Peach Pulse: August 27, 2010

National News:

State Guidance Now Available for FMAP Funds

Last week the Center for Medicare and Medicaid Services (CMS) released guidance on how states can apply for money now available through the extension of the enhanced federal Medicaid funding, known as FMAP.  That extension was recently signed by the President and will provide Georgia with $230 million in Medicaid funding that the state needs to stave off deep cuts to essential health services.  According to CMS, “as a condition of receiving these additional Federal funds…the Chief Executive Officer of the State must submit a request…within 45 days of enactment, or by September 24, 2010.”  In order to receive the funding, the Chief Executive Officer of the State must submit a letter of intent to the Secretary of Health and Human Services and affirm that certain conditions are met. To view the letter and learn more about the requirements, read the CMS bulletin here.

The FMAP funding extension was already built in to the 2011 budget, but the amount Georgia will receive is less than was anticipated and will still leave the state with a budget gap.

What’s New in Georgia:

Department of Community Health Presents Options for Budget Cuts to Health Programs

On Thursday, the Georgia Department of Community Health presented its proposed options for cuts to the amended FY 2011 budget and the FY 2012 budget in response to a requirement from the Governor to reduce all programs in FY 2011 by 4, 6, and 8 percent and all programs in FY 2012 by 6, 8, and 10 percent, using the current FY 2011 budget as the baseline. Medicaid and PeachCare are not exempt from these cuts; however, because of Maintenance of Effort (MOE) requirements in the new federal health care law, states must maintain current eligibility standards for Medicaid and the Children’s Health Insurance Program (PeachCare). As a result, cuts will likely come from reimbursement rates to providers, which would negatively impact access to services for Medicaid and PeachCare beneficiaries. Significant cuts to public health programs were also proposed. To view the full presentation, click here. To learn more about the MOE requirements, click here.

Georgia Misses Opportunity to Protect Citizens Against Insurance Rate Hikes

The Affordable Care Act requires the Secretary of the Department of Health and Human Services (HHS), in conjunction with the States, to establish a process for the annual review of health insurance premiums to protect consumers from unreasonable, unjustified and/or excessive rate increases.  As part of process, the Federal government has made $46 million available to states to provide for grants to help them improve the health insurance rate review and reporting process between now and 2014.  In the first round of grant funding, Georgia passed on $1 million to help crack down on unreasonable health insurance rate hikes.  Georgia is just one of just five states who did not apply for the money. This is a missed opportunity to correct a situation that far too many Georgians face—being priced out of a plan when a disease or condition is diagnosed and costs sky-rocket.  Georgia is still able to apply for the second round of funding but it remains to be seen whether they will pursue this opportunity. For more information, click here.

Savannah Passes a Smoke-Free Ordinance

On Thursday, the Savannah City Council passed an ordinance supported by Mayor Johnson and Healthy Savannah to ban cigarette smoking in bars and other public spaces in Savannah, thereby reducing exposure to second-hand smoke and improving public health. The ordinance could serve as a model for the state. For more information, click here. To learn more about the work of Health Savannah, click here.

Local Doctors Build Advocacy Campaign in Georgia

Doctors for America (DFA) is a non-profit, grassroots, national organization of physicians and medical students who advocate for changes in the health care system to ensure affordable access to quality care for all.  Here in Georgia, confusion persists about the new health care law, and many doctors have come together to build a Georgia chapter of DFA to educate their patients and communities about the new law so that they can make appropriate, well-informed decisions regarding their care. If you are a physician and want to learn more about how you can get involved, please contact Gayathri Suresh for more information.

Special Council on Tax Reform and Fairness Continues its Work

On Wednesday, the 2010 Special Council’s four economists presented the principles of tax reform that will guide the council. These principles are:

  • Growth enhancing
  • Stability
  • Clearness/simplicity
  • Efficiency
  • Equity/fairness
  • Properly developed/transparency

This week the Council also held its first public hearing, or “fact finding session,” in Atlanta to gather comments from interested parties. Let the Council hear from you on the need to protect revenues for important services like public health, Medicaid, and PeachCare by submitting comments online ( or by attending one of the upcoming fact finding sessions in your community.

FACT FINDING SESSION SCHEDULE:  (All meetings from 4:00 PM to 7:00 PM)

To address the Council, submit a request by 5pm on the day prior to the hearing here.

