Laura Colbert, with Georgians for a Healthy Future, said one clue that parity is not working is how often behavioral health is not covered by Georgia insurance plans. She spoke about mental health parity earlier this year during a town hall meeting hosted by the Georgia Council on Substance Abuse.

“Georgia families are forced to navigate a really confusing insurance system in the middle of what might be a substance use crisis or a mental health crisis,” Colbert said. “You may be denied coverage for substance use services because the insurance company says they’re not ‘medically necessary.'”

“It will do monumental things for people who get covered and can go to the doctor and get prescriptions filled and have some peace of mind that they can take care of their health and their family’s health if something happens while they have this coverage,” Laura Colbert, executive director of the patient advocacy group Georgians for a Healthy Future, said.

But even so, Colbert called the plan “a four-year coverage gap fix.”

“There is no certainty about who our elected officials will be in four years and whether there will be an appetite to extend this program,” she said.

“These gaps really make it so that Georgians can’t afford needed health care. If they receive health care, they’re left with medical debt, or they have to make really tough choices about their health versus other necessities,” Colbert said.

“This level of interest from Georgia individuals and families demonstrates that the marketplace is serving a valuable purpose and meeting its intended goal of keeping people covered in an affordable and comprehensive way, even while many deal with big life changes brought on by the pandemic,” said Laura Colbert of the consumer advocacy group Georgians for a Healthy Future.

Laura Colbert, executive director of Georgians for a Healthy Future, agreed the issues of drug prices and transparency, coupled with the role PBMs play in the equation, will come up again in January.

“Discussions over PBMs have been going on for several years, and the legislature seems pretty fired up over continuing that effort,” Colbert said, explaining that PBMs were formed to help health insurers negotiate better deals with pharmaceutical manufacturers, and then pass those savings along to consumers.

“But realistically, it’s hard to know if those savings are actually being passed along,” Colbert said. “Pharmacies and health insurers are buying up PBMs, and it’s become especially hard to see where savings are being accumulated.”

“Medicaid members are best served when they have ready access to providers, insurers are eager to resolve their health care needs, and policymakers exercise strong oversight to ensure members’ health and well-being are prioritized over profits,” said Laura Colbert, executive director of Georgians for a Healthy Future, a consumer advocacy group.

Losing out on Medicare and Medicaid would likely make the economics unsustainable for many Georgia nursing homes, said Laura Colbert of the consumer advocacy group Georgians for a Healthy Future.

“Medicaid is actually more important than Medicare to nursing homes, people may find that surprising, but Medicaid is the primary payer for about three quarters of Georgia’s nursing home stays, so withholding either bucket of funds would be pretty financially detrimental.”

She added, “Given the vulnerability of people who are in nursing homes and long-term care facilities, I think it’s a very appropriate incentive to get workers vaccinated.”

The increased competition shows more certainty from insurers about the stability and viability of the health insurance exchange, said Laura Colbert of the consumer group Georgians for a Healthy Future.

She noted that many uninsured Georgians are eligible for discounted exchange policies with premiums that are less than $50 and in some cases as low as zero, but that these people are often unaware that such deals are available.

“Clawbacks mean people did not get health care,’’ said Laura Colbert, executive director of Georgians for a Healthy Future, a consumer advocacy group.

“Essentially, people may have missed services they needed last year. That’s no fault of the [Medicaid insurers] because we saw that happen access the board regardless of the type of insurance.  The state still has a right to address that based on their contract,” added Colbert.

Laura Colbert of the consumer advocacy group Georgians for a Healthy Future said Wednesday that “coverage under a waiver must be at least as affordable and comprehensive as under the ACA and cover a comparable number of people.’’

“The Trump administration, which approved Gov. Kemp’s waiver, interpreted these guardrails so loosely that it allowed for rollbacks of fundamental consumer protections,” she said. “The Biden administration has proposed re-interpreting this part of the law so that consumer protections are maintained. The federal government seems to be asking Georgia to prove that this plan meets these re-interpreted standards.”