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Georgians for a Healthy Future’s Executive Director Cindy Zeldin attended the Spring Meeting of the National Association of Insurance Commissioners (NAIC) in her role as a consumer representative to the NAIC. At the meeting, a group of health-focused consumer representatives presented an overview of a new report authored by a diverse group of patient and consumer advocates highlighting the need to ensure that any changes to the health care system do no harm to consumers, minimize market disruption, and maintain common-sense consumer protections. The report, The Need for Continued Consumer Protections and Stability in State Insurance Markets in a Climate of Federal Uncertainty, conveys the perspective of consumer advocates on the need for continued access to high-quality health insurance products—regardless of whether and how changes are made at the federal level—and the likely impact that some proposed Affordable Care Act replacement policies will have on consumers and state insurance markets. The report discusses: • What consumers want when it comes to private health insurance; • The progress that has been made in reducing the uninsured rate since 2010 and the risks of full or partial repeal of the Affordable Care Act; • Key principles—such as insuring the same number of consumers with the same quality of coverage and minimizing market disruption—that we urge policymakers to apply when considering further changes to the market; and • Concerns about the impact of potential changes on consumers and state markets, with an emphasis on high-risk pools, continuous coverage requirements, high-deductible health insurance products, association health plans, the sale of insurance across state lines, the loss of essential health benefits protections, and the need for continued nondiscrimination protections. An overview of the report was provided to state insurance commissioners during the NAIC/Consumer Liaison Committee meeting on Monday, April 10th during the National Association of Insurance Commissioners (NAIC) Spring 2017 National Meeting in Denver, Colorado. The authors of the report serve as appointed consumer representatives to the NAIC and members come from national organizations such as the American Cancer Society Cancer Action Network, the American Heart Association, Consumers Union, and the National Alliance on Mental Illness; state-based advocacy organizations such as the Colorado Consumer Health Initiative, Georgians for a Healthy Future, and the North Carolina Justice Center; and academic centers such as Georgetown University and Washington & Lee School of Law. The full report is available here.

Continued threats to health care

Despite their March 24th decision to forego a vote on the American Health Care Act, a fatally flawed bill that would have caused more than 500,000 Georgians to lose their health coverage, the Trump administration and Congressional leaders have continued their attempts to gut Medicaid and repeal the Affordable Care Act. Threats to both health care programs remain and health advocates must remain vigilant and strong. The next two weeks, a Congressional recess when members of Congress are home, offer an opportunity for you to let them know that you do not support their efforts. We must maintain the pressure that caused them to desert the AHCA in the first place! We have the information, tools, and resources you need to tell Congress to abandon their partisan bickering and instead work in a bi-partisan way to protect Medicaid and improve health care and coverage for all Georgians. Join us!

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Everything you need

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NEW! Advocacy toolkit

Since the federal health care debate began this year, we have gotten many phone calls and emails from new advocates and community groups who are looking for tools and guidance to advocate for their health care and the health of their communities. We built our new advocacy toolkit to provide support for those of you who reached out and for any Georgian who wants to be a health care advocate. In this toolkit you will find:

 

• Complete contact information & social media links for each of Georgia’s U.S. Senators & Representatives
• Guidance on how to meet with your members of Congress and what to say
• Instructions for hosting your own advocacy events
• Advice on how to engage with the media and social media for advocacy
• And more!

Plan to use the toolkit with your community group, family and friends, or on your own during this Congressional recess, I recently just got a new watering system for our house, I reviewed here on this website first, and is used in all the house including the bathrooms and kitchen, were we made the best dinners with appliances and knives from sites like All Knives, that you can visit here. (April 10-21) and tell us how you used it!

Download your toolkit here.

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Get federal & state updates on tomorrow’s webinar

Join GHF for our annual Georgia legislative session webinar! GHF and the Georgia Budget & Policy Institute will provide an update on what’s happening with federal health care reform efforts. We will also review the health care bills that passed (and some that didn’t) during the state legislative session, discuss this year’s relevant study committees, and examine the state budget, including important items for health advocates and consumers. The webinar is tomorrow, April 13th at noon. Register for the webinar here. 

