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Whether you struggle with an illness like depression or addiction yourself or a person in your life does, we are all witness to the life-changing impacts of mental illness and substance use disorders. However, accessing the necessary care and treatment to manage mental illness and substance use disorders is too difficult for some Georgia families. 

According to the Mental Health Association of Georgia, Georgia ranks 48^th out of 50 states and D.C. for access to mental health care, resources, and insurance. Two in five Georgia children have trouble accessing the mental health treatment they need.

For years, Georgia’s mental health and substance use advocates have been working to improve access to services. While several policy wins have been achieved, the resulting changes have been modest and have not erased the biggest barriers to care. 

This year is different. State legislators and advocates have named 2022 the “year of mental health.” Leaders have committed to improving access to mental health and substance use services for Georgia families. 

The legislature has moved quickly on its commitment. On January 26^th, House Speaker David Ralston introduced the Mental Health Parity Act. The Mental Health Parity Act is a landmark bill covering many aspects of mental health and substance use care. Topics covered in the bill range from how insurers must cover treatment to increasing the mental health and substance use provider workforce to creating mental health response teams around the state. 

One of the central parts of the bill is mental health parity. Mental health parity means treating mental health and substance use services the same as physical health services, especially in how insurance companies cover these benefits. Insurers sometimes put limits on the number and types of mental health and substance use treatments that are covered but do not put those same limits on physical health treatments (like getting a broken arm fixed). This unequal treatment means that Georgians who need mental health and substance use services may have a more difficult time getting treatment and pay more for their treatment. 

The Mental Health Parity Act would require insurers in Georgia to cover mental health and substance use just as they cover physical health. The bill would require private health insurers and Medicaid insurers to submit data showing that their approval and denial of mental health and substance use benefits is no more restrictive than benefits for physical care. The bill would require the state agencies that oversee private insurance and Medicaid to make it easier for consumers to file complaints if they believe their insurer is not covering mental health and substance use fairly. It will also create a full-time position dedicated to examining the data that insurers submit to make sure they are actually following the law. These measures will ensure the state has accurate data on how insurers cover these important benefits and allow the state to take action against insurers for violations. 

The bill also includes steps to increase the number of behavioral health and substance use providers throughout the state, especially in rural areas. One such step is student loan forgiveness options for students training as mental health and substance use providers. Two other changes would increase Medicaid payments for certain providers, and improve data collection so state leaders will better understand the true workforce shortages. 

Georgians for a Healthy Future applauds Speaker Ralston for his leadership on the Mental Health Parity Act. We support the strong provisions in the bill. The Mental Health Parity Act has been referred to the House Health and Human Services Committee, which Representative Sharon Cooper chairs. GHF will continue to provide updates as the bill moves through the legislature and look forward to working with our elected leaders to ensure all Georgia families can access the life-saving mental health and substance use treatment they need. 

Want to know more? Check out this fact sheet that summarizes key pieces of the Mental health Parity Act. Share it with your family, friends, and social media networks!

Do you have a story to share about difficulties accessing mental health or substance use treatment? Share your story here. Your story can power the changes that Georgians need!

Legislative update: Week 4

In this week’s update:

• Take action to increase Medicaid coverage for new moms
• Legislation about private insurance coverage of mental health & substance use, prior authorization of prescription medicines, and a proposed study committee on smoking!
• Advocacy events for your calendar
• GHF’s got you covered this session!

Legislative update: Week 3

In this week’s update:

• Georgia House Speaker introduces Mental Health Parity Act
• Legislation on increasing postpartum coverage, drug prices, COVID-19 vaccines, and more!
• The General Assembly sets their 2022 calendar
• Advocacy events for your calendar
• GHF’s got you covered this session!

Legislative Update: Week 2

General Assembly meets for joint budget hearings 

The Georgia General Assembly met last week for joint budget hearings. During “budget week” both the House and Senate heard from Governor Kemp and agency leaders about their requests for the current and upcoming state budgets. The General Assembly’s budgetary considerations consist of two parts:

1. Changes to the current FY 2022 state budget (sometimes called the “little budget”) which will run through June 30, 2022, and
2. The FY 2023 general state budget (the “big budget”), which will begin on July 1, 2022.

After the agency presentations, the House will pull together the budget requests into legislation and continue to review funding requests.

Below we highlight some of the primary asks made by the state agencies that most impact our health, especially during the current health crisis. For more detailed budget analysis, please see the Georgia Budget and Policy Institute’s Overview of Georgia’s 2023 Fiscal Year Budget.

The General Assembly will reconvene on January 25th for the fifth day of legislative session.

