you.

Our organizations work for you but we cannot do our work without you! Please support our consumer advocacy efforts with a donation today. Thank you!

Consider a donation to our partners at Georgia Watch too!


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GHF welcomes new Story Collection Coordinator

GHF is excited to welcome Lois Hairston as the organization’s new Story Collection Coordinator. In this role, Lois will work to collect, develop, and share the stories of Georgia individuals and families as part of GHF’s Close the Gap initiative.

Lois is a graduate of Old Dominion in Virginia, where this past year, she served as the Communication and Membership Chair for the University’s Black Alumni Chapter. Her professional background includes experience with marketing agencies in Virginia and the District of Columbia, where she managed direct marketing campaigns for clients such as the Democratic Governors Association and the HealthWell Foundation. Recently, in her role as Communications Manager for Youth Entrepreneurs, Lois managed the creation of branded content and acted as the public relations liaison for the national nonprofit.

When Lois first moved to Atlanta in 2016, she took a position with Spelman College leading fundraising campaigns for faculty, students, and young alumnae. She was also nominated and served as Vice President of the Spelman Staff Council Board. Before joining GHF, Lois was an independent contractor in the disciplines of photography, graphic design, and media production.

Purposeful, driven, and creative, Lois’s mantra is to get better every day, even if only by a little!

We are pleased that Lois has joined our team! You can contact Lois at lhairston@healthyfuturega.org or 404-567-5016 x 4.


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Legislative Update: Steep budget cuts and significant health bills close 2020 session

Sine Die

Georgia’s 2020 legislative session comes to a close

Friday, June 26, marked the final day of the 2020 Georgia legislative session. This year’s Sine Die (the last day of the legislative session) came after a months-long suspension due to safety concerns over COVID-19. The final two-week legislative sprint brought the approval of a number of bills that will benefit consumers if approved by the Governor. Unfortunately, this progress comes against a backdrop of steep budget cuts that will put many Georgians at risk, especially those who are most marginalized.

Below you will find an overview of the approved state budget, summaries of notable health-related legislation, and short status reports on other health bills. GHF’s legislative tracker is updated so you can check on the health bills you were watching this session.


General Assembly passes FY2021 state budget

Legislators’ primary responsibility upon returning to the state capitol this month was to finish and pass the FY 2021 state budget, which goes into effect this Wednesday, July 1. On Thursday, the Georgia House and Senate passed a state budget that includes $2.2 billion in budget cuts for the FY 2021 budget. Although cuts were reduced from 14% to 10%, the approved budget curtails funds to many critical health care programs and social services. Notable changes to this year’s budget include:

  • Department of Behavioral Health and Developmental Disabilities: $91 million cut
    • One-third of the cuts ($29 million) comes from adult developmental disability services 
    • Another third ($29.9 million) comes from child and adult mental health services
  • Department of Community Health: Increase of $178 million
    • Increase in funds due to a higher projected growth for Medicaid
    • $19.7 million added to provide six-months of Medicaid coverage for new mothers (see below for more info.)
  • Department of Public Health: $8.2 million cut
    • Funding restored for grants to local health departments
    • No reduction in funding for maternal mortality review board

The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. Voice’s for Georgia’s Children also has a relatively easy-to-read version of the budget changes here.


Our priorities

General Assembly passes four bills to reform PBM practices in Georgia 

This year’s Georgia General Assembly took a keen interest in pharmacy benefit managers (commonly called PBMs). PBMs are companies that manage prescription drug benefits for health insurance companies. In order to secure lower prices on medications, PBMs have adopted practices that are seen as burdensome by pharmacies, restrictive and hard-to-navigate by consumers, and opaque by elected officials. The following four PBM bills were passed last week in an effort to increase patient access to and decrease costs of medications:

  • HB 918, sponsored by Rep. Sharon Cooper, limits the practices of PBMs as they audit pharmacies so that pharmacies can more easily meet audit requests. The bill gives the benefit of the doubt to pharmacies when small or innocuous mistakes are discovered.
  • HB 946, sponsored by Rep. Matt Knight, and SB 313 by Senator Dean Burke are companion bills with the same legislative language. Both bills would require that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. The bills also increase fines on PBMs when they “steer” consumers to specific pharmacies and disallows PBMs from building drug formularies (lists of covered medicines) in a way that discriminates against people with prescription drug needs.
  • HB 991, sponsored by Rep. Matt Hatchet, establishes an oversight committee which will oversee the contracts and subcontracts under the State Health Benefit Plan (covers state employees and their families), Medicaid, and PeachCare for Kids. This legislation aims to increase transparency around the pharmacy benefit managers contracted by these plans. The oversight committee is made of nine members, one of whom must be a consumer covered by one of the state health plans.

