Peach Pulse: March 14, 2011

March 15th: Cocktail Reception and Fundraiser

If you haven’t done so already, please register for Georgians for a Healthy Future’s 2nd Annual Cocktail Reception and Fundraiser.  Taking place at Ri Ra on Tuesday, March 15th from 6:00pm to 8:00pm, the evening will include substantive updates on important issues facing the General Assembly as well as an opportunity to network and unwind before Cross-Over Day. We hope to see you there! Click here to purchase your ticket.

What’s New in Georgia

Update on the 2011 Legislative Session

Twenty-eight of the 40 legislative days are now complete. The Legislature is in session Monday and Wednesday of this week for legislative days 29 and 30. Day 30 is also known as crossover day, the deadline for bills to pass their chamber of origin to remain viable, unless attached to another piece of legislation as an amendment. Georgians for a Healthy Future is monitoring several bills that would impact health care coverage and access in Georgia. If you’d like to weigh in on these bills, you can find your legislator’s contact information here.

Recent Action Was Taken on the Following Bills:

House Bill 476 establishes the Georgia Health Exchange Authority, the governance body for Georgia’s health insurance exchange. Under the Affordable Care Act, Georgia recently received a $1 million grant from the Department of Health and Human Services to begin planning for a health insurance exchange. The exchange will be a structured marketplace where, beginning in 2014, individual consumers and small businesses can purchase health insurance plans from a range of private insurers, in many cases with tax credits to offset the cost of the premiums. HB 476 also creates an Advisory Committee to make policy recommendations to the exchange governing board and the Governor by November 15, 2011 for next steps. This is a constructive first step towards developing a better functioning, value-driven health insurance market for consumers in Georgia. The bill was favorably passed out the House Insurance Committee last week. For more information on HB 476, including several policy reports outlining policy choices for states, click here. For more information about the legislation, click here.

House Bill 47 would allow Georgia insurers to sell individual health insurance products with benefit designs equivalent to those sold in other states, circumventing current Georgia standards for basic consumer protections and essential medical services that all insurers must cover today under Georgia law. The bill was passed by the House last week and moves to the Senate Insurance Committee. For more information about the concerns this legislation raises for patients and consumers, click here. For more information about the legislation, click here.

House Bill 229 requires that DCH process appeals requests and refer them for hearing before an Administrative Law Judge (ALJ) within 15 days. Currently, after the ALJ hears a case and renders an impartial decision, DCH may appeal the decision to itself.   HB 229 removes DCH’s ability to overturn the ALJ’s decision, providing a fair and efficient administrative appeal process that protects the integrity and impartiality of the hearing before the Administrative Law Judge. The bill was favorably passed by the House Judiciary Committee last week and will be voted on by the House this week. To learn more about the benefits of HB 229, click here. For more information on the legislation, click here.

Senate Bill 63 would enact a Georgia Medical Assistance Fraud Prevention Program. The bill, as introduced, would have put in place a pilot program that would involve fingerprinting Medicaid patients at the point of service. A committee substitute bill stripped the biometric identification requirement and instead requires a pilot program utilizing smart card technology along with language that the Department may also implement a biometric verification process if it so chooses. Implementing the bill could present barriers to accessing care, and the methodology proposed has not been proven to be successful method to target fraud within the Medicaid system. To see the fiscal note on the bill as originally proposed, click here. For more information on the legislation, click here.

Additional Analyses & Resources on Proposed Health Care Legislation in Georgia
You can also track the status of various health care related bills and download analyses and resources on these bills on our new legislative tracking page on the Georgians for a Healthy Future website. The page is available here.

Budget Update

Last week, the House of Representatives passed the FY 2012 budget.  For the Department of Community Health, the House version of the budget restored proposed funding cuts to dental, vision, and podiatry services for adults on Medicaid; partially restored Medicaid reimbursement cuts to providers; and partially restored funding for the Children 1st program which provides screening services for newborns and other at-risk children and links children to services to address developmental and other health needs.  To learn more about the health care budget, click here to read Georgia Budget and Policy Institute’s latest report.

