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Category: GHF Blog

GHF shares information about network adequacy at the NAIC summer meeting

naicGeorgians for a Healthy Future’s Executive Director Cindy Zeldin attended the summer meeting of the National Association of Insurance Commissioners (NAIC) last week in San Diego in her capacity as a consumer representative to the NAIC. Cindy presented information on the enactment of health insurance provider directory improvement legislation in Georgia (SB 302) as part of a panel of consumer representatives discussing how the NAIC network adequacy model act is being taken up in the states. Also presenting were Claire McAndrew of Families USA, who provided a bird’s eye view of activity across the nation on network adequacy, and consumer representatives from Colorado and Maryland. This discussion was part of the Consumer Liaison meeting, which provides a forum for consumer representatives to interface with state insurance regulators from across the country.

naic2Also at the summer meeting, the consumer representatives released a new policy paper on prescription drug access and affordability. The report, Promoting Access to Affordable Prescription Drugs: Policy Analysis and Consumer Recommendations for State Policymakers, Consumer Advocates, and Health Care Stakeholders, provides a series of recommendations to assist regulators, lawmakers, and the NAIC on ways to promote access, affordability, nondiscrimination, transparency, and meaningful oversight of prescription drug coverage. The report includes examples of existing state and federal approaches to addressing these issues as well as recommendations for consumer-protective policies to be considered by state and federal policymakers. The report was made possible with support from the Robert Wood Johnson Foundation.


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Policy and advocacy opportunities to get Georgia covered

policy-prioritiesTremendous progress has been made over the past three years in increasing enrollment into health insurance that facilitates access to care and provides financial protection for individuals and families across the state of Georgia. However, too many Georgians are still uninsured, the trends toward narrow networks and consolidation within the health industry threaten to negatively impact access to care, and consumers express concerns about affordability. Addressing these issues will require collaboration between enrollment and health care stakeholders, advocates, and policymakers. Here are three things Georgia lawmakers can do to ensure that all Georgians have access to the quality of care they need.

  1. Close the coverage gap – Despite robust Marketplace enrollment in Georgia, we still have one of the highest uninsured rates in the nation, largely because our state policymakers have not yet closed the coverage gap. Georgia’s enrollment assisters have repeatedly expressed to advocates that this is the biggest barrier to enrollment that their consumers face.
  2. Addressing Affordability – Rate review is an annual process during which insurance companies submit their proposed plan rates for the coming year to be reviewed by state and federal regulators. We encourage state regulators to scrutinize these rates closely to ensure they are justified and to request adjustments if they are not. We also encourage policymakers to explore emerging approaches in health care payment and delivery reform that hold the potential to enhance value for consumers.
  3. Ensuring Access to Care – We encourage policymakers to build on the progress made by SB 302 by enacting comprehensive network adequacy standards in 2017.

For more details on policy and advocacy opportunities and our findings from research around the third open enrollment period, download our new report, Getting Georgia Covered: What We Can Learn from Consumer and Assister Experiences During the Third Open Enrollment Period.


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Policy Forum: Getting Georgia Covered

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Last week, Georgia health advocates, service providers, and enrollment assisters combined forces for a day of learning, sharing, and planning at our second annual Getting Georgia Covered summit. In conjunction with the event, Georgians for a Future released a new publication focusing on key themes in consumer and assister experiences during the 2016 open enrollment period, best practices for outreach, enrollment, and reaching eligible Georgians who remain uninsured, and policy opportunities to increase enrollment, improve access to care, and address affordability issues. The report, Getting Georgia Covered: What We Can Learn From Consumer and Assister Experiences During the Third Open Enrollment Period, is intended to be a resource for health care stakeholders, advocates, and policymakers.

 

In addition to workshops that fostered collaboration between organizations and individuals working on behalf of health care consumers in different ways, we also featured presentations and remarks from Dr. Pamela Roshell, Region IV Director, US Department of Health and Human Services, Dr. Bill Custer, Director of Center for Health Services Research and Associate Professor, J. Mack Robinson College of Business, Georgia State University, Heather Bates, Deputy Director, Enrollment Assister Network, Families USA and Sandy Anh, Associate Research Professor, Georgetown University Center on Health Insurance Reforms. Jemea Dorsey, Chief Executive Officer for the Center for Black Women’s Wellness, and Sarah Sessons, Executive Director of the Insure Georgia Initiative of Community Health Works also offered their expertise and insights in a closing panel. In the coming weeks, we will release a publication highlighting promising opportunities to improve consumer health through collaboration, drawing on the discussions and ideas that came out of the workshops and discussions.