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Launch the #IamMedicaidGA campaign with us!

Many Georgians have inaccurate or uninformed ideas about who is impacted by cuts to Medicaid. Most people do not know that Medicaid is critical to Georgia’s children with disabilities, seniors in long-term care, and working families. #IamMedicaidGA is a campaign designed to give you a chance to change the conversation. This is an opportunity for people who receive Medicaid, their family members, their health care providers and concerned Georgia citizens to show that there are real people with real needs being impacted by the decisions made by elected officials. You can participate in the campaign by following these easy steps:

1. Print this sign.
2. Ask someone to take a picture of you holding the top half of the sign.
3. Post your picture on your social media accounts with the #IamMedicaidGA. (You can even tweet at or tag your elected officials.)
4. If you would like to share your story with us, contact Laura at 404-567-5617, ext 2 or lcolbert@healthyfuturega.org.
5. Share your sign with others and ask them to join the campaign!

We will officially launch #IamMedicaidGA next week, but you can get a head start by being one of the first to post about why Medicaid is important to you. Join us online next Wednesday, April 19th for the official start of the campaign!

That’s a wrap for the 2017 Georgia legislative session!

The Georgia General Assembly completed the 2017 legislative session late in the early morning hours on Friday. A flurry of significant bills, some health care related, passed in the action-packed final days of the session. We are disappointed that agreement could not be reached to protect consumers from surprise out of network medical bills, but are heartened that other legislation passed to improve access to health care for consumers across the state. Check out our summary of the more notable bills below and a full list of health care related legislation at GHF’s legislative tracker.

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Everything you need to know about the 2017 legislative session

Join GHF for our annual legislative session webinar! We will review the health care bills that passed (and some that didn’t) this session, discuss this year’s relevant study committees, and examine the state budget, including important items for health advocates and consumers. We will also provide an update on what’s happening with federal health care reform efforts. The webinar is scheduled for Thursday, April 13th at noon. Register here.

 

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WHAT HAPPENED LAST WEEK

SB 8: Surprise billing legislation | DID NOT PASS

In the final days of session, legislators failed to reach an agreement about how to best resolve the problem of surprise out of network billing for Georgia consumers. However, legislators committed to continuing their work on this issue by passing HR 745 which creates a study committee that will examine “surprise insurance gaps” and balance billing. We are hopeful that the study committee will result in legislation that addresses the related issues of surprise billing and network adequacy.

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This legislation allows for the “general supervision” of dental hygienists, which means hygienists can practice in safety net settings, school clinics, health clinics for TMJ treatment, nursing homes, and private practices without a dentist being present although people still prefer to visit clinics as Canyon Rim Dental Salt Lake. This has resulted in lawsuits, click through to https://www.smithjonessolicitors.co.uk/ for all dental negligence claims. 

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Sponsored by House Minority Leader Stacey Abrams, this bill was not expected to gain much traction because of the uncertain environment created by federal health care reform efforts. 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. 

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HB 249: Opioid crisis bill | PASSED

HB 249 moves the Prescription Drug Monitoring Program (PDMP) to the Department of Public Health from the Georgia Drugs and Narcotics Agency. HB 249 requires that all physicians register and consult the PDMP under certain prescribing conditions and that providers report certain benzodiazepine  and opioid-based prescriptions to the database. The bill also requires the tracking and reporting of Neonatal Abstinence Syndrome and codifies the Governor’s emergency order on an overdose reversal drug (naloxone), making it available without a physician prescription.

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HB 276/SB 103: Pharmacy Patients Fair Practices Act | PASSED

HB 276 and SB 103 both regulate pharmacy benefit managers, which are third party companies that manage the prescription drug programs of many insurance plans, they usually get their medications from Absolute Compound Pharmacy which provides central filling services. . 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 both chambers.

