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Peach Pulse, February 12, 2015

Legislative Update georgia-capital-buildingToday marked the fifteenth day of the 2015 Legislative Session—we’re more than one-third of the way through already! Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015, is set for March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd. Georgians for a Healthy Future is monitoring and advocating on bills of importance to health care consumers in Georgia. As part of this week’s legislative update, we spoke with Senate Insurance Committee Chairman Charlie Bethel about the legislation moving through his committee and about his priorities with respect to health care policy in Georgia. This conversation also includes a discussion of Senate Bill 1, which would provide for certain insurance coverage for autism spectrum disorders. Other issues we’re watching include: The State Budget Our friends over at the Georgia Budget & Policy Institute have put together an analysis of the health care spending within the proposed 2016 state budget. Click here to read GBPI’s health care budget overview.  Medicaid Payment Parity Last week, Sen. Unterman talked to us about her request for $60 million to restore Medicaid payment parity.  Sen. Unterman and advocates continue to work with the health appropriations chairmen in both chambers, but no decisions have been made to date. Closing the Coverage Gap Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians. Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills for their support and show your support by filling out a postcard that we’ll mail to your legislators! Tobacco Tax Georgians for a Healthy Future and our coalition partners continue to support a $1.23/pack increase in Georgia’s tobacco tax to bring us in line with the national average, decrease smoking rates, and bring in needed revenue for health care investments in our state. Click here for our new fact sheet on why Georgia should increase the tobacco tax. While no legislation has been introduced this session to increase the tobacco tax, we expect it may enter the mix as legislators discuss transportation funding. We will continue to monitor this issue and will let you know when advocacy opportunities arise.
Time is running out – get covered today! Open enrollment is quickly coming to a close, ending this Sunday, February  15th.  If you haven’t gotten covered yet or you know someone who doesn’t have coverage, don’t wait!  Act now before Sunday’s deadline.  Click here to find a Navigator near you or visit healthcare.gov to sign up.  These Georgians got covered and you can too! Got Covered - CorneliaCornelia, a recent college graduate, had coverage on her parents’ plan…until she turned 26 and became ineligible.  She really wanted to stay with the same insurer, but also needed an affordable plan.  She applied and found that she qualified for a plan with the same carrier with even better coverage for less money. After her subsidy, Cornelia’s plan cost her only $83 per month. Got Covered - ScottScott Quimby found an enrollment event near his home by visiting getcoveredamerica.org. He and his wife were able to enroll in a plan, which is a big deal because his wife had a pre-existing condition.  She had suffered brain trauma previously and expressed how grateful she was that she could get covered at an affordable price because of the Affordable Care Act: “I know I made the best decision because I came and got help.” Got Covered - Mechul2Mechul had gone uninsured previously—for six years—going to the ER when he was seriously ill. He lost coverage when he turned 18, having been enrolled in Medicaid until then as a foster child under his grandmother’s care. He was told when he was younger he was pre-diabetic and felt anxious not have a way of getting regular care.  In March, he went to healthcare.gov to try to enroll but then decided to a navigator to get more information, and finally completed enrollment himself at home. He found a no cost silver-level plan, which was great because cost was the most important factor for him.  Now Mechul is employed and will get coverage through his employer, but he said it was a relief and gave him peace of mind to have health insurance there when he needed it. If you or someone you know has an enrollment success story they’d like to share, let us know!  With your help, others can get covered and stay covered.
King v. Burwell — What’s at stake for Georgia? King Burwell Potential Result On March 4th, the United States Supreme Court will hear oral arguments in King v. Burwell, a lawsuit challenging the tax credits that consumers utilizing the federal Health Insurance Marketplace receive to help make health insurance affordable. Consumers in thirty-four states, including Georgia, use the federal Marketplace to find and enroll in coverage. Nearly nine out of 10 people who enrolled in coverage through healthcare.gov received financial help and paid 75 percent less than the full monthly premium. This has helped bring the nation’s uninsured rate to an historic low. A study by the Robert Wood Johnson Foundation and the Urban Institute found that the majority of health care consumers who would be impacted and who would likely become uninsured if the tax credits were struck down live in the South. Here in Georgia, hundreds of thousands of people are at risk for becoming uninsured. We believe there is no legal basis for this challenge and that in June, when a decision comes down, we’ll all breathe a sigh of relief. If the court does, however, strike down the tax credits, such a decision would disproportionately impact the South and would put states like Georgia at a competitive disadvantage by exacerbating existing regional health disparities. If this comes to pass, Georgians for a Healthy Future will advocate for a contingency plan to ensure that Georgians have the same access to tax credits that their counterparts in states like New York, California, Colorado, and Kentucky (states that set up their own health insurance exchanges) have. Our friends at Families USA have put together a resource page for advocates interested in learning more about King v. Burwell. Click here to find out everything you need to know about the case!
Medicaid Minute This week, we learned that the Tennessee legislature failed to pass the Insure TN plan.  This is a big disappointment for the 300,000 Tennesseans who fall into the coverage gap and who could have had access to health insurance if the Tennessee plan moved forward. This outcome shows how important it is to garner support from elected officials on both sides of the aisle. There are lessons we can learn for our work here in Georgia. Thank you to all of the Georgia advocates who continue to reach out to your legislators across the state to let them know you support closing Georgia’s coverage gap.  If you’d like to get involved and join the Cover Georgia coalition, email Laura Colbert.
Infographic of the Week deadline-fine MORE >

