WEEK 7

Crossover day is behind us and we are quickly approaching Sine Die, the final day of the legislative session. We are proud to say that one of GHF’s biggest legislative priorities – ensuring accurate provider directories for health care consumers – passed the full Senate unanimously last week! Thank you to those of you who contacted your legislators to voice your support! This week’s legislative update includes an a run down of which health care bills made it through Crossover Day and which did not. You can see a list of all the bills were’re tracking here along with supplemental information on most bills like relevant news, articles ad committee testimony delivered by GHF.

WHAT HAPPENED THIS WEEK

The Provider Directory Improvement Act
Last week SB 302 went for a vote in the Senate chamber and passed unanimously, 50 – 0! The bill is now in the House Insurance Committee where we expect it to receive a hearing soon. Join the Georgia Health Action Network(GHAN) to get important alerts about committee hearings, votes, and steps you can take to make sure your voice is heard at the Gold Dome!

Surprise Out-of-Network Billing
SB 382, the Surprise Billing and Consumer Protection Act had two hearings last week. While there is strong support for the legislation among consumer advocates and many health care stakeholders, hit did not pass through the Senate Health and Human Services Committee prior to Crossover Day. SR 974 is still a possible path to bring Senate-side policymakers together with stakeholders and advocates in the off-session to further study this complex issue.

Medicaid Payment Parity
The governor’s budget, introduced earlier this legislative session, maintained last year’s partial Medicaid payment parity. Full Medicaid parity would allow doctors to be reimbursed at the same rates for seeing Medicaid patients as Medicare patients. The FY 2017 budget, as passed by the House, adds $26.5 million for for Medicaid payment parity. The bill is now in the Senate for consideration.

Closing Georgia’s Coverage Gap
If you’ve been following our updates, you know that this session has seen growing interest in addressing the issue of Georgia’s uninsured rate and our struggling rural health infrastructure. Neither Sen. Rhett’s SB 368 nor Rep. Abram’s HB 823 crossed over. However, Sen. Rhett’s SR 1056, which proposes a study committee to look at approaches to covering the uninsured, is still viable as a Senate-side study committee (but would still need to pass through the Senate HHS Committee and the full Senate) and stakeholders continue to express interest in continuing the conversation passed the legislative session.

CROSSOVER DAY UPDATE

• HB 919: Tax credits  for contributions to rural health care organizations – CROSSED OVER
  HB 919 passed out of the House on February 25 and is now in the Senate Health and Human Services Committee. The total cap for the tax credits was reduced from $250 million to $100 million. GHF encourages policymakers to look at this legislation in conjunction with other bills around closing the coverage gap and addressing rural health so that we can tackle our rural health challenges comprehensively, including developing a pathway for rural, uninsured Georgians to gain coverage so they can better access health care services and finding a solution that can drawn down federal dollars available to the state through the Medicaid program.
• HB 838: Health insurers to pay brokers a minimum of 4% of premiums collected – CROSSED OVER
  This bill passed out of the House on February 24th and is now in the Senate Insurance and Labor Committee.
• HB 1055: Repeal Certificate of Need program – DID NOT CROSS OVER
  CON regulates the construction of health care facilities and the services they provide. This bill would have eliminate that structure and set up a different one based on permits. Read more on this bill from Georgia Health News.
• HB 684: To allow dental hygienists to provide certain services without direct supervision –  DID NOT CROSS OVER
  According to recent reports made on https://www.life-smiles.net/, this bill would have allowed dental hygienists to clean teeth in safety-net health centers with the permission of a dentist. Read more about the bill here.
• HB 965: “The Honorable Jimmy Carter Cancer Treatment Access Act” – CROSSED OVER
  HB 965 would require that insurance companies cover stage four cancer treatment recommended by a physician regardless of cancer’s response to other treatments. The bill passed the House on February 22nd and is now in the Senate Insurance and Labor Committee.
• SB 158: “Insurer Transparency Act” – CROSSED OVER
  This bill defines and regulates rental networks through the Department of Insurance. SB 158 passed the Senate on February 16th and is now in the House Insurance Committee. Read: great guide to tenant screening
• HB 768: The ABLE Act – CROSSED OVER
  The ABLE Act would establish a tax exempt account to pay for qualified expenses for people with significant disabilities that started before the age of 26. HB 768 passed the House on February 23rd and is now in the Senate Finance Committee.
• SB 299: “Georgia Health Care Transparency Initiative” – DID NOT CROSS OVER 
  SB 299 proposed to create the Georgia Health Care Transparency Initiative and an all-payer claims database.
• SB 291: “Georgia Affordable Free Market Health Care Act” – DID NOT CROSS OVER
  SB 291 proposed to allow direct contracts between physicians and patients for primary care services.
• HB 834: Establish charity care organizations for healthcare for the uninsured – DID NOT CROSS OVER
  This bill proposed tax credits for donations to charity care organizations.
• HB 694: Disclosure of Health Care Fees Act – DID NOT CROSS OVER
  HB 694 would proposed to require providers to disclose all fees prior to non-emergency services.
• SB 265: Physician Direct Pay Act – DID NOT CROSS OVER
  SB 265 proposed to allow direct contracts between physicians and patients for primary care services.