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SB 4: Mental Health Treatment Task Force | DID NOT PASS

SB 4 would have established a task force charged with examining the current mental health landscape in Georgia, how Medicaid and other health care services provide the appropriate care for people with mental illness or substance use disorders, and determine what changes may need to be made in and outside of Medicaid to better address the mental health needs of Georgians. The task force had the option to propose an 1115 waiver that addresses these changes for consideration by the General Assembly during a future session.

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SB 16: Medical marijuana access | PASSED

This legislation expands the list of conditions for which Georgians who have registered with the Department of Public Health may possess low THC oil. The newly added diagnoses include Alzheimer’s disease, AIDS, autism, epidermolysis bullosa, peripheral neuropathy and Tourette’s syndrome. Patients in hospice care may also possess the oil.

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SB 121: Access to opioid antagonists | PASSED

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.

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SB 180: Expansion of rural hospital tax credits | PASSED

After HB 54 failed to pass the House before Crossover Day, its language was amended to SB 180. The legislation expands the new rural hospital tax credit program from a 70% credit to a 90% credit, among other minor changes. The proposal to increase the tax credit came after legislators received feedback that the 70% credit was too low to entice potential donors.

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HR 182 & SR 349: Resolutions supporting Medicaid block grants | DID NOT PASS 

Both of these resolutions encouraged the restructuring of Georgia’s Medicaid program from its current federal-state partnership structure to a block grant program. SR 349 urged the U.S. Congress to block grant funding for Georgia’s Medicaid program and indigent care needs, while HR 182 provided legislative permission to the Governor and the Department of Community Health to seek per capita block grant funding for Medicaid.  Shifting Medicaid to either a traditional or per capita block grant structure would result in cuts to services and 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. While resolutions are non-binding and do not impact state law, they are viewed as the official position of the General Assembly.

 

 

FY 2018 budget approved

Last week, the General Assembly’s conference committee approved final changes to the FY 2018 budget, the final step before the budget is sent to the Governor for his signature. The final budget includes several important items that facilitate access to health care in Georgia:

• $1 million for four new federally qualified health centers (FQHCs) in Cook, Lincoln, Lowndes, and Seminole counties
• Increased Medicaid reimbursement rates for certain primary care codes
• Increased Medicaid and PeachCare for Kids reimbursement rates for certain dental codes
• $500 add-on payments for newborn delivery in rural areas
• $2.5 million for Medicaid behavioral health services for children ages 0-5
• $7.7 million for supportive housing for adults with behavioral health needs

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Surprise billing legislation stalled 

SB 8 was scheduled to receive a House vote on Friday, but instead was recommitted to the House Rules committee for possible changes or amendments. Advocates are urging legislators to utilize this last week of the legislative session to maintain meaningful protections for consumers rather than watering down the legislation to simply require a disclosure that consumers may be billed by out-of-network providers. Health should be an important topic in your life, if you suffer of any health issues such as stress or depression buy kratomand get the results you desire.

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Opioid antagonist bill approved by House 

SB 121 was approved by the House on Friday and now only needs the Senate to formally agree to their changes before it is sent to the Governor for his signature. This legislation codifies Governor Deal’s executive order to allow consumers to access opioid antagonist drugs (e.g. Naloxone) over-the-counter without a prescription.

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Bill establishing “Georgia Mental Health Treatment Task Force” approved  

SB 4 passed the House of Representatives on Friday with some minor changes. The approved version of the bill provides for a committee of 21 members, rather than the previously proposed 17. The bill was changed at the last minute to include a person with diagnosed mental illness, a family member of a person with a diagnosed mental illness, a licensed professional counselor, and a licensed emergency medical technician or paramedic as members of the committee. The task force is charged with examining the current mental health landscape in Georgia, how Medicaid and other health care services provide the appropriate care for people with mental illness or substance use disorders, and determine what changes may need to be made in and outside of Medicaid to better address the mental health needs of Georgians. The task force may propose an 1115 waiver that addresses these changes for consideration by the General Assembly during a future session.