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Partnering to Cover Kids

chidlrenshealthcoverageGeorgia’s rate of uninsured children has dropped from 11 percent during the depths of the recession to 7.6 percent in 2014. Despite this improvement, that means that 189,000 Georgia kids do not have access to needed health care and their families are without the financial protection that comes with coverage. In order to address this need, people who regularly work with children need to be aware of the importance of health coverage to children, and have the resources they need to connect kids and families with coverage quickly and easily.

That is why GHF partnered with the Georgia Departments of Education and Public Health to conduct a webinar called “Covering Kids.” The webinar was created for school nurses because they are such important sources of health information for families and students. During the webinar, Laura Colbert, Director of Outreach and Partnerships, reviewed the short and long term benefits of health care coverage for kids, which include academic and economic benefits on top of improved health outcomes. She also discussed trends and current statistics on children’s coverage in Georgia, and highlighted the pathways to coverage for kids which vary based on family income. Most importantly, she identified valuable community resources so that school nurses across the state can connect families and children with local assistance and information to help get them enrolled. This webinar is available to view on the School Nurse Exchange, and nurses who complete the webinar and an evaluation can receive CEU credits.

For more information about children’s health care coverage, check out these resources:


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New Policy Report Released!

EnrollmentBrief2016imageGetting Georgia Covered: What We Can Learn from Consumer and Assister Experiences During the Third Open Enrollment Period

With three annual open enrollment periods completed and a fourth one just around the corner, the Health Insurance Marketplace has become established as the avenue for purchasing coverage for roughly half a million Georgians. This report builds on last year’s Getting Georgia Covered: Best Practices, Lessons Learned, and Policy Recommendations from the Second Open Enrollment Period and focuses on understanding the characteristics of the people who have enrolled in marketplace plans and the experiences of consumers and the enrollment assisters who helped them. Their insights can inform the work of advocates, stakeholders, and policymakers to reach shared goals of reducing the uninsured, improving access to care, and addressing affordability for consumers.

Inside you’ll find:

  • Key themes in consumer and assister experiences during the 2016 open enrollment period
  • Best practices for outreach, enrollment, and reaching eligible Georgians who remain uninsured
  • Policy opportunities to increase enrollment, improve access to care, and address affordability issues

Go to the report.


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Postcards for Coverage

Who doesn’t love to get mail? A hand-written note from a friend? An invitation to a wedding or surprise birthday party? A post-card from a family member enjoying their vacation in an exotic locale? Getting personal mail is not something that happens much this day and age, but still holds a lot of meaning to most people. If someone took the time to write you a letter to ask you to do something, wouldn’t that get your attention more than email? Now imagine that you got multiple letters asking you to do something from your friends, family members, and neighbors. That’s exactly what happened for a majority of Georgia’s state Senate and House members.

Postcards3 Rep Erika Thomas Whitney4 WhitneyAnna

In July, Georgians for a Healthy Future mailed out stacks of post-cards to Georgia’s state legislators. These were not any post-cards. These were the postcards that GHF, with the help of the Cover Georgia Coalition, had been collecting over the past few years asking legislators to close the coverage gap. These postcards were signed by Georgians all across the state and were collected through outreach events, online petitions, and even Facebook ads. We collected more than 1100 postcards and sent them to legislators in every corner of the state. Many postcards included handwritten notes to their legislator asking them to close the coverage gap to help themselves, their family members, and fellow Georgians.

