Peach Pulse: April 30, 2013

Preparing for the next phase of health reform: outreach and enrollment

Open enrollment into the new health insurance marketplace, or exchange, begins in just five months (October 1, 2013) for coverage starting in January 2014.  Georgia has one of the highest numbers of uninsured in the nation (1.86 million), and many of these uninsured Georgians will be able to access affordable health care coverage for the first time through the marketplace.  [However, unless Georgia implements the Medicaid expansion, our state’s lowest-income uninsured will still lack a pathway to coverage.  To learn more about this coverage gap and Georgians for a Healthy Future’s efforts to cover this population, click here.]

According to research from Enroll America, more than three-quarters of the uninsured don’t know about the new health insurance marketplace. Multiple surveys have also found that when uninsured individuals who would be eligible for affordable coverage through the marketplace learn about the new health insurance options that will become available to them, they say they will need help navigating the process.

Georgians for a Healthy Future is currently working with Enroll America to assess the interest and capacity of Georgia community-based organizations, health care-focused nonprofits, and other stakeholders in working collaboratively on education, outreach, and enrollment into the new health insurance options available to consumers in 2014 through the Affordable Care Act. As a first step, we held a webinar on April 10th and an in-person meeting on April 11th that many of you attended. For those who missed the meetings, the materials can be found here.

If your organization has a stake in covering the uninsured, we’re asking you to complete a brief survey about your current work and future plans to engage in connecting uninsured Georgians to coverage either through applying to become a health insurance navigator or in other ways. Georgians for a Healthy Future plans to use the overall results of the survey to guide the formation of a new enrollment-focused coalition and to inform an upcoming policy brief on health insurance outreach and enrollment.

Please take a few minutes to complete this survey. Georgians for a Healthy Future is committed to advancing the goal of covering Georgia’s uninsured by bringing stakeholders together who are interested in and able to collaborate towards this shared goal. The results of this survey will provide a baseline and starting point for this important work. Thank you!

More than 800,000 Georgians will be eligible for health care tax credits in 2014

Many of the Affordable Care Act’s major health insurance reforms take effect in 2014. One of the most important changes impacting consumers will be the availability of substantial new tax credits to help individuals and families afford health care coverage. Individuals with annual incomes between about $15,860 and $45,960 (or between about $32,500 and $94,200 for a family of four) will be eligible for the health insurance tax credits. According to a new study by Families USA, about 800,000 Georgians will be eligible for these credits to help make coverage more affordable for them. Georgians for a Healthy Future joined with Families USA in a co-release of the report to highlight the Georgia-specific findings. You can find media coverage of the report’s findings here, here, and here. You can download the report here.

HHS issues proposed regulations on health insurance navigators

Connecting uninsured Georgians to new coverage opportunities will be a major undertaking. To facilitate consumer education, outreach, and enrollment, the Affordable Care Act creates a health insurance navigator program. Earlier in April, the U.S. Department of Health and Human Services (HHS) issued proposed regulations providing more information about how the program will work. The proposed regulations contain strong conflict of interest provisions, cultural competency and accessibility requirements, and training standards. You can read an analysis of the proposed regulations from the journal Health Affairs here.  HHS is accepting public comments on the regulations until May 6th. Please consider sending comments in support of these consumer-friendly provisions.

The proposed regulations also indicate that state-level restrictions on navigators that are so burdensome as to prevent the viability of the navigator program will be preempted. This was included in response to a spate of bills that have popped up in legislatures across the country at the behest of the health insurance broker and agent lobby. Many of these bills are nearly identical across states and, if implemented, could impede the critically important navigator program. During the 2013 legislative session, Georgia legislators passed HB 198, which would place restrictions on navigator functions and require navigators to meet licensing and training requirements in Georgia. Although there is good reason to believe at least parts of HB 198 will be preempted, Georgians for a Healthy Future remains vigilant about the potential negative impact of HB 198 on the participation of small consumer and community-focused nonprofit organizations in the navigator program. The robust participation of these types of entities will be needed to ensure hard-to-reach populations in Georgia learn about and enroll in the new health insurance options available to them. Should HB 198 be signed into law, Georgians for a Healthy Future hopes to work with state officials to implement it in a way that is consistent with federal law and that strengthens the navigator program, perhaps by offering a training curriculum on state-specific programs like Medicaid and PeachCare, rather than weakens it.