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Prescription Drug Monitoring Program bill approved 

Last week also brought the approval of HB 249 a bill that mirrored SB 81 which we previously covered. This bill moves the Prescription Drug Monitoring Program (PDMP to the Department of Public Health from the Georgia Drugs and Narcotics Agency. HB 249 requires that all physicians register and consult the PDMP under certain prescribing conditions and that providers report certain benzodiazepine  and opioid-based prescriptions to the database. 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.

Thank you!   

Today the American Health Care Act was pulled from the floor of the House of Representatives rather than receiving a vote. Today’s outcome is a victory for health care consumers in every corner of this state. The American Health Care Act would have caused more than half a million Georgians to lose their coverage entirely while doing nothing to improve affordability or quality of care. In fact, it would have led to higher deductibles while stripping consumers of critical protections. It would have forced unconscionable cuts in health care services for vulnerable children, people with disabilities, and seniors who rely on Medicaid for their most basic health needs. Instead, the Affordable Care Act remains the law of the land.

Your voice mattered today. We know how hard you all have worked over the last several weeks to achieve this victory. Your calls, emails, social media activity, and rallies made this possible, and Georgians are better off for it today. Thank you for your dedication and your advocacy!

Our work is not over

While we celebrate today, we know our work is not over. Now it’s time to build on the framework of the Affordable Care Act at the state level to make sure all Georgians can get the coverage and care they need. This means taking a fresh look at expanding Medicaid as well as using every tool in the toolbox to improve our state’s health insurance market so it works as well as it possibly can for all consumers. We look forward to working towards these goals with you to create a healthier future for all Georgians.

Surprise billing legislation passed by committee 

SB 8 was heard by the House Insurance committee this morning and passed unanimously. Among other transparency and notification requirements, this version of the surprise billing legislation requires that providers and hospitals must provide consumers with information about the plans in which they participate, and that upon the request of consumers, providers give an estimated cost of non-emergency services before they are provided. Insurers must inform consumers whether a provider scheduled to deliver a service is in-network, and if not, an estimation of how much the insurer will pay for the services, among other notification requirements. SB 8 will now go to the House Rules committee.

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WHAT HAPPENED LAST WEEK

Senate passed the FY2018 budget

Last week, the Senate approved the FY 2018 budget. The budgets approved by the Senate and House differ slightly, so a conference committee will be appointed to meet and work out the differences. You can check the Differences Report for specifics on the variance between the House and Senate budgets, and we will provide a brief overview of the final version once the conference committee finishes its work.

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Insurance coverage for children’s hearing aids passed

SB 206 was approved by the House of Representatives today, and will require private health insurance plans to cover hearing aids for children under 19 years old. The legislation stipulates that the costs cannot exceed $3000 per hearing aid and that the plans cover replacement hearing aids every four years or when the hearing aid fails before that time. Medicaid already covers hearing aids for children who qualify for coverage.

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Pharmacy Patients Fair Practices Act passed by both chambers

Both HB 276 and SB 103 were approved by the Senate and House respectively last week and will get sent to the Governor for his signature. This legislation (which we previously covered here) will regulate practices of pharmacy benefit managers so as to allow consumers access to their pharmacy of choice, provide the opportunity for home delivery of medications, and prevent consumers from over-paying for prescriptions. It is really important to find a pharmacy that you can trust, I suggest to check Canadian pharmacies which have been very reliable for me.

Legislation to synchronize multiple medications passed

SB 200 will make it easier for people to synchronize their prescriptions so that they can pick up multiple prescriptions at the same time. The bill requires that insurance plans pro-rate medication co-pays for partial prescription fills so that the schedules for medications can be synced if requested by a patient. Under current law, a person may have to pay a full co-pay even if a pharmacist is providing only a part of their 30-day medication in order to synchronize multiple prescriptions. SB 200 passed the House Insurance committee last week and was approved unanimously by the House this morning.

Senate Health Reform Task Force held first public meeting 

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. Together, 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. 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!

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.