Rep Carolyn Hugley1 Rep Margaret Kaiser Rep Pat Gardner3 Rep Stacey Abrams1

It’s not often that constituents are able to feel like they can directly communicate with their elected officials and this postcard project was intended to help give everyday people a voice for a topic that was important to them. More than 300,000 Georgians fall into the coverage gap and are unable to get affordable health insurance. Often these Georgians go without coverage and regular medical care. Many Georgians want to fix this issue and took the time to let their legislators know that they support closing the coverage gap.  These postcards will have an impact as state legislators hear from their constituents that they want all Georgians have access to quality, affordable health insurance.

We will continue collecting postcards and sending them to legislators as we get them. If you haven’t signed a postcard yet, you can still do so by signing our online petition.


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Get to know our awardees!

2016 Linda Smith Lowe Health Advocacy Award: Tim Sweeney, Former Deputy Director & Health Policy Analyst Georgia Budget and Policy Institute

2016 Community Impact Award: Carole Maddux, Executive Director & CEO, Good Samaritan Health & Wellness Center


Tim-SweeneyFor more than ten years, Tim Sweeney set the standard for reliable and responsible health policy analysis in Georgia. His insights and analysis equipped Georgia’s health advocacy community with the information needed to be a strong voice for consumers. He dissected the state budget each year, decoding line items and formulas. Tim read studies and briefed us on their findings, helping us all connect the dots between data and the health care stories of individuals, families, and communities across our state. While we know he will continue to achieve great things throughout his career, the people of Oregon will now benefit from his expertise and commitment. For his decade of service in Georgia, we are proud to honor Tim with the Linda Smith Lowe Health Advocacy Award.


Carole Maddux HeadhotCarole Maddux lives and breathes health care access through her work leading Good Samaritan Health & Wellness Center in Pickens County. Under her leadership, Good Samaritan has recently transitioned to a federally qualified health center, is undergoing an expansion to better meet the community need, and is engaged in a local partnership to foster better collaboration locally. Carole also provides a clear, moral voice for systemic change in health care, speaking out on behalf of Medicaid expansion and other public policies that would expand coverage and increase access to care for all Georgians. For her leadership, commitment, and impact, we are proud to honor Carole with the Community Impact Award.

 

We hope you’ll join us on September 28th as we recognize Tim and Carole! RSVP


Health Hero 

Bristol-Myers Squibb

Health Champion 

Harry Heiman & Abby Friedman
Piedmont Healthcare

Health Guardian 

AIDS Healthcare Foundation
Cindy Zeldin & Doug Busk
Easter Seals Southern Georgia
Georgia Association for Primary Health Care

Health Defender

AbsoluteCARE Medical Center & Pharmacy
Andy Lord
Bennett Graphics
CEU Concepts
Georgia Charitable Care Network
Georgia Watch
Ilene Engel & Bob Arotsky
Julie Edelson
Lauren Waits

Health Ally

American Diabetes Association
Bancroft Lesesne
Bill Rencher
Bo & Chris Hagler
Don Rubin
Deep Shah
Essig Gehl Consulting
Feminist Women’s Health Center
The GHF Staff
Jay Berkelhamer
Jeff Cornett & Edward Fernandez-Villa
UGA College of Public Health
Voices for Georgia’s Children

 


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Meet our 2016 Powerhouse Policymaker Awardees!

2016 POWERHOUSE POLICYMAKER AWARDEES

Representative Stacey Abrams
Senator P.K. Martin

Please join us on September 28th as we recognize our 2016 Powerhouse Policymakers.


Representative Stacey Abrams, House Minority Leader

Abrams 2014 Head Shot CroppedAs House Minority Leader, Stacey Abrams leads her caucus in its efforts to enact legislation across a range of complex public policy issues. Despite a full plate, Leader Abrams always makes time for health care. Whether it is raising awareness with constituents about new health insurance opportunities available to them or tirelessly championing the need to close Georgia’s coverage gap by expanding Medicaid, leader Abrams has proven over and over again her determination to ensure every Georgian has a pathway to health coverage. For this steadfast commitment, we are honored to recognize her as a 2016 Powerhouse Policymaker.


Senator P.K. Martin, Senate Insurance Committee

PK Martin HeadshotAlthough only in his second legislative session, Sen. Martin is not one to back down from a challenge and isn’t afraid to take on complicated issues. Improving provider directory accuracy was one such topic. SB 302 is a groundbreaking piece of legislation that sets basic standards for directories and protections for consumers who rely on them. The bill has been recognized nationally as an important example of consumer protections. Sen. Martin has shown that he is someone who will fight for what he believes in and we are proud to recognize him as a 2016 Powerhouse Policymaker.

