Peach Pulse: July 13, 2010

FMAP and the Looming Budget Crisis in Georgia

The economy is still in a fragile state and all across the country states are struggling to balance budgets and still provide for their citizens.  Here in Georgia, it is no different.  Governor Purdue’s FY 2011 budget was balanced in large part based on the assumption of a continuation of enhanced FMAP for an additional six months.  Provisions were enacted through last year’s Recovery Act to enhance the Federal match dollars to protect state Medicaid programs at a time of crisis.  The crisis was two-fold, for individual families and as fiscal relief to states.  The enhanced FMAP was used to help keep state budgets afloat and to maintain vital health services to children and families at a point where much assistance was needed.  To date, no FMAP extension has been approved by Congress which places our state in a dangerous position.  Without an extension of the enhanced FMAP through the end of our 2011 State Fiscal Year, Georgia is short at least $375 million dollars.

Advocates must make their voices heard to get the FMAP extension passed very soon.  Take Action Today!  Call Senator Isakson and Senator Chambliss and urge them to support their constituents in Georgia and to extend the enhanced FMAP.  Their support will maintain our state’s commitment to providing coverage and health service access to vulnerable Georgians through Medicaid.

Update on the Babies Born Healthy Program

Effective June 7th, the Department of Community Health ceased operations of the Babies Born Healthy Program, which provides prenatal care to women who are at or below 250 percent of the federal poverty level, ineligible for Medicaid, and otherwise uninsured or underinsured. The Department of Community Health recently released a letter explaining this decision, which is available for download here, and an FAQ on the decision, available for download here. Since the program has closed, Healthy Mothers, Healthy Babies Coalition of Georgia, which operates a Powerline program to connect women in need of services with those health care services, is working to locate low-cost prenatal resources across the state of Georgia. If you are aware of low-cost prenatal services in your community, Healthy Mothers, Healthy Babies would like to be able to share that information with the women who call the Powerline. Please contact Pam Gaston, Executive Director of Healthy Mothers, Healthy Babies, with this information.


New Report on Metro Atlanta Hospitals

Only about half of metropolitan Atlanta’s hospitals comply with state regulations to advertise the availability of financial assistance, according to a report released in June by Georgia Watch. These findings are the result of an 18-month study through the organization’s Metropolitan Atlanta Hospital Accountability Project, or HAP, which focuses on financial aid programs for low-income, uninsured and underinsured patients at general hospitals in the 21-county metro area. For this project, Georgia Watch representatives visited all hospitals studied to see if signage was posted advertising the availability of free or reduced cost care, and if financial assistance policies were made available to the public. In addition, the HAP team surveyed 900 low-income, uninsured, or underinsured individuals about their financial experiences at area hospitals. Using publicly-available information, HAP compared and contrasted hospitals throughout the metro area in regards to their offerings for these vulnerable populations, and analyzed the specific barriers and challenges these populations face. You can read the report at

New Poll Reveals Cancer Patients Struggle to Afford Health Care and Pay Bills in Tough Economic Times

A new American Cancer Society Cancer Action Network(ACS CAN) poll of families affected by cancer shows that cancer patients, survivors and their families continue to struggle to afford health care and pay for other basic needs such as food and heat in the troubled economy. The findings suggest the need to implement the Affordable Care Act so that it benefits people with cancer.

The poll finds that nearly half of cancer patients and survivors under age 65 have had difficulty paying for health care costs such as health insurance premiums, co-pays and prescription drugs in the past two years. One-third of those currently in active treatment have had to delay some type of health care in the past year.  To learn more about the poll, take a look at the ACS Press Release and the Lake-Bellweather Poll Report.

The Commish: The Race for Insurance Commission is On

Georgia’s Insurance Commissioner is responsible for regulating insurers and enforcing consumer protections in health insurance. As many features of the new health care law begin to take effect, the Insurance Commissioner will have new watchdog and enforcement responsibilities over health insurance.  On June 25, the Atlanta Press Club hosted several candidate debates in advance of the July 20th primary elections, one of which was between candidates for the office of Insurance Commissioner. Georgia Public Broadcasting has the video on its website now of the Republican primary debate. There was no debate in the Democratic primary because that race is uncontested. There were several questions about health insurance regulation and the new health care law. The video is available here.


The Pre-Existing Conditions Insurance Plan and Web Portal are Live!

An important reform of the 2010 Patient Protection and Affordable Care Act takes effect July 1 when Georgians who have been without health coverage for at least six months and who have been denied coverage because of pre-existing health conditions will be given access to affordable, quality coverage. They will receive it through a new Pre-existing Condition Insurance Plan (PCIP) created by the U.S. Department of Health and Human Services (HHS).To find the new coverage available in Georgia and information about the complete range of health coverage options available for consumers by ZIP code through a website set up by HHS, see

The HHS Web site and other information about the new program will be available on July 1.  The new website is the first to provide consumers and small businesses with information about private insurance, Medicaid, the Children’s Health Insurance Program, Medicare, and other coverage options in one place. Federal officials are emphasizing that the PCIP is not the long-term solution to the insurance industry’s practice of denying coverage based on pre-existing conditions; instead, it will serve as a bridge to 2014, when the reform law bans denials of coverage based on pre-existing conditions.

State-Level Implementation and Insurance Regulation:  New Resources from the NAIC

Over the next several years, state Insurance Commissioners will play an important role in implementing the new federal health care law. The National Association of Insurance Commissioners, comprised of health insurance regulators across the 50 states, is charged with several standard-setting and consultative responsibilities and now has a special section on its website dedicated to state insurance regulation and the Patient Protection and Affordable Care Act (PPACA). Among other things, the site includes information about potential funding opportunities for states through PPACA, a glossary of health care terms, and information about the new high-risk pools, now known as the Pre-Existing Condition Insurance Plan (PCIP).

New Reports and Resources

A  new series of issue briefs released by the Robert Wood Johnson Foundation walks through the effect on state governments, children, young adults, seniors, health outcomes, and premiums. The series is available for download here. The Georgetown Center for Children and Families also released a new report outlining key decisions for states in the implementation of the new law. That report is available for download here. For Georgia-specific information, the Health Policy Center at Georgia State University has a fact sheet on the implications of health reform in Georgia, which is available for download here.