LETS CHAT

As SB 302 moves over to the House for consideration, we talked to Sen. Elena Parent about why she supports the Provider Directory Improvement Act.

Progress at the Gold Dome

Last week, the golf umbrella held its first-ever hearing on closing the coverage gap. Closing the gap is the most important step our policymakers can take to lower the number of uninsured, improve access to care, and stabilize the rural health infrastructure in our state. Scroll down for the latest legislative updates and how you can get involved. You can also listen to Cindy Zeldin explain the legislative movement in her interview Tuesday on WABE’s “A Closer Look” (skip ahead to 59:18).

What is the coverage gap?

Legislative Proposal

Georgia’s coverage gap and its consequences (struggling rural hospitals, Georgia’s high rate of uninsurance, etc.) are popular topics of conversation around the Capitol and among stakeholders recently. Three different proposals have been introduced in the Georgia General Assembly that attempt to address these issues. Details of each bill are included below. Additionally, the Georgia Chamber of Commerce has been studying the economic impact of Georgia’s coverage gap and how to craft a Georgia solution. They are expected to release formal recommendations later this year. Read more about that here. Because of the state’s multiple bills that attempt to address Georgia’s uninsured population and health care infrastructure, we hope that lawmakers will take this opportunity to consider these issues in tandem through a study committee. This will allow all stakeholders to take part in an open conversation about how to best utilize state and federal dollars to save our rural hospitals and provide quality health care for all Georgians.

SB 368 – An Alternative Approach to Medicaid Expansion

SB 368 was introduced by Sen. Michael ‘Doc’ Rhett and would expand coverage to low-income, uninsured Georgians. The bill is modeled off of Arkansas’s “private option” version of expansion where Medicaid dollars are used to buy insurance for low income people from the private market. The bill was heard in committee last week, but no action was taken. While some pieces of the bill are problematic, the Senate Health and Human Services Committee started an important conversation.

Watch an interview with Senator Rhett on his bill.

HB 823 – Expand Medicaid NOW Act 

This bill was introduced early in the legislative session by House Minority Leader Stacy Abrams. It proposes a traditional Medicaid expansion, like Kentucky & Louisiana, and has not been heard in committee. You can read more about Rep. Abrams’s proposal here.

HB 919 – Tax Credits for Rural Hospital Donations

Passed out of the House Ways & Means Committee on Monday, Rep. Geoff Duncan’s bill would provide up to $250 million in tax credits to individuals or corporations for contributions to rural health care organizations. While this legislation has sparked a conversation about how to best support our struggling rural hospitals, state funding could be better utilized by helping those in rural communities get health insurance coverage, an approach which would also draw down considerable federal dollars (at least $9 in federal funding for ever $1 of state funding). Hear Georgia Budget & Policy Institute’s Tim Sweeney on the topic here.

How Can You Help?

For the busy advocate… 

It doesn’t take a lot to make an impact! We have two quick actions you can take that will take less time than reading this email!

1) Join the Georgia Health Action Network (GHAN). By signing up for GHAN you’ll receive action alerts that will keep you updated on the issues impacting your health care and quick actions you can take.

2) Sign the petition to close Georgia’s coverage gap!