Bill to increase taxes and raise the age of purchase for vaping products passes

Multiple pieces of legislation were introduced this year that would change the way Georgia regulates tobacco, vaping devices and other nicotine products. Ultimately, only SB 375, sponsored by Senator Jeff Mullins, saw final passage. The bill will establish a 7% tax on vaping products and would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age. This increase in the so-called “age of purchase” brings state law in line with federal law.


Legislation to establish an All Payer Claims Database passed

SB 482, sponsored by Senator Dean Burke, builds on Georgia’s new surprise billing legislation (HB 888). HB 888 authorizes Georgia’s Department of Insurance to establish an all payer claims database (APCD) that will inform the surprise billing payment resolution process. APCDs can be a powerful tool that can also help policymakers, stakeholders, and advocates develop better understandings of health care costs, use of services, population trends, and disparities.

SB 482 goes farther than HB 888 by setting up an advisory body to assist in the creation of the APCD and establishing the purposes of the APCD, among other provisions. The advisory body does not currently include consumer representation. 

The creation of Georgia’s APCD is subject to appropriations. It was not funded in the FY2021 budget but state leaders have expressed optimism about funding it in future state budgets and attracting private funds to help support its development.


Surprise billing legislation awaits Governor’s signature

The Surprise Billing Consumer Protection Act (House Bill 888), was recently passed by the General Assembly and now heads to Governor Kemp’s desk for his signature.

This bill will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers. After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how legislation will work and what consumers may expect.

After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how the legislation will work and what consumers may expect.


Postpartum Medicaid coverage bill passed and funded

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth, up from the current 60-day limit. The General Assembly approved the legislation and funding ($19.7 million) last week. HB 1114 now heads to Governor Kemp’s desk for his signature.

In order for this change to take effect, the Georgia Department of Community Health will need approval from federal health officials.


Sine Die recap

HB 792: Amended FY 2020 Budget | SIGNED BY 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 been signed by the Governor. The amended budget went into effect on March 17th.


HB 793: FY 2020 Budget | SIGNED BY GOVERNOR HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. The budget includes several steep cuts to behavioral health and other health care programs. 


HB 719:  Effort to modernize HIV laws | DID NOT PASS 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 789: Creation of a surprise bill rating system | PASSED HB 789, sponsored by Rep. Mark Newton, would create a surprise bill rating system based upon the number of certain physician specialty groups contracted with a hospital within a health insurer’s network. 


HB 842: Gracie’s Law – organ transplant discrimination | DID NOT PASS 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 987: Protection of elderly persons | PASSED HB 987, sponsored by Rep. Sharon Cooper, would increase training requirements for staff members in elderly care facilities and raises the number of staff who would have to be on site at any given time to watch over residents. It would also increase fines for violations or if a facility causes a resident’s death.


SB 303: Georgia Right to Shop Act | PASSED 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 352: Online provider directories | DID NOT PASS 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.


SB 408: Family Care Act Sunset Removal | PASSED SB 408, sponsored by Senator Brian Strickland, would extend the sunset on the Family Care Act to July 1, 2023. The Family Care Act allows employees to use sick time to care for ill family members. 


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.

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.


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Medicaid expansion: An evidence-based response to COVID-19, unemployment, & racial disparities

“Any plan that does not address the coverage gap is insufficient and ultimately fails Georgians. Refusing to address coverage on the front end means that our friends and family lead less productive lives and end up (with) bills they cannot afford that get left with the state at the end of the day. This is our problem one way or the other and the Governor’s Medicaid plan does not address the fundamental problem facing Georgians, which is the lack of basic health care.”