Thank you to all attendees for being a part of Georgians for a Healthy Future’s 12th annual Health Care Unscrambled! We were thrilled to have so many advocates, policy makers, health care providers, and public health professionals join us for this year’s virtual event! 

Highlights from a bi-partisan legislative panel

While we were hoping to convene in a hybrid in-person & virtual fashion, the pivot to a fully virtual platform did not damper the impact of this year’s Health Care Unscrambled program. Our accomplished and bi-partisan panel of state legislators answered tough questions about the state of health in Georgia and discussed the issues they see as most pressing in 2022. 

Sen. Dean Burke hinted that an extension of Medicaid coverage to pregnant women for up to 12 months after birth or miscarriage was a top priority for him–a preview of the Governor’s similar announcement at the State of the State address later in the week. Sen. Sonya Halpern highlighted the imperative for Georgia leaders to address mental health and substance use in a holistic way across the lifespan, including our education and juvenile justice systems for youth well-being. She also highlighted the need to understand drivers of racial and geographic health disparities and address the root causes to meaningfully close those gaps. Rep. Lee Hawkins discussed health care workforce development initiatives like higher pay rates, expanded training opportunities in rural areas, and loan forgiveness programs. Other topics discussed included telemedicine; tobacco and vaping prevention and taxes; community health workers and other local solutions; Medicaid expansion; public health systems & infrastructure; and more.

A keynote address about Georgia’s public health system

The legislative panel set the stage for our keynote speaker, Dr. Georges C. Benjamin, Executive Director of the American Public Health Association (APHA). We learned from Dr. Benjamin what makes up a resilient and effective public health system, how we can ensure that Georgia has one now and in the future, and how public health can help us address some of the state’s toughest health challenges. Dr. Benjamin also highlighted the 10 essential public health services, discussed how to protect public health from being politicized, and called out voting and civic engagement as a fundamental social determinant of health. Dr. Benjamin’s slides are available here for your reference.

Missed Health Care Unscrambled 2022?

Don’t stress! Materials from the event are available on our digital program.

Click here to view the recording of event. Here are some helpful time stamps: 

• 3:00—Amy Bielawski shares her health care story
• 10:50: Legislative panel
• 1:14:42: Executive Director’s remarks
• 1:29:01: Keynote address from Dr. Georges Benjamin

Visit GHF’s Facebook page to view photos from the virutal event! Check out the #HCU2022 discussion on Twitter.

Thank you again for attending! 

Legislative Update: Week 1

The 2022 legislative session has begun

The Georgia General Assembly convened (for less than 1 hour) last Monday, Jan. 10th to officially kick off the 40-day legislative session. 

GHF held Health Care Unscrambled on Tuesday as Georgians celebrated UGA’s national football championship win. Thank you to those who attended Health Care Unscrambled! We will be in touch with a recap and a recording of the event very soon! 

The General Assembly reconvened Wednesday through Friday, completing the first four days of the session. The primary focus of the first week of the 2022 legislative session was Governor Kemp’s State of the State address. 

This week will be dedicated primarily to budget hearings for the current (FY 2022 Amended) and next year’s (FY 2023 General) state budgets. The General Assembly will reconvene Monday, January 24th for the fifth official day of legislative session. 

In the spring of this year, Georgians for a Healthy Future, Georgia Watch, and SOWEGA Rising launched a project in Southwest Georgia to address the burden of medical debt. Southwest Georgia, including the Albany area, experiences medical debt at a higher rate than the rest of Georgia and the country. In Dougherty County, 22% of residents have a medical debt in collections, compared to 19% for Georgia and 15% nationally. This debt also disproportionately impacts communities of color. In Dougherty County, 25% of Black residents have a medical debt in collections, compared to 21% in Georgia and 17% nationally (Urban Institute, 2020).  

Medical debt can have a profound impact on the quality of a person’s life. Studies have found that medical debt is associated with a decreased use of health services, especially among low-income individuals who often become sicker while delaying care, which increases the cost of their care (Crawford, 2021). These impacts can trickle down to affect the health of the entire community.

To better understand both the individual and community impacts of medical debt, Georgians for a Healthy Future, Georgia Watch, and SOWEGA Rising have used several outreach methods to invite residents of southwest Georgia to share their stories and feedback on experiences with medical debt. Since May of 2021, SOWEGA Rising has organized in-person listening sessions and Facebook Live virtual events to help individuals share their experiences with accessing and affording care in the community, including sharing whether they currently have unpaid medical bills, bills in collections, and how those bills are impacting their lives. So far, we’ve conducted seven listening sessions, and the experiences shared with us show that southwest Georgia residents are struggling to afford their care. Over 60% of those we spoke to reported delaying or avoiding care due to cost concerns, and over 70% reported an outstanding medical bill that had been sent to collections.

