Peach Pulse: March 25, 2011

Georgians for a Healthy Future in the AJC: “Pro & Con: Is first year of health care reform law living up to promised claims?”

Georgians for a Healthy Future’s Cindy Zeldin and Voices for Georgia’s Children’s Joann Yoon marked the one-year anniversary of the new health care reform law by setting the record straight in the AJC on the benefits of the new law to Georgia consumers. The article is available here.

Second Annual Cocktail Reception

Thank you to everyone who came out for Georgians for a Healthy Future’s 2nd Annual Cocktail Reception and Fundraiser!  We were delighted to see so many new and also familiar faces supporting the work of our organization.  Click here to view pictures from the event.  If you were unable to attend and would still like to support the important work of our organization, please click here.

What’s New in Georgia

Update on the 2011 Legislative Session

Thirty-three of the 40 legislative days are now complete. The Legislature is out of session for the remainder of this week; in session each day next week for legislative days 34 through 38, out of session the week of April 4th; and in Session for the final two legislative days on April 12th and April 14th.  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 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 and is now in 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 214 would move the Division of Public Health out of the Department of Community Health and establish a new, independent agency, the Department of Public Health, implementing the recommendation of the Public Health Commission. The new stand-alone agency would operate on the same budget as the Division of Public Health and provide Georgians a nimbler and more efficient public health agency with a clear focus on prevention and population-level health. The bill was passed by the House and passed through the Senate HHS Health Care Delivery Subcommittee on Wednesday. It now moves to the full Senate HHS Committee. For more information about the legislation, click here.

House Bill 229 would require 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 would remove DCH’s ability to overturn the ALJ’s decision. The bill did not pass by Crossover Day, which means that it is no longer viable this year unless attached to another piece of legislation. To learn more about the benefits of HB 229, click here. For more information on the legislation, click here.

House Bill 476 (pulled from the calendar on Crossover Day) would have established 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. HB 476 also would have created an Advisory Committee to make policy recommendations to the exchange governing board and the Governor by November 15, 2011 for next steps. The bill was pulled under pressure from tea party activists just prior to Crossover Day and is no longer viable this Session. Governor Deal has indicated he will move forward with an Advisory Committee. For the AJC article on HB 476 and the Georgia Exchange, click here.

Senate Bill 17 would establish a Special Advisory Commission on Mandated Health Insurance Benefits to study the social and financial impact of current and proposed health insurance benefit mandates and providers. The bill has passed the Senate and has passed through the House Insurance Committee.  To learn more about SB 17 and benefit mandates, click here for a recent AJC article. For more information about the legislation, click here.

Senate Bill 63 would enact a Georgia Medical Assistance Fraud Prevention Program utilizing smart card technology to verify identification of Medicaid recipients, first directing the Department of Community Health to develop and implement a pilot program. Implementing the bill could present barriers to accessing care, and the methodology proposed has not been proven to be a successful method to target fraud within the Medicaid system. Further, there has been some controversy over a vendor that has been lobbying for the bill. SB 63 has passed the Senate and has not yet had a hearing in the House.  To see the fiscal note on the bill as originally proposed, click here. For a recent AJC article on this issue, click here. For more information on the legislation, click here.

House Bill 461 and Senate Bill 177 would enter Georgia into an interstate “health care compact” to allow member states to opt out of any federal health care law. While interstate compacts are typically used to handle regional and multi-state problems such as transportation issues, water rights or environmental protection, they require approval from the U.S. Congress and the President of the United States. Thus, the compacts have no chance of becoming law. HB 461 passed the House and is in the Senate Insurance Committee. SB 177 passed the Senate and is in the House Insurance Committee. For a recent AJC article on this issue, 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.

Bump It Up a Buck Delivers Petitions and Rallies for an Increase in the Cigarette Tax

This week, the Georgia Coalition for Tobacco Prevention ran a 48-hour petition drive to raise awareness and support for the Bump It Up a Buck campaign—an effort to raise the state’s tobacco tax by a dollar.  Doubling expectations, at the end of the drive the coalition had collected over 1,000 names and on Wednesday, held a press conference with local physicians to highlight the momentum behind the movement and hand deliver the petitions to the Governor’s office.  Dr. Harry Heiman, a Professor at Morehouse School of Medicine and Board Member for Georgians for a Healthy Future explained that “tobacco has no redeeming quality.  There is nothing good that comes out of smoking tobacco.  We have the support—the only question is, do we have the political will?” To view coverage of the Press Conference, click here, and here and to read more, click here.

