Peach Pulse: October 21, 2010

What’s New in Georgia

Insurance Commissioner Candidate Survey Released

To educate Georgia voters on the role of the Insurance Commissioner with respect to health care issues, Georgians for a Healthy Future and Voices for Georgia’s Children surveyed all three candidates for Insurance Commissioner. Each candidate provided responses to eight questions about how they would approach the health insurance issues that fall under the purview of the office they are seeking. Today, our organizations are releasing a Voter Guide featuring those responses. Download the guide here.

On Election Day, Georgia voters will head to the polls to elect our state’s policymakers. Most voters are familiar with certain elected offices, like that of Governor, but many Georgians may be unaware of the importance, or perhaps even the existence, of the Office of State Insurance Commissioner.

The Insurance Commissioner runs the Georgia Department of Insurance and is elected every four years in a statewide vote. Among the core functions the Department of Insurance performs is the regulation of health insurance in Georgia. The Insurance Commissioner ensures that companies selling individual and small group policies in Georgia are financially solvent and enforces consumer protections and state laws regarding benefits that private insurers must include in policies sold in Georgia.

With the recent enactment of the Affordable Care Act, the new health care law, the role of the Insurance Commissioner has expanded. Our next Insurance Commissioner’s decisions will play an important role in shaping Georgia’s health insurance system for consumers in 2011 and well into the future.

Quality, affordable health coverage optimizes the health and wellbeing of Georgia’s children and families and ensures a healthy, productive workforce to grow our state’s economy. While the Insurance Commissioner alone is not responsible for the health of Georgia constituents, he or she will be one of a key group of elected and appointed state officials who together will implement different components of the new health law to maximize benefits for Georgians.

Georgia Receives Grant for Consumer Assistance Program

As part of the Affordable Care Act, the new health law, Georgia’s Department of Insurance applied for and received a grant for $822,156 on Tuesday to:

  • Expand and enhance ability to provide assistance to consumers with health insurance issues, including ability to assist consumers wishing to formally appeal decisions made by their health insurer
  • Improve capability to receive and track telephone calls from consumers seeking assistance by implementing calls center functionality
  • Upgrade existing database systems to enhance the security of personally identifiable information and to obtain the ability to collect, track, and report data requested by Department of Health and Human Services

While these resources are needed to bolster existing capacity within the Department of Insurance, Georgia has not funded and has left vacant the role of independent consumer advocate since 2003. The Affordable Care Act includes stronger regulations on private health insurers and a range of new consumer protections. As these new provisions take effect, there will be a commensurate increase in the need for consumer navigation and assistance. An independent consumer advocate accountable only to consumers would be a welcome first step to meeting this increased need.

A number of other states receiving grant awards used their funds to create this sort of position or department, including North Carolina and Tennessee. To learn how other states are utilizing the Consumer Assistance Program grants, click here.

New Report Shows that 934K Georgians to Receive Premium Health Care Tax Credits in 2014

A new report released by Georgians for a Healthy Future and Families USA shows that 933,900 Georgians will be eligible for new tax credits beginning in 2014 that will significantly reduce the cost of private health insurance for individuals and families. The tax credits will offset a portion of the cost of health insurance premiums, and Georgians’ tax reductions will approximate $3.6 billion in that year.

Some key findings of the report show that working families will benefit the most:

  • Approximately 823,700 Georgians will be in families with a worker who is employed full-time
  • Another 71,500 people will be in families with a worker who is employed part-time

The tax credits will benefit both Georgians who are currently uninsured , who will utilize the tax credit to help purchase health insurance and Georgians who are currently insured who will use the tax credit to relieve some of the burden of health costs by making premiums more affordable.

  • Approximately 466,400 uninsured Georgians will be eligible for a premium tax credit to purchase insurance
  • Another 467,600 insured Georgians will be eligible for a premium tax credit to help with the cost of insurance

These tax credits will be financed entirely with federal dollars and will be available to Georgians purchasing insurance through the new health insurance exchanges. The state of Georgia was just awarded a grant from the Department of Health and Human Services to begin planning for an exchange here in Georgia. This is an opportunity for our state to ensure this marketplace navigates consumers to the appropriate health insurance option, whether that be Medicaid, PeachCare for Kids, or private insurance that will now be made affordable through these hefty tax credits.