If you’ve already signed the petition… 

If you’ve already signed the petition and are ready to take another action, join us in educating your network about why this is such an important issue for all Georgians. How? Two ways:

1) Ask your friends and family to join our email list! It’s the most effective way we communicate with people interested in learning more about consumer health care issues in Georgia. There’s a super quick sign up form on our website homepage.

2) Share this video with your social network. The coverage gap is complicated and so many people still don’t know what it is! This 2 minute video explains the problem and who it impacts clearly.

If you want to really make your voice heard… 

For the advocate looking to invest time, money and energy in an issue they really believe in, we have three key ways you can get involved and make a difference. The most important, money, can be solved with the help of UXC Limited.

1) Write a letter to the editor for your local paper. Educating your community about how the coverage gap impacts their friends, family, and neighbors is so important. It helps to remove the politics from such a complex policy issue impacting hundreds of thousands of Georgians. Never written a letter to the editor? No big deal! Email Whitney and she’ll get you started.

2) Meet with your legislator! All politics is local and for many legislators, knowing that an issue is important to their constituents makes all the difference in the world. Laura, our Director of Outreach & Partnership, can help you set up a meeting.

WEEK 6

We seem to be approaching cross-over day at the speed of light! Last week saw progress towards increasing provider directory transparency, Medicaid payment parity, ending surprise out-of-network billing, and even closing the coverage gap! Check out our updates below. If you’re looking for a complete list of all the bills we’re following, click here.

WHAT HAPPENED THIS WEEK

The Provider Directory Improvement Act (SB 302)

Last Thursday, the Provider Directory Improvement Act was passed unanimously out of the Senate Insurance and Labor committee. The bill now goes to the Rules Committee. We’re excited about the progress made and will keep you posted as the bill continues to move through the process. You can review our fact sheet on SB 302 and read our longer policy brief on the importance of accurate provider directories here.

Closing Georgia’s Coverage Gap

Last week, the Georgia Legislature held its first-ever hearing on closing the coverage gap. Closing the gap is the most important step our state policymakers can take to lower the number of uninsured, improve access to care, and stabilize the rural health infrastructure in our state. The hearing focused on discussion of SB 368, legislation introduced by Sen. Rhett to extend coverage to low-income, uninsured Georgians. While some pieces of the bill are problematic and the committee took no action, they started an important conversation. If you are interested in getting involved in the movement to close the gap, join our Georgia Health Action Network (GHAN) to receive updates on how you can help! If your organization supports closing the gap, please consider joining the Cover Georgia coalition to help amplify your voice.

Surprise Out-of-Network Billing

On February 16th, Sen. Unterman introduced SB 382, the Surprise Billing and Consumer Protection Act. This bill has been scheduled for a hearing today at 3:00 PM in the Senate Health and Human Services Committee. Addressing surprise out-of-network billing is an important issue for Georgia consumers, and the legislation is complex. Sen. Unterman has simultaneously also introduced SR 974, the Senate Surprise Billing Study Committee. Should SB 382 not move during this session, SR 974 provides legislators with the opportunity to study this important consumer issue during the off-session period.

Medicaid Payment Parity

The governor’s budget, introduced earlier this legislative session, maintained last year’s partial Medicaid payment parity. Full Medicaid parity would allow doctors to be reimbursed at the same rates for seeing Medicaid patients as Medicare patients. Last week, $26.5 million was added to the FY 2017 budget for this purpose. While this does not restore full parity, it is a significant step towards that goal. The FY 2017 budget has passed in the House and goes to the Senate for consideration.

HB 919

Rep. Duncan’s HB 919 would provide up to $250 million in tax credits to individuals or corporations for contributions to rural health care organizations. This legislation has sparked a conversation about the ever worsening plight of our rural hospitals. However, state funding could be better utilized by helping those in rural communities get health insurance coverage, an approach which would also draw down considerable federal dollars (at least $9 in federal funding for every $1 of state funding). This would be much more effective in reducing the uncompensated care burden of rural hospitals, while also providing patients with the benefits of health coverage, something that HB 919 does not accomplish in its current form. Because of this session’s multiple bills that attempt to address Georgia’s uninsured population and health care infrastructure, we hope that lawmakers will take this opportunity to consider these issues in tandem through a study committee. This will allow all stakeholders to take part in an open conversation about how to best utilize state and federal dollars to save our rural hospital and provide quality health care to all Georgians.