— Commenter

Georgia remains one of 14 states that has not yet expanded Medicaid to cover low-income adults. As a result, more than 400,000 poor, uninsured Georgians have no health coverage during a pandemic, a number that is growing as more Georgians lose their jobs and their job-based coverage.

While the health and economic impacts of COVID-19 are hitting Georgians of color hardest, uninsured rates were consistently higher among Black and Hispanic Georgians compared to whites even before the pandemic began. Thirty six percent (36%) of those in the coverage gap between Medicaid and the Affordable Care Act’s marketplace are Black and 22% are Hispanic.

In the face of clear evidence that Medicaid expansion would benefit Georgians impacted by COVID-19, support Georgia’s COVID-19 response efforts, and reduce health disparities experienced by Black and Hispanic Georgians, Governor Kemp continues to pursue a plan that he put forward in 2019 that would allow Medicaid to cover a small fraction of low-income, uninsured Georgia adults and cost the state three times more per person to operate. The plan would not cover any additional Georgians until July 2021.

In November 2019 and January 2020, Georgians were asked to participate in two 30-day public comment periods to tell state decision makers and federal health officials what they thought of Governor Kemp’s Medicaid plan. Over 2,700 comments were submitted during the two comment periods.

GHF conducted an analysis of all available comments and found that by a 9-to-1 margin, commenters were opposed to Gov. Kemp’s plan and preferred a full Medicaid expansion. Commenters largely felt that Gov. Kemp’s plan did not cover enough people, ignored the great financial deal offered by a full Medicaid expansion, and imposed too many barriers to health care.

Even though the comment periods occurred before the health and economic impacts of the COVID-19 pandemic unfolded and the movement for racial justice was sparked by the violent deaths of Black Georgians and others, commenters touched on themes relevant to both:

“Medicaid helps my community by increasing the health and longevity of parents and children, especially in communities of color, in order to be able to provide increase parenting skills and empowerment for adults, and healthier growth and development for the children. It also decreases the equity gaps produced by centuries of inequities in all areas of our state institutions. This is turn contributes to better educational attainment and decreased crime—a direct correlation with better and preventative healthcare provided by Medicaid—which benefits all of us!”

— Commenter

“I am a person living with HIV and Medicaid expansion is critically important for me. Under the partial Medicaid expansion proposal, I would not be eligible because I make too much. However, I am in between jobs and don’t have the resources to pay for healthcare coverage. I am concerned that the funds allocated could be better utilized to serve more Georgians like myself. Georgia would have to pay 3 times more per person than it would under Medicaid expansion.”

— Commenter

“I have a severe disability that limits my ability to work, so I work part-time from home. Every extra bureaucratic step involved in getting the medications and healthcare I need to function well, directly lowers the number of hours I can work and engage with my community. Delays in receiving this care can impact me for weeks, months, or years, potentially resulting in permanent loss of function. I want all of my neighbors, friends, and family to be able to access the care they need to live fulfilling lives. Instead of opting for the Governor’s expensive Medicaid waiver that will leave hundreds of thousands of Georgians uninsured, please expand Medicare coverage instead. . . Georgians want everyone who needs healthcare to get coverage, not to institute needless and complicated barriers to care. Our generosity in caring for each other is what will make our state great.”

— Commenter

“I am one of 5,000 volunteer caseworkers with St Vincent de Paul Georgia working each day around our state to help low income people in need. We meet working people every day who cannot pay their rent because of unexpected medical bills. We see people going without medical care and needed medications and their numbers are growing…The recent coronavirus outbreak and shocking mass shootings should drive home the fact that denying people access to primary care and mental healthcare makes all of us vulnerable…”

— Commenter

“ Governor Kemp’s plan is fiscally and morally irresponsible. This plan will cost more money to cover fewer Georgians than full Medicaid expansion leaving thousands of Georgians who would be eligible for Medicaid without healthcare….This plan is bad for Georgia and bad for our budget.”

–Commenter

The COVID-19 pandemic and the uprising for racial justice have added urgency to the calls for an equitable health system that is accessible and affordable for all Georgians. Medicaid expansion will help Georgia meet this moment.