 

 

We hope you’ll join us on September 28th as we recognize Sen. Martin and Rep. Abrams! RSVP Here.


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The complex factors that contribute to health

by Laura Colbert, Director of Outreach & Partnerships

ColbertWhen you think about the things in your life that keep you healthy, what comes to mind? I think of how often I exercise, the food and drinks I put in my body, which I recommend using trying Lumitea skinny tea to help your digestive system, help with sleeping, maintaining my mental health by keeping stress low, and being socially connected to friends and family. Sometimes I would just prefer to have healthy meals delivered gold coast at my front door so I don´t have to cook and I have the satisfaction that it´s really good food, I could also use my time learning about bread machines from the Village Bakery so I can learn to do healthy food myself, like learn how to prepare fresh fish and other food. I also love to take care of my face so I use the elite eye serum to make sure I don´t have any bags under them If you like to exercise I recommend getting a waist training that will help you get fit followed by some good protein snacks for after the gym. I also like to use a pre workout before going to the gym and since I am really into organic right now, my go to is Black Wolf organic pre workout. None of these things are directly connected to what we traditionally think of as the health care system, yet they greatly impact my health. As you can see there´s many factors that have an impact on health, when it comes to stress there´s many ways you can get rid of it, an example is by taking care of yourself and having time to relax, you can check massage chairs expert where you will find many suggestions, you can also visit swedish massage darling harbour where you will get one of the most relaxing massages.

At Georgians for a Healthy Future, we have historically spent much of our time and energies on HIV Early Detection STD Testing | STDAware. Yet, as demonstrated above, there are many factors outside the healthcare system that greatly impact the health of Georgians, read this comparison which will give tons of helpful info. These factors are called social determinants of health, and can include education, housing, criminal justice and corrections, transportation, the built environment (the way we build communities, roads, and buildings), and more. Social determinants of health act on the population level to influence not just an individual’s health but the health of whole communities. For example, moldy or otherwise unhealthy housing can influence the rates of asthma among children in a community. A community with a variety of transportation options like bike lanes, safe sidewalks, and public transit may prompt higher rates of physical activity among its residents, which improves cardiovascular health, obesity, and mental health in the population. If you want to get to know how to cook to better your health I suggest to check http://beptruong.edu.vn/day-nau-an/ for more info.

This year, GHF is launching a new project, supported by the Healthcare Georgia Foundation, to bring together stakeholders and advocates from across sectors to identify promising policy initiatives that can address the social determinants of health. We are fostering relationships with and interviewing advocates and policy experts who work in other sectors to learn about their work and how it intersects with health. We are building on that with research to identify best practices from other states and promising initiatives in Georgia that could be expanded statewide with support from communities and policy makers. In the end, this work will result in policy recommendations for state policy makers, better connectivity among advocates across sectors, and a shared direction for health advocates and others.

We look forward to sharing our learnings and results with you as our work progresses. In the meantime, you can learn more about the social determinants of health with these resources:

 


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Department of Justice Moves to Block Major Health Insurance Mergers

Proposed MergersA win for Georgia health care consumers! 

Today the Department of Justice (DOJ) announced they will file suit to block both the Aetna-Humana and Anthem-Cigna health insurance mergers. Georgia’s attorney general is listed as one of the plaintiffs in the Aetna-Humana case.

Earlier this week we released a policy report, Proceed with Caution: Proposed Health Insurance Mergers Could Harm Georgia Consumers, which details Georgia’s current health insurance market and how these mergers could decrease competition like what happened in California’s Health Insurance Quote, and access to care while increasing prices from many insurance companies, but it may not affect private online companies as InsurancePartnership.org and others.

In light of the DOJ’s announcement, the Georgia Department of Insurance is indefinitely postponing its review of the Aetna-Humana merger and has canceled next week’s hearing. This marks an important milestone victory for Georgia health care consumers and we will keep you posted on any future developments.


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