Peach Pulse, February 5, 2015

Legislative Update

With this week’s legislative update, we bring the Gold Dome to you! Our biggest update this week is that Senator Renee Unterman is making a $60 million appropriations ask in the state budget to maintain Medicaid payment parity. Medicaid payment parity is an effective strategy to increase access to health care services for low-income children and families enrolled in Medicaid (click here to learn more about what payment parity is and why it matters for health care access). Your GHF team was at the Capitol this week to talk with Senator Unterman about her proposal.


Also this week, the Senate Appropriations Subcommittee on Health held a hearing that included discussion about Medicaid payment parity. No decisions were made at the hearing but we expect the topic will come up again. What can advocates do?  Contact one or more of these legislators!

  1. Call or email Senator Unterman and thank her for leading the charge on this important initiative!
  2. Call or send an email to Senator Burke, who chairs the Senate Appropriations Subcommittee on Health, and Representative Butch Parrish, who chairs the House Appropriations Subcommittee on Health, and thank them for their support on Medicaid payment parity.
  3. Contact Senate Appropriations Chair Jack Hill and House Appropriations Chair Terry England and let them know you support Medicaid payment parity.

Other issues we’re watching.

Medicaid Expansion

There has been no action to date on closing the coverage gap by expanding Medicaid. Please contact your legislators and the leaders of the Health and Human Services and Appropriations Committees to ask them to hold hearings on this important issue.

Click here to let your state senator and representative know that you support closing Georgia’s coverage gap.

Tobacco Tax

Georgians for a Healthy Future and our coalition partners continue to support a $1.23/pack increase in Georgia’s tobacco tax to bring us in line with the national average, decrease smoking rates, and bring in needed revenue for health care investments in our state. All eyes in the House and Senate have been on the transportation funding proposal unveiled last week on the House side, which did not include an increase in the tobacco tax. However, the Senate is expected to take a more diversified approach in this area and the possibility of a tobacco tax increase may be on the table. We will continue to monitor this issue and will let you know when advocacy opportunities arise.

Other Health-Related Bills

Senate Bill 1, which would require insurance companies to provide limited autism benefits for Georgians enrolled in certain individual and small group plans passed the Senate and is now on the House side. A hearing has not been scheduled for the bill on the House side.

Senate Bill 74, which would authorize tax credits for donors to health charity organizations, has been introduced in the Senate and referred to the Senate Finance Committee.