The Augusta Chronicle recently interviewed Georgians for a Healthy Future’s executive director about the importance of the navigator program, the proposed rules, and Georgia’s HB 198. That article is available here.

CMS announces simplified health coverage application

Based on feedback from consumer groups, the Centers for Medicare & Medicaid Services (CMS) announced today a shortened and simplified health coverage application that will help individuals easily apply for coverage when open enrollment begins on October 1, 2013.  Additionally, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options including those in the marketplace, Medicaid, PeachCare, and tax credits to help pay for premiums.  To view the new applications for individuals and families, click here and here, and here.

The stakes are highest for the state’s lowest income citizens

One of the guiding principles of the Affordable Care Act is that everyone should be eligible for some type of health care coverage.  While the new health insurance marketplace opens in 2014 and will make affordable health insurance available for nearly 800,000 Georgians, hundreds of thousands of additional low-income Georgians could be left out in the cold unless Georgia policymakers implement the Medicaid expansion, which was made optional by last summer’s U.S. Supreme Court decision.  Tax credits are available to consumers with incomes between 100% and 400% of the federal poverty level (or starting at about $15,860 for an individual or $32,500 for a family of four) to purchase coverage through the health insurance marketplace. Medicaid was intended to be the route to coverage for individuals and families with incomes below that threshold, and many states are indeed extending Medicaid to their lowest-income citizens. We need your voice to move Georgia from no to yes on the Medicaid expansion!

Please join the efforts of the Cover Georgia coalition however you can. Here are some suggested ways to engage in this important issue:

  1. Take five minutes to call Governor Deal at 404-656-1776 and ask him to support expanding Medicaid in Georgia to people with incomes up to 138% FPL.  For talking points, click here.
  2. Sign and share the petition to Governor Deal.
  3. Share your story with us–are you one of the people who would gain coverage with expanded Medicaid? Do you know people who would? Have them share their story with us to help put a face on this important issue to policy makers and the media.
  4. Write an op-ed or letter to the editor.  Explaining how the expansion would affect different populations across the state is our best way to show how widespread the effects of the decision’s reach.  For help with media outreach, email Amanda Ptashkin.  For an excellent example of a compelling op-ed on the topic, click here.
  5. Join Cover Georgia and become an active participant in a statewide coalition dedicated to expanding coverage for Georgians.  Once October hits and we see hundreds of thousands of Georgians begin to learn about their coverage options, we will also begin to see just how many people stand to fall into the coverage gap created by the failure to expand Medicaid.  Help the advocacy community overcome this obstacle by joining our efforts to #CoverGeorgia.

SAVE THE DATE: All Hands on Deck! An Evening with Georgians for a Healthy Future

Please save the date for Georgians for a Healthy Future’s annual cocktail reception and fundraiser.  This year’s event, All Hands on Deck!, stresses the critical nature of our collaborative work as we collectively navigate the health care landscape in our state.  Please join us for a fun and entertaining evening!

WHEN:  Thursday, June 27, 2013, 6pm to 8pm
WHERE:  18th Floor Deck, Nelson Mullins Riley & Scarborough

Invitation and RSVP link to follow shortly.

Health care town hall focused on how the ACA affects Georgia’s LGBT community

On April 17th,  Georgia Equality and Georgians for a Healthy Future held a health care town hall meeting to share the specifics of what health care reform means for Georgia’s LGBT community.

The ACA brings with it great changes to our health care system and how people are able to access coverage.  While these changes will affect everyone, there are some very specific issues that the LGBT community should be aware of.

Brian Bassinger, an associate at King & Spalding and former Georgia Equality Board member, gave an informative presentation which included the history of LGBT health care access and the implications of the ACA’s provisions for LGBT individuals.  To view Brian’s presentation, click here.  Georgians for a Healthy Future’s Amanda Ptashkin also presented at the town hall about the importance of coverage, particularly through the lens of the Medicaid expansion. To view Amanda’s presentation, click here.  To download two health reform focused LGBT specific fact sheets, click here and here.