Legislative Update: Medicaid coverage for new moms, tobacco tax increase, & action on state budget

Legislative Update: Week 11

Final days of 2020 legislative session set as General Assembly debates budget cuts

Last week legislators returned to the Capitol to complete their work on the FY 2021 state budget and address key legislative priorities. On Friday, the Georgia Senate passed a state budget that cuts $2.6 billion in spending during the upcoming year. This budget includes deep cuts to K-12 education and to critical health care programs, which we have detailed below along with next steps in the budget process.

On Saturday, the General Assembly set the calendar for the remainder of the legislative session. Both chambers will convene every day this week and plan to conclude their 2020 business this Friday, June 26th, likely late in the evening.

Don’t miss the bevy of action alerts in this week’s email. Scroll down for actions you can take to make improve Medicaid coverage for new mothers, increase Georgia’s tobacco tax, and protect Georgia’s budget from drastic cuts.


Surprise Billing Legislation Unanimously Approved By Senate

Surprise billing legislation heads to Governor’s desk

Last week, the Georgia Senate unanimously approved the Surprise Billing Consumer Protection Act (House Bill 888), bringing Georgia one step away from ending onerous surprise medical bills. HB 888 now heads to Governor Kemp’s desk for his signature. The Governor is expected to sign the bill as he pointed to this issue as a high priority during his January State of the State address.

This bill will mark a huge win for Georgians as it will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers.  Please call these leaders and thank them for their support and dedication to this issue:

  • Gov. Brian Kemp: 404-656-1776
  • Lt. Gov. Geoff Duncan: 404-656-5030
  • Senator Chuck Hufstetler: 404-656-0034
  • Chairman Richard Smith: 404-656-5141
  • Representative Lee Hawkins: 404-656-7855

Legislation to Extend Postpartum Medicaid Coverage Moves Ahead

Postpartum Medicaid coverage bill heads to Senate floor today

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. After unanimous approval in the Senate Health and Human Services committee last week, this legislation heads to the Senate floor for a vote today. 

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.

Action alert: Contact your state senator now and encourage their support for the passage and funding of this important piece of legislation! The Senate will convene at noon and a vote on HB 1114 is expected soon after.


 Progress on Tobacco Tax Increase

Resolution to increase tobacco tax moves ahead in Senate

On Friday, the Senate Finance Committee approved SR 435, sponsored by Senator Randy Robertson, aimed at increasing the tobacco tax rate from 37 cents to $1.35 per pack. We thank the members of the Senate Finance Committee for their quick action to find and approve new revenue to improve health in Georgia. Raising Georgia’s tobacco tax could bring in as much as $600 million annually and help to lower smoking rates among youth and adults.

Action alert

  1. Please contact members of the Senate Rules Committee and ask them to approve the bill for a vote on the Senate floor.
  2. Call or email your state senator today and encourage their support for this important piece of legislation!


Georgia Senate Passes State Budger that Includes Deep Cuts

Key health programs see cuts of $250 million

Last Thursday, the Senate passed its version of the FY2021 budget, which will begin July 1, 2020. The budget includes deep cuts to many state agencies, including 12 furlough days for staff and hiring freezes. The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. State agencies and programs that directly impact the health of Georgians were not spared in the budget cuts:  

  • Department of Behavioral Health & Developmental Disabilities would see a cut of $122 million total, with the biggest cuts focused on services for adults with developmental disabilities, child and adolescent mental health services, (including prevention programs and supported education services), housing vouchers for people with mental illnesses and other adult mental health services, and adult substance use recovery services.
  • Department of Public Health would see a cut of $27.4 million total. More than half of that cut ($13.9 million) would come from a reduction in grants to local health departments and another $4.9 million would be cut from health promotion funds.
  • Department of Human Services (which includes the Dept. of Family & Children Services, Division of Aging Services, and other agencies serving vulnerable populations) would see a cut of $100 million. The funding cut would require 50 Dept. of Family & Children Services office to close and consolidate, exacerbating the limited access of families to food assistance, cash assistance for families with children, and other social services. 
  • Georgia’s Medicaid agency, the Department of Community Health, was able to offset $205 million in cuts because the federal government has increased its support of the Medicaid and PeachCare programs as part of the federal coronavirus relief packages, although some cuts were still made in the DCH budget.