Bump It Up a Buck Campaign Launches

On March 3rd, the Georgia Alliance for Tobacco Prevention (American Cancer Society, American Lung Association, American Heart Association, ACS CAN, GASCO, Georgians For A Healthy Future, Georgia Public Health Association) launched the “Bump It Up a Buck” campaign, aimed at increasing the state’s tobacco tax by a dollar.  The bump of $1 will generate an estimated $350 million per year in revenue at a time when the state is facing a $2 billion deficit, and will help save critical programs and services, save kids from addiction to tobacco and encourage current smokers to quit.  To learn more about the campaign and to see useful fact sheets on the issue, visit and find them on Facebook and Twitter.

The Affordable Care Act and You

Early Retiree Reinsurance Program Provides Financial Relief to Georgia Health Plan Sponsors, Including State Health Benefit Plan

The Early Retiree Reinsurance Program (ERRP) was established by the Affordable Care Act to assist businesses, state and local governments, non-profit organizations, and other plan sponsors that provide health insurance to early retirees with the cost of that coverage. The ERRP is intended to help stabilize plans that provide insurance to early retirees. Without such coverage, early retirees between the ages of 55 and 64 face difficulties securing an affordable health insurance policy in the individual market because of their age or pre-existing health conditions. As of December 31, 2010, over 5,000 plan sponsors were approved for participation in ERRP, including 74 Georgia-based plans. The Georgia Department of Community Health was among the approved applicants, receiving $34.9 million for the State Health Benefit Plan. More information about the ERRP and the funds directed to Georgia employers is available here. For a full report on the ERRP in 2010, click here.

New Report Finds Full Implementation of the Affordable Care Act Will Reduce Georgia’s Rate of Uninsured by 12.6 Percentage Points

A new report by the Robert Wood Johnson Foundation estimates the effects of the Affordable Care Act on states, in particular the increases in insurance coverage, subsidies in the exchanges, Medicaid enrollment and federal spending.  Nationally, full implementation will lead to a 10.3 percentage point decrease in uninsurance for the non-elderly—in Georgia that reduction is 12.6 percentage points. In terms of the Medicaid program, upon full implementation, 1.8 million Georgians will be enrolled in Medicaid. Among this group, 29% will be newly eligible and newly enrolled.  For more data on the effects of full implementation and to read the full report, click here.

Progress Continues on Health Insurance Exchanges

Georgia’s planning work on a state health insurance exchange continued with the introduction of HB 476, and progress continues in states around the country. For primers on how exchanges will work, what points of flexibility states have, and resources for how to ensure the exchanges are consumer friendly, see Families USA’s Health Insurance Exchange Resources. For a recent AJC article on Georgia’s progress, click here.

National News

New Flexibility

President Obama outlined a proposal to move up the date from 2017 to 2014 in which states wishing to innovate to achieve the same coverage and affordability goals as will be met under the Affordable Care Act can apply for a waiver to pursue these strategies. As Georgians for a Healthy Future discussed in media interviews (here and here) on this topic, the provision is intended for states that are already at near-universal coverage and it is unlikely that Georgia would be able to shift course and set up a separate system that would meet the coverage and affordability benchmarks without doing it under the framework in the Affordable Care Act.

Employers and Health Care Reform

A new policy brief issued by the Robert Wood Johnson Foundation examines the issues surrounding the effects of health care reform on employers.  To expand access and strengthen the employment-based health system, the ACA requires midsize and large companies to make payments to the federal government if they do not offer health insurance to their employees and dependents starting in 2014. The brief explores the current state of employer-sponsored coverage and what the likely impact is of implementation.  To read the brief, click here.

Small Business: A Year Later

A new fact sheet from Small Business Majority details how provisions of the new health law address concerns with rising health care costs and ultimately affect small businesses across the country.   A recent study found that nationally 87% of small businesses are eligible for tax credits to help offset the cost of health care for employees.  Additionally, small businesses benefit from access to the Pre-Existing Condition Insurance Plan and free preventive care now available through health plans.  To learn more about the effects of the law on small business, click here.