August 30 – Augusta – Doubletree Hotel, Master’s Ballroom?2651 Perimeter Parkway?Augusta, GA 30909

August 31 – Savannah – Coastal Georgia Center, Auditorium?305 Fahm Street?Savannah, GA 31401

September 1 –Valdosta – Wiregrass Georgia Technical College, Brooks Hall Conference Center?4089 Val Tech Road?Valdosta, GA 31602

September 2 – Macon – Macon State College, Professional Sciences Conference Center, Banquet Hall?100 College Station Drive?Macon, GA 31206

September 7 –Rome – Forum Civic Center, Riverwalk Ballroom?Downtown Rome ?2 Government Plaza?Rome, Georgia 30162

September 9 –Gainesville – Gainesville State College, Gainesville Campus, Continuing Education, Business Division and Performing Arts Building, Auditorium?3820 Mundy Mill Road?Oakwood, GA  30566

The Affordable Care Act and You:
Health Reform Implications for Employers

Earlier this week, the Health Policy Center at Georgia State University released an analysis of the employer responsibility provisions of the new health care law and an interactive calculator for small businesses to estimate their eligibility for tax credits available through the new law to provide health insurance for their workers. The report is available here. The calculator can be accessed here.

Several Health Reform Provisions To Take Effect on September 23rd:  Spotlight on the Dependent Care Provision

On September 23, 2010, the 6-month anniversary of the passage of the Affordable Care Act, several key reforms will go into effect. One of the most highly anticipated changes is the dependent care provision, which will allow young adults up to age 26 to remain on a parent’s health insurance plan.  Today, young adults aged 19 through 29 comprise about 13 million of the 47 million uninsured Americans.  Previously, young adults not enrolled in college full-time could not remain on their parents’ private health insurance plans as a dependent. However, because young adults just entering the workforce tend to have a more tenuous connection to the labor market (for example, as part-time, temporary, or low-wage hourly workers), they are less likely to have access to an employment-based health insurance plan. If they had been eligible for public programs like Medicaid and PeachCare as a child, they also generally lose eligibility for these programs when they reach age 19. To address this problem, the ACA requires private health plans to extend the age of coverage for dependents to 26, regardless of whether that young adult is enrolled in school.  While the provision takes effect on September 23, families who want to extend coverage to their children should consult their insurer and determine when their open enrollment period occurs.

On September 3, Young Invincibles, a group that works on health care issues for young adults, will unveil their Getting Covered campaign aimed at educating families about this new provision.  Their website, will go live that day and help educate the public about their rights under this provision.

Future issues of the Peach Pulse will highlight additional provisions taking effect on September 23rd.

Implementation and the States: New Resources Available

Several elements of the new health care law will be implemented at the state level. To help states prepare, a range of resources have recently become available. The National Governors Association recently released a document identifying states that have passed legislation or issued Executive Orders to oversee and coordinate the process for health reform implementation. Highlighting eighteen states and the U.S. Virgin Islands, the document explains how many state legislatures and governors have begun setting up the infrastructure for implementing the new law. State implementation efforts, to date, include creating task forces or appointing officials responsible for moving forward with federal requirements.  Georgia has not yet set up such a structure. The table is available here.

The National Conference of State Legislatures also recently released a checklist for state legislatures that identifies state laws that may need to be amended to be in accordance with the new federal law. The checklist is available for download here.

Earlier this month, the Alliance for Health Reform held a briefing to outline key challenges and decision points for states as they embark on implementation. To read the event summary, transcript or to listen to the podcast, visit the Alliance for Health Reform website.

Additional resources to help guide state officials and advocates as they think through implementation include a recent report from the Robert Wood Johnson Foundation on harnessing federal resources for state goals, available here, and a guidebook from U.S. Pirg to help officials and advocates deliver on the promise of health reform, available here.

New Information on the Medicaid Expansion

The new health care law significantly expands the Medicaid program. Beginning in 2014, all Americans with household income up to 133 percent of the federal poverty level will be eligible for health insurance through Medicaid. Here in Georgia, this expansion is expected to considerably reduce the number of low-income uninsured Georgians. By 2019, between 645,000 and 900,000 could gain coverage through Medicaid. The Kaiser Family Foundation recently released two reports providing additional information about how this expansion will impact states. The first report provides state-by-state information on the number of people who will gain coverage through the program and the associated cost to states and is available here. The expansion will be entirely federally financed in the first two years, and will scale down to 90 percent federal/10 percent state in 2020 and thereafter. The second report describes several state Medicaid agencies’ efforts to prepare for health reform implementation while addressing challenges associated with the current economic downturn and is available here.

New Implementation Timeline Helps Explain the ACA

The Commonwealth Fund recently released an updated timeline for implementation of the Affordable Care Act.  Several provisions have recently taken effect, including the Pre-Existing Insurance Program (PCIP), the launch of the web portal and a requirement that no cost-sharing be applied to preventive services. However, most of the changes place between now and 2014. To view the timeline, visit the Commonwealth Fund’s website.