Knowledge is power: Terry’s enrollment story

Terry S“This is your health we’re talking about.  How important is it to you?”  Terry Stidom, an Atlanta health care consumer, cares about his health and is glad about his decision to get covered. “It became a no-brainer,” he said about his decision to enroll in a health plan through the Health Insurance Marketplace last year.  This year, with the increase in providers and plans available in Georgia, he was able to find an even more affordable, comprehensive plan.  What does he love about his plan?  “[It] includes medical, dental, vision, no deductible, low doctor visit co-pays, I get $20 a month in cash back just for going to a gym at least 8 times per month — the list goes on.”  While Terry researched his options and signed up on his own, he encourages others to seek help.  “As you sit and look at each plan, don’t be intimidated by the numbers.  If you’re unsure, call someone to help you.  Knowledge is power!”

Open enrollment ends February 15th – don’t miss out on the opportunity to find the plan right for you and your family.  Click here to find a Navigator in your area and get covered today!

If you or someone you know has an enrollment success story they’d like to share, let us know!  With your help, others can get covered and stay covered.

2015 Advocate’s Guides are Here!

Advocates_Guide_2015Each year Georgians for a Healthy Future develops our signature A Consumer Health Advocate’s Guide to the Legislative Session, and the 2015 editions are in! Whether you are an individual interested in contacting your legislators to let them know you care about health care issues or if you work for an advocacy group and want to get multiple copies for your volunteers, we’re happy to get the guides into your hands. We create them each year to help you be a better advocate.

In this year’s guide, you will find:

  • Detailed legislative process overview
  • Listing of all representatives and senators, their offices and numbers
  • Key contacts in the governor’s office and relevant agency staff
  • Members of key committees and subcommittees
  • Contact information for other health advocate organizations
  • Media contacts
  • Tips to make you an effective advocate

You can download a PDF version or contact Laura Colbert and arrange to pick up hard copies from GHF’s office.

Medicaid Minute

Welcome-to-Indiana-3x2-555x370CMS has approved Indiana’s plan to expand health care coverage for low-income Hoosiers through a waiver program known as Healthy Indiana.  This is great news for the 350,000 Indianans who will now have access to health care coverage. The Healthy Indiana plan, however, includes some features that raise concerns, such as a 6-month lock out policy for people with low incomes who can’t afford to make payments on premiums. Some of these features could create barriers to access. For a breakdown of the pros and cons of the Healthy Indiana plan and what advocates should be watching, see this analysis from our friends at the Georgetown Center on Children and Families.

Infographic of the Week



Your voice is needed!

Coverage Gap _ Georgia_EDITTEDWe all know how crucial closing the coverage gap is – it would improve access to health care services for low-income Georgians, bolster our state’s health care delivery system, and strengthen local economies throughout Georgia. We are asking our legislators to schedule hearings on this issue, and we need your help!  Last year, the legislature sent the message with HB 990 that they wanted to be part of the conversation around finding a Georgia solution to cover the uninsured.  We have yet to see them take steps towards opening up that debate.  Tell your legislators that it is time to close the coverage gap.  Send them an e-postcard telling them why you think covering the uninsured should be a priority for the 2015 legislative session.


Peach Pulse: January 30, 2015

Legislative Update


The Legislature has completed eight days of the 40-day session and will convene Monday through Wednesday next week. There will also be several committee hearings next week, including:

1) Senate Appropriations Community Health subcommittee meeting Tuesday at 3 PM in CLOB 307.  The agenda for this hearing will feature testimony about the importance of maintaining Medicaid parity for primary care providers in Georgia.

2) Senate Health and Human Services committee meeting on Tuesday at 1 PM in CAP 450 (Agenda to be announced).

3) House Health and Human Services committee meeting on Monday at 3 PM in CLOB 606 to discuss HB 47.

Committee meetings are open to the public and we encourage health-focused advocates to attend. Of course, your Georgians for a Healthy Future team is monitoring legislative developments and advocating for our priority issues throughout the legislative session and we will keep you informed about key opportunities for advocacy as they emerge. Below is a status report on the issues Georgians for a Healthy Future is supporting this year.