To read the report, Lower Taxes, Lower Premiums, in its entirety, click here.

Mental Health Care in Georgia to Improve with Recent Court Decision

This week, the State of Georgia and the United States Department of Justice settled the Justice Department’s litigation against the state based on both conditions in the state’s seven psychiatric hospitals and the lack of community services for people with mental illness and developmental disabilities.  Olmstead was at the heart of the lawsuit and is central to the settlement agreement.  In Olmstead, the U.S. Supreme Court held that people with disabilities have the right to receive services in the community rather than in institutions.

Highlights of the settlement include:

  • 9000 people with mental illnesses will receive services
  • Increased funding for individuals with mental illnesses and developmental disabilities by approximately 59 million over next year and a half.
  • 150 – 250 additional people with developmental disabilities will obtain Medicaid vouchers each year over next five years
  • Increased family supports to 2350 additional people with developmental disabilities by 2015
  • Housing subsidies for 2000 people with severe and persistent mental illness by 2015
  • 22 Assertive Community Treatment Teams that will serve 100 people each that will be brought to fidelity by 2015
  • New case management, peer support, crisis stabilization, and supports for individuals with disabilities.

The settlement, over a decade in the making, is a success for the mental health and developmental disability community and will make great strides to ensuring that these populations receive the care they need in the setting that is right for them. To learn more, click here for a recent AJC article and to read the Department of Justice press release, click here.

Public Health Commission Meeting

The Public Health Commission met for the fourth time on Monday, October 18.

The Commissioners voted to instruct their contract consultant to draft a report for their review that recommends Public Health become an independent agency, with an “attached” agency being the back-up preference. The next meeting of the Public Health Commission is scheduled for November 15 and its final report is due on December 1, 2010. For more information about the Public Health Commission, click here.

The Affordable Care Act and You

New Interactive Timeline for Implementation

The Kaiser Family Foundation has updated their Health Reform Source to include an interactive implementation timeline. The timeline is designed to explain how and when the provisions of the health reform law will be implemented over the next several years. You can show or hide all the changes occurring in a year by clicking on that year. Click on a provision to get more information about it.  To view the timeline, click here.  Additionally, if you have not done so already, be sure to check out KFF’s video Health Reform Hits Main Street here.

National News

Child-only Health Plans

Among the provisions of the Affordable Care Act that went into effect on September 23rd was a requirement that insurers no longer deny coverage to children with pre-existing conditions. While only a small number of children are impacted by this change, they tend to be particularly vulnerable (without access to employment-based health insurance through a parent and ineligible for Medicaid or CHIP). In a controversial response to the new requirement, several insurance companies announced that they would stop selling child-only policies due to concerns that families would apply for these plans only after a child became sick. On October 13th, U.S. Department of Health and Human Services (HHS) Secretary Sebelius sent a letter to the National Association of Insurance Commissioners clarifying the HHS regulation and outlining options for insurers and states. To read the letter, click here. For additional information on this issue from the Georgetown Center for Children and Families, click here.

Health Care Lawsuit Moves Forward in Florida

Last week, the U.S. District Court in Pensacola, Florida permitted a lawsuit against the Affordable Care Act to move forward.  Dismissing four other claims, Judge Vinson allowed the case to proceed to address the constitutionality of two main issues: the individual mandate and the Medicaid expansion.  Georgia is one of twenty states involved in the suit.  Despite this ruling in Florida, judges in Maryland, California, and recently Michigan have dismissed cases challenging the constitutionality of the Affordable Care Act.  Additionally, despite the legal challenges to the law, many provisions have already gone in to effect and will continue to do so while the issue is litigated.  Already, this law has:

  • Ensured that kids with pre-existing condition have access to coverage;
  • Given tax-credits to small-businesses that provide insurance to their workers;
  • Allowed recent college graduates looking for jobs to stay on their parents plans;
  • Sent checks to seniors to help pay for their prescriptions; and
  • Protected consumers from insurance company abuses.

To read more about the lawsuit, click here and here.