The Affordable Care Act and You

Insurance Commissioner Hudgens Requests Adjustment to Medical Loss Ratio Rules

Last week, Insurance Commissioner Ralph Hudgens submitted a request to the U.S. Department of Health and Human Services on behalf of the state of Georgia for an adjustment to the recently issued rules pertaining to medical loss ratio (MLR). The MLR rules are designed to ensure that consumers get value for their premium dollar by requiring insurers operating in the individual health insurance market to spend at least 80% of premiums they collect from consumers on medical care and health care quality improvement as compared to administrative expenses such as marketing and profits. The rules were developed by the National Association of Insurance Commissioners (NAIC) after a thorough process. States requesting waivers can propose a phase-in to the MLR requirements for the years 2011, 2012, and 2013 if they can demonstrate immediate implementation of the MLR standard would destabilize the individual health insurance market in their state. They cannot waive them entirely. Georgia thus proposed a phase-in period for the MLR Standard. The application detailing the adjustment request is available here. The data on Georgia insurers that the Insurance Department provided in support of its application is available here. A recent article on this issue from Georgia Health News is available here. The application is under review by the U.S. Department of Health and Human Services. Once deemed complete, public comments will be accepted. More information about how to file public comments is available here.

Focus on Primary Care

By 2014, more than a million uninsured Georgians will gain health insurance as a result of the Affordable Care Act, either through the Medicaid program (when it will be expanded to all Georgians at or below 133 percent of the federal poverty level) or through private insurance purchased through the exchange. Once these Georgians become insured, it is imperative that this coverage translates to access to the health care delivery system. A new state-by-state study of primary care physician supply projects that Georgia will need between 177 and 285 additional primary care physicians to meet the expected increase in primary care utilization resulting from the coverage expansion. In addition to sheer physician supply, an important policy priority will be to ensure that there is an adequate network of primary care physicians participating in the Medicaid program. Beginning in 2013, under the Affordable Care Act, there will be an increase in the Medicaid reimbursement rate for primary care providers such that it is at parity with Medicare reimbursement rates. This increase is funded entirely with federal dollars. Several new reports take an in-depth look at this issue. First, a study in the journal Milbank Quarterly provides state-specific projections of primary care utilization and necessary supply; second, a report by the Center for Studying Health System Change specifically examines primary care participation in the Medicaid program; and third, the Center for Health Care Strategies, Inc, provides a policy roadmap for states to implement the Medicaid primary care rate increase. Finally, a recent media article examines a renewed interest in primary care among medical students due to health reform. For more Georgia-specific information and policy recommendations on our state’s primary care supply, please see this recent presentation to the Georgia General Assembly made by the Georgia Area Health Education Centers.

One Year Later

This week marks the one year anniversary of the passage of the Affordable Care Act and advocates across the state and the country are evaluating the provisions that have already taken effect and seeing how far we have come in just one year.  On Monday, Georgians for a Healthy Future held a press teleconference with Terry Gardiner of the Small Business Majority and Alpharetta small business owner Julie Haley to detail the provisions of the law that help small businesses. These provisions include tax credits that offset the cost of providing insurance coverage for employees.  To read the press release, click here.  Beyond the benefits that small businesses see from the new law, young adults to seniors are also enjoying some new provisions.   The ability for a young adult to remain on a parent’s insurance plan up to age 26 will help get the next generation off on the right foot as they enter the job market in this sensitive economy.  The $250 donut hole checks for Medicare beneficiaries and free preventive services helps lower costs for seniors and allows them to better manage their care.  For more information about the impact of the ACA to date, check out our blog series, “One Year Later,” that explores these topics and more.

New Resources Available

The Consumers Union Guide to the Affordable Care Act was released this week and is a free, easy-to-use guide that walks the reader through parts of the ACA that have already been enacted.  It explores implications for people who currently have insurance, are uninsured, are a Medicare beneficiary, or own or work for a small business.  To access the guide, click here.  Additionally, Young Invincibles released a tool kit this week designed to help young adults figure out the best way to get covered.  To access the tool kit, click here.