Closing Georgia’s Coverage Gap: There has not yet been any legislative activity in this area, as the General Assembly has been focused on addressing the transportation funding issue.  Georgians for a Healthy Future supports holding hearings on the need to close Georgia’s coverage gap as a first step to achieving this legislative priority. Please contact your Representative and Senator and tell them you support holding hearings on Medicaid expansion this year. You can find your legislators here.

Increasing Georgia’s Tobacco Tax: There has been early momentum around increasing Georgia’s tobacco tax, and a bill has been drafted to increase the state excise tax on cigarettes by $1.23 per pack. The bill also includes a comparable increase on other tobacco products. This bill is awaiting a fiscal note from the state, which we expect to be completed by the first week in February.  See our one-pager on how increasing the tobacco tax can help reduce smoking and improve health in Georgia. Georgians for a  Healthy Future is proud to be part of a coalition of health organizations working on this important issue—please stay tuned for updates on this issue once the fiscal note is in!

Medicaid Payment Parity:  Georgians for a Healthy Future supports maintaining payment parity for primary care providers (see this week’s Medicaid Minute for an explanation of how this improves access to care for Georgia patients) by restoring the temporary reimbursement rate hike that expired at the end of 2014.  Senator Renee Unterman has proposed a $60 million appropriation for this, and Medicaid payment parity will be a topic of conversation at next week’s Senate Appropriations subcommittee hearing (on Tuesday at 3pm).  This hearing presents an opportunity to weigh in with your state legislators to let them know you support the payment bump and to ask them to include it in the FY 2016 Budget.

Coverage Day at the Capitol Recap

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This past Tuesday was Coverage Day at the Capitol! Laura Colbert, GHF’s Community Outreach Manager, spearheaded the day with the help of many Cover Georgia partner organizations.  The opportunity to talk with legislators about the coverage gap drew about 75 advocates and volunteers to the State Capitol. After an advocacy training session, the group met with their legislators throughout the morning by “working the ropes.”  The group reconvened for lunch and a press briefing, covered by both WABE and the Georgia Report! Members of the Cover Georgia coalition displayed their information, materials, and projects in the Capitol Rotunda throughout the afternoon. It was a full day of advocacy in support of closing Georgia’s coverage gap!  We’re hoping that Georgia’s legislators heard our message loud and clear – it’s time to start talking about closing Georgia’s coverage gap!

GHF Receives MLK Community Service Award

IMG_0286GHF celebrated Martin Luther King Jr. Day last week by receiving an award at Emory University’s 23rd annual MLK Community Service Awards.  This year’s award program recognized organizations that work to address injustices in the Atlanta community, often before those injustices become headlines.  Harry Heiman, out-going board chair, and Laura Colbert accepted the award on GHF’s behalf.  In Harry’s acceptance speech, he remembered Dr. King’s quote: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”  GHF works hard to ensure equal access to high quality, affordable health care for all Georgians.  We are honored to accept this award and congratulate the other very deserving awardees.

Medicaid Minute

Georgia’s Medicaid patients could face longer wait times for doctor’s appointments without legislative action. That’s because a nation-wide bump in primary care provider reimbursement rates expired at the end of 2014, triggering a need for state action. This temporary rate bump resulted in an average eight percent increase in appointment availability, according to a new study published in the New England Journal of Medicine. The study examined ten states, including Georgia, and concluded that payment rate increases are an effective strategy for enhancing access to primary care services. According to a participating physician in Texas, his practice was able to double the amount of Medicaid patients seen during the two year time the pay bump was in effect.  By restoring the rate bump, known as Medicaid payment parity, Georgia policymakers can help ensure patients get timely access to primary care in an appropriate setting and help keep patients from ending up in the emergency room.