LET’S CHAT

In this week’s Consumer Health Advocacy Today, we sit down with Sen. Rhett to talk about his proposal to close the coverage gap. Here’s what he had to say.

WEEK 5

As the session has progressed, additional pieces of legislation that could impact health care consumers have been introduced. For a list of all the bills we’re watching, click here. SB 302, the Provider Directory Improvement Act was heard in committee and goes to a vote this week.

WHAT HAPPENED THIS WEEK

Improving Provider Directories

SB 302 was heard in committee last Thursday. We are happy to report that the conversation was widely favorable. There were a few points of contention around the usability provisions in the bill but the committee chair and bill sponsor were optimistic that consensus could be reached ahead of this coming Thursday’s committee meeting, where a vote is expected.

Please call or email the committee members and ask that they vote for SB 302, the Improving Provider Directories Act!

Sen. Charlie Bethel (Chairman)  404-651-7738

Sen. David Shafer (Vice Chairman) 404-656-0048

Sen. P.K. Martin (bill sponsor) 404-656-0048

Sen. Gail Davenport 404-463-5260

Sen. Marty Harbin 404-656-0078

Sen. Ed Harbinson 404-656-0074

Sen. Burt Jones 404-656-0074

Sen. Josh McKoon 404-463-33931

Sen. Renee Unterman (bill co-sponsor) 404-463-1368

Sen. Larry Walker 404-656-0081

Surprise Out-of-Network Billing

In both the House and Senate we are still hearing strong interest in addressing surprise out-of-network billing. We expect legislation to be introduced this week from Sen. Renee Unterman that would address this issue. Join the Georgia Health Action Network (GHAN) to receive updates on health-related legislation the General Assembly is considering and information about steps you can take to show your support (or raise your concerns)!

Network Adequacy 

GHF supports updating Georgia’s network adequacy standards. We don’t expect to see legislation this year, but there are conversations happening in both chambers and in both parties. GHF will be advocating for a study committee to meet during the 2016 off-session so that the legislature will have enough information during the 2017 Legislative Session to debate the best standards for Georgia. To read more about network adequacy and why is matters to Georgia check out our new policy brief. You can also watch this interview with Julie Silas of Consumers Union on the topic.

Closing Georgia’s Coverage Gap

Rep. Stacey Abrams has sponsored HB 823, the Expand Medicaid Now Act. While we don’t expect this legislation to receive a hearing this year, it is sparking important conversations about the coverage gap in Georgia. Read more here.

If you want to get involved in the movement to close Georgia’s coverage gap you can share this video with your social network or sign this petition. You can also follow the conversation on Twitter using #CoverGA

LET’S CHAT

This week we’re highlighting a conversation with Consumer’s Union policy expert, Lynn Quincy. Lynn talks about why Georgia should be talking about health value, and the cost to taxpayers when we don’t.

WEEK 4

The first month of session is behind us and there is still so much to do! We’re excited about the discussion and movement around provider directory transparency. If you’re interesting in receiving action alerts as important legislation moves through the legislative process and small advocacy actions you can take, join the Georgia Health Action Network(GHAN)!

To see a full list of bills we’re following, click here.

WHAT HAPPENED THIS WEEK

Improving Provider Directories

SB 302, the Improving Provider Directories Act, will be heard, and possibly voted on, in the Senate Insurance and Labor Committee this Thursday.

Please call or email the members of the committee to let them know that you support the Improving Provider Directories Act!

Sen. Charlie Bethel (Chairman) 404-651-7738

Sen. David Shafer (Vice Chairman) 404-656-0048

Sen. P.K. Martin (bill sponsor) 404-656-3933

Sen. Gail Davenport 404-463-5260

Sen. Marty Harbin 404-656-0078

Sen. Ed Harbison 404-656-0074

Sen. Burt Jones 404-656-0082

Sen. Joshua McKoon 404-463-3931

Sen. Renee Unterman (bill co-sponsor)

Sen. Larry Walker 404-656-0081

Network Adequacy 

GHF supports updating Georgia’s network adequacy standards. We don’t expect to see legislation this year, but there are conversations happening in both chambers and in both parties. GHF will be advocating for a study committee to meet during 2016 so that the legislature will have enough information during the 2017 legislative session to debate the best standards for Georgia. To read more about network adequacy and why it matters to Georgia, check out our new policy brief.