 The budget is now being considered by a conference committee made up of members from both the House and Senate. Please contact these conference committee members to let them know that they can avert these steep budget cuts by considering new revenue options. Several common sense proposals (Increasing Georgia’s tobacco tax, expanding Medicaid, reclaiming the health insurance assessmentamong other options) could increase revenue without impacting the amount of taxes paid by the vast majority of Georgia families. Contact the budget conference committee members today!

  • Senator Mike Dugan: 404-656-7872
  • Senator Blake Tillery: 404-656-0089
  • Senate Butch Miller: 404-656-6578
  • Representative Terry England: 404-463-2247
  • Representative Jon Burns: 404-656-5052
  • Representative Jan Jones: 404-656-5072

Pharmacy Benefit Manager Legislation Keeps Moving

Two bills to reform PBM practices in Georgia move forward 

Georgia’s House and Senate continued their efforts last week to better regulate how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. After presenting a revised version of SB 313, Senator Dean Burke’s bill was approved by the House Special Committee on Access to Quality Health Care. The revised version requires that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. GHF will detail the other revisions included in SB 313 in future email updates.

Additionally, Rep. Knight’s HB 946 was approved by the Senate Insurance & Labor Committee on Friday and was passed by the full Senate today. The bill will return to the House for an “agree” to the bill’s amendments before it heads to the Governor’s desk.
 

(For an overview of both bills in their original forms, please read our March 2nd legislative update.)


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.

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.





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Legislative Update: Surprise billing moves ahead, budget cuts, & Georgia Can’t Wait!

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

Ask Governor Kemp and your state lawmakers today to avert budget cuts and improve health in Georgia by raising state revenue!  


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.

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.


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Health insurance options for Georgians during COVID-19

An estimated 1.4 million Georgians have lost their health coverage due to job loss. If this is your situation, you can keep yourself and your family covered during this health crisis.

You have three main pathways to coverage:

  1. Affordable Care Act (ACA) coverage
    1. With financial assistance—half of Georgians who lose their insurance (775,000) will qualify for ACA coverage with financial help to lower the costs of monthly premiums and, in some cases, deductibles & co-pays.
    1. 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.
  2. Medicaid & PeachCare for Kids—About 25% of Georgians losing their health coverage may qualify for Medicaid. Georgians most likely to qualify for Medicaid coverage after a job loss 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.
  3. 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. This brings the total number of Georgians in the coverage gap to 436,000 (likely on the low end).

If you are in the coverage gap because you lost your job, please read the “If you are uninsured” section below. Then contact Georgians for a Healthy Future at 404-567-5016 x 2 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 and will let you know if you qualify for financial help to lower your premiums and other cost-sharing. 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 these organizations:

  • Insure Georgia, insurega.org, 866-988-8246
  • The Health Initiative, thehealthinitiative.org, 404-688-2524 (leave a voicemail in the general mailbox)— The Health Initiative may be especially helpful if you are an LGBTQ+ individual or if your health insurance covers an LGBTQ+ individual

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 and PeachCare for Kids

You can enroll yourself, your family, or your children in Medicaid or CHIP at any time, if you qualify. Enroll at gateway.ga.gov.

Children are most likely to qualify for Medicaid and PeachCare. Pregnant women and some parents may be eligible for Medicaid coverage depending on your monthly income. (The amount of unemployment that you get from Georgia counts as income but the additional $600 per week from the federal govt 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 lose that coverage or be disenrolled 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:

References & resources

COVID-19 Town Hall PowerPoint slides by Center on Budget & Policy Priorities

Frequently Asked Questions by Center on Budget & Policy Priorities


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Behavioral Health in the time of COVID-19

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:

  • 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:

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

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Four ways to celebrate Medicaid Awareness Month with GHF!

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:


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.


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GHF In The News

Jul 17, 2020
Kemp Signs Maternal Mortality, Surprise Billing Legislation Into Law
Emma Hurt

“In total, the bill will cover about 2.5 million Georgians, we estimate,” said Laura Colbert, executive director of Georgians for a Healthy Future, who lobbied to get the bill through…

Peach Pulse Archive