GHF Board Changes

With the New Year, GHF kicks of a new board.  Kathy Floyd has stepped into the position of board chair, taking the reins from Harry Heiman.  A board member of several years, we know she will bring strong leadership and vision to our growing organization.  We are also thankful for Harry’s incredible run and accomplishments as board chair during a period of growth for GHF. We are excited to welcome new board members Danté McKay, Jay Berkelhamer, Natalie Hernandez, and Monica Ponder!  Each brings substantial experience and expertise and we’re excited to have them as part of the GHF team.  As the same time, we are sad to see wonderful partners rolling off the board.  Julie Edelson, Marci Thomas, Jeffery Graham, Sylvia Caley, and Iris Feinberg have all finished their board terms and, while we will miss them, we hope they will enjoy their newfound free time!

Infographic of the Week

Countdown infographic end of open enrollment


Peach Pulse: January, 23, 2015

Coverage Day at the Capitol 

IMG_0771Please join us this coming Tuesday, January 27, from 9 am to noon for a day of advocacy!  GHF and the Cover Georgia coalition have planned a full day of activities to raise awareness about the important role that coverage plays in the health and financial security of all Georgians and to ask our legislators to close Georgia’s coverage gap.  More than 15 organizations are already participating, and it’s not too late to join us! We’ll provide breakfast and lunch, an advocacy training, and opportunities to share your materials and personal health care stories at our afternoon Capitol Rotunda display.

To sign up, click here.  If you have any questions, please contact Laura Colbert.

The 2015 Legislative Session is Underway!

georgia-capital-buildingThe legislative session opened last week, and health care is already a hot topic. Here is what we have learned in the first week and a half:

It’s budget week! Governor Deal released his budget on Friday, and legislators have been holding budget hearings all week. Here are two aspects of the health care budget that have our attention:

  • The proposed budget eliminates State Health Benefit Plan (SHBP) coverage for non-certificated school employees (bus drivers, custodians, etc) who work less than 30 hours a week.  State officials estimate it will affect more than 11,000 state employees.  We’re still sifting through the details, but we’re very concerned that some of those employees may fall into the coverage gap if they lose coverage through the SHBP.
  • There is no money in the state budget to sustain the primary care reimbursement rate increase that was temporarily funded with federal dollars. This temporary bump  made it easier for patients in Georgia and other states to get medical appointments and access care.
There has also been some early momentum at the Capitol around an increase in the tobacco tax, one of Georgians for a Healthy Future’s legislative priorities! As bills and budget items impacting health care in Georgia are introduced and discussed, we will keep you posted and identify opportunities for advocacy. We’ll be at the Gold Dome throughout the session so look for updates and alerts in each Peach Pulse!

Thank you for making Health Care Unscrambled a huge success!

Health Care Unscrambled Health Care Unscrambled Health Care Unscrambled Health Care Unscrambled Health Care Unscrambled

Thank you to those of you who joined us for our fifth annual Health Care Unscrambled policy breakfast on January 15! This year’s event featured two powerhouse panels: a bipartisan legislative discussion and a panel that focused on the recent experiences of Kentucky and Arkansas, two Southern states that are moving forward with innovative plans to cover their uninsured and improve population health, and featured the insights of a national expert.

This year’s Health Care Unscrambled also provided an opportunity for Georgia health care advocates, policymakers, stakeholders, and consumers to come together just as the 2015 Legislative Session got underway to focus our attention on the most pressing health policy issues facing our state, including a robust discussion about the coverage gap.  Senator Dean Burke said that while last year he would have said there was a 0 out of 10 chance for Georgia to close the gap, this year he moved it to a 5 out of 10.  We’re excited about these improved chances and will continue to advocate for movement this legislative session!

We wrapped up the event with a reveal of our 2015 legislative priorities, which you can find here. You can read Georgia Health News’s coverage of the event here.

GHF goes to Washington

Families USA HHS Sec IMG_2495 IMG_2520

This week, Cindy and Anna are representing Georgians for a Healthy Future at Families USA’s Health Action 2015 conference!  We’re getting inspiration from national leaders, learning about best practices from experts and advocates doing great work around the country, and sharing our own experiences advocating for Georgia health care consumers. GHF’s Executive Director Cindy Zeldin spoke on a workshop panel about how to advocate for consumers enrolled in private health insurance. Check out Facebook and Twitter through Saturday for conference updates!