In October, we launched the Dish the Debt campaign in a focused effort to encourage community members, especially people of color who have been disproportionately impacted by medical debt, to share their encounters with medical bills, medical debt, and unfair debt collection practices. The campaign included social media posts throughout the month that talked about the issue of medical debt and explained why it’s so crucial for those affected by medical debt in southwest Georgia to share their story. Each post linked to a story collection form on Georgia Watch’s website where individuals could share their stories and contact information for follow-up.

A more recent effort to engage the southwest Georgia community to share their experiences with medical debt came during Georgians for a Healthy Future’s Southwest Georgia Health Care Affordability forum. During the forum, speakers from Albany Area Primary Care, Samaritan Clinic, and Valley Healthcare (local clinics that provide free or low-cost care to the community) shared how high medical costs negatively impact southwest Georgia. GHF also shared data on the disproportionate share of medical debt among communities of color in southwest Georgia during the forum. Each organization that spoke during the forum is also sharing links to the medical debt story collection form to elicit more stories from the southwest Georgia community.

Our organizations will continue to create opportunities for community feedback and stories regarding medical debt in southwest Georgia. We will ramp up our community feedback and story collection efforts in 2022, starting with a dual listening session and Affordable Care Act enrollment event in Cuthbert. We invite anyone interested to join us on January 13^th, from 5 – 8 pm. Location in Cuthbert TBD.

 We know that personal stories are critical to making lasting legislative and policy changes. While data on medical debt and the disproportionate impact on communities of color is deeply concerning, sharing stories creates a connection between those impacted by medical debt and Georgia’s decision-makers in a way that data cannot. We hope to use these stories, alongside data, to encourage hospital systems and lawmakers to enact policies that will protect Georgia communities from the crushing impacts of high health care costs and medical debt.

References

Crawford, K (2021). Stanford News: Stanford study finds medical debt is a double whammy for the poor. https://news.stanford.edu/2021/10/07/study-finds-medical-debt-double-whammy-poor/

Urban Institute (2020). Debt in America: An Interactive Map.https://apps.urban.org/features/debt-interactive-map/?type=overall&variable=pct_debt_collections

“Georgians for a Healthy Future praises our champions in the U.S. House of Representatives for their passage of the Build Back Better Act. This move brings uninsured Georgians one-step closer to a 4-year coverage gap fix. We encourage the Senate to urgently take up and approve this legislation so Georgians who have been left behind for almost a decade can easily & affordably access health care—like people just like them in 38 other states.”

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The high cost of medical care has long been a concern for consumers and a frequent topic of conversation among policymakers and industry leaders. Therefore, it’s no surprise to learn that many Georgians struggle to pay for health care or worry about their ability to pay for care in the future. A new survey conducted by Altarum Healthcare Value Hub, in consultation with Georgians for a Healthy Future, gives surprising new data on exactly how much Georgians struggle with the cost of healthcare.

            The purpose of Altarum’s Consumer Healthcare Experience State Survey (CHESS) is to provide advocates, policymakers, and industry leaders with a better understanding of consumers’ struggles with health care costs, reveal the cost-drivers that need to be addressed in Georgia and provide support for system changes and policy solutions to improve health care affordability for consumers.         

            The Georgia CHESS revealed the majority of Georgians struggle with health care affordability burdens. Many Georgians are uninsured, delay needed care, or struggle to pay their medical bills due to high costs. Even more Georgians are worried about affording care in the future, especially care related to aging or medical emergencies. These results indicate the need for policymakers and stakeholders to address high costs across all areas of health care  – from coverage to care to prescription drugs Additionally, consumers need more protection from high health care costs and robust, easy-to-understand tools to navigate the costs associated with care.

            The survey data also unveil the need and support for Georgia lawmakers to act to relieve cost concerns for Georgians. Lawmakers can apply the CHESS results to their efforts in the 2022 legislative session, using the information to pass laws that eliminate cost as a barrier to care for Georgians, protect Georgians from rising health care costs, and require system-level changes so consumers can better tell what the true cost of their care will be.

            If you would like to learn more about the Georgia results and the affordability burdens faced by Georgians, we invite you to join us on October 14^th for “Coming Up Short: Affordability, Access, and Policy Fixes for Georgians,” where you’ll hear from experts about Georgia’s results and ways to address health care spending.