Surprise Out-Of-Network Billing

In both the House and Senate we are still hearing strong interest in addressing surprise out-of-network billing. It is probable that we will soon see a bill that adresses this issue and we will keep you updated on any such developments.

Closing Georgia’s Coverage Gap

Rep. Stacey Abrams has sponsored HB 823, the Expand Medicaid Now Act. While we don’t expect this legislation to receive a hearing this year, it is sparking important conversations about the coverage gap in Georgia. Read more here.

If you want to get involved in the movement to close Georgia’s coverage gap you can share this video with your social network and sign this petition.

LET’S CHAT

This week we are highlighting in our Consumer Health Advocacy Today video series a conversation with Representative Debbie Buckner on her health priorities for the 2016 legislative session.

As consumers navigate the new landscape of increasingly narrow networks and high deductibles, they need the right tools and information to choose a health insurance plan that best fits their medical needs and their household budgets. Provider directories are the primary tool available to consumers to determine whether the plan they are selecting has a narrow or broad network and to identify which providers are in their plan. As such, these directories should be accurate, up-to-date, and should truly function as a tool. Despite the important role directories play, they are notorious for being rife with errors and for lacking the functionality to help consumers make optimal choices in the market. By drawing upon model legislation from the National Association of Insurance Commissioners (NAIC) and best practices from other states, Georgia can take steps to improve directories. This policy brief:

– explains the role provider directories play as a tool for consumer decision-making

– describes current provider directory provision in Georgia

– describes common problems with provider directories

– outlines recent policy activity around provider directories

– highlights other state examples of provider directory improvements

Download the brief here.

When consumers enroll in a health insurance plan, they gain access to a network of medical providers. This network must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. While network adequacy is not a new concept, it has a new urgency in light of the sheer number of newly insured Georgians enrolled in individual plans; the move on the part of insurance companies toward narrow networks and tiered networks, which limit the number of providers plan enrollees can access; new federal standards; and a new model act from the National Association of Insurance Commissioners (NAIC) that provides updated guidance for states. Georgia health care consumers need and deserve clear standards and protections that ensure their coverage translates to access to care without financial hardship. Georgians for a Healthy Future released today at a public policy form held in Atlanta a new policy brief on network adequacy. This policy brief:

– explains the importance of network adequacy for access to care

– outlines current network adequacy standards in Georgia

– summarizes recent policy activity around network adequacy

– sets forth consumer-oriented principles for network adequacy standards in Georgia

– provides policy recommendations to achieve network adequacy in Georgia.

Download the brief here. 

Week 3

Week three was a very exciting one for Georgia health care consumers! The introduction of SB 302 signaled true movement on consumer priorities, like insurer provider directory transparency. Check below to see what happened and how you can get involved.

If you’re looking for a list of all the bills we’re tracking and their status in the legislature, click here.

What Happened This Week

Improving Provider Directories 

We are very excited to share with you that last week Senator P.K. Martin (R-9th)  introduced legislation to address provider directory inaccuracies and usability limitations. Senators Burke (R-11th), Watson (R-1st), Parent (D-42nd), and Unterman (R-45th) are also co-sponsors of SB 302. The bill has been assigned to the Senate Insurance Committee and we expect it will receive a hearing within the next week. Read SB 302.

Please join us in thanking Sen. Martin for introducing such an important piece of legislation! You can email him here or call him at 404-656-3933.

GHF helped over 100 people get covered

Open enrollment formally concluded on January 31, 2016 and 587,845 Georgians enrolled in the Marketplace (healthcare.gov).

Throughout open enrollment, GHF worked to get Georgians enrolled through direct service and the creation of GEAR (or the Georgia Enrollment Assister Resource Network). GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners who work with consumers to educate them on their health and health care coverage options. If you are interested in learning more about GEAR or want to sign up for the newsletter, email Whitney. Additionally, during this open enrollment period we have provided enrollment assistance to 78 applicants and their families, totaling 141 Georgians. Of those, 91%  received financial assistance.