Story collecting with Mercy Care

Mercy Care EventGHF partnered with Mercy Care to kick off the legislative session by collecting the stories of people who fall in the coverage gap.  As the governor was being inaugurated and our legislators were being sworn in, we talked to Mercy Care’s patients how health care coverage would help them.  Everyone we talked to expressed that health care coverage would help them go back to work, take better care of their family, or better manage their health.  We will be sharing these stories on Coverage Day through social media and in person as we talk with policy makers about the importance of closing the coverage gap. HealthSTAT and the National Health Care for the Homeless Council were critical partners for this story collection effort!

 If you are in the coverage gap and would like to share your health care story with us, click here .

Medicaid Minute

Last year, the number of uninsured Americans declined, fewer adults reported difficulties paying for medical bills and medical debt, and fewer adults delayed care because of cost. These encouraging findings, which come from the Commonwealth Fund’s Biennial Health Insurance Survey, are great news for patients and consumers. These coverage and access gains, however, were not experienced evenly across the country. People living in states (like Georgia) that haven’t expanded Medicaid were more likely to be uninsured and to face burdensome medical bills than those living in states that have expanded Medicaid. Let’s not leave Georgia patients and consumers behind-let’s close the coverage gap!

Infographic of the week

women and the aca


Peach Pulse, December 18, 2014

Time to Act on Tobacco

With the holiday season upon us and the 2015 Legislative Session just around the corner, the health of our state’s children and families is at the top of all of our minds. Georgians for a Healthy Future has focused heavily on promoting policies that ensure a pathway to coverage and meaningful access to care for all Georgians in recent years, but identifying and advocating for policies that improve health outcomes is also close to our hearts. In that spirit, we believe it is time to act on tobacco, which is the leading cause of preventable disease and death. 

Earlier this month, Georgia’s Medicaid program amended its state plan to include a comprehensive smoking cessation program. This is an important victory that will help reduce smoking in our state. If you haven’t already, please take a moment to thank Commissioner Clyde Reese for taking this important step. There is, however, more to do. We need your partnership and your voices to help us take on the biggest hurdle we face in curbing smoking and its harmful effects: increasing the tobacco tax in our state. 

According to the American Lung Association’s annual state report card, Georgia scores an “F” on tobacco taxes. Georgia currently ranks as the 48th lowest tobacco tax in the country at just 37 cents per pack.  Not only does this make tobacco much more accessible to youth (and all Georgians), but it takes much needed revenue off the table for Georgia as the state tries to find funding for transportation infrastructure, education, and health care coverage for Georgians.

In fact, Georgia is so far below the national average for tobacco taxes that we could raise our tax by over a dollar per pack and still just be at the national average.  That is why this year GHF and a coalition of supporters will propose raising Georgia’s cigarette tax by $1.23 per pack.  It’s as easy as 1-2-3! 

One – for the kids who we can prevent from ever starting

Two – for the improved health outcomes that smoking reductions will bring

Three – for the revenue the tobacco tax will bring to our state that can be invested in coverage, access, and prevention.

Network Adequacy: Action Alert

If you’ve been following the Peach Pulse you know that network adequacy is a hot topic in health care right now. (And if you missed it, check here and here to get caught up!) Decision-makers are weighing policy choices that will have implications for health care consumers in Georgia and across the nation. We know that they are hearing from health industry stakeholders; now they need to hear from you!  

1) The US Department of Health and Human Services (HHS) Proposed Rule on the 2016 Notice of Benefit and Payment Parameters is open for comment until December 22, 2014.  To submit a comment, click here.         

2) The National Association of Insurance Commissioners (NAIC) is currently updating its model act on network adequacy. This model provides an example that states can use to enact their own legal protections to guarantee private insurance consumers an adequate provider network once they are enrolled in coverage. Advocates can email jmatthews@naic.org until January 12, 2015 with input.

Consumer advocates are asking these two entities to put in place 1) specific network adequacy standards such as time and distance standards and appointment wait time standards and 2) rules that provide consumers the right to go out-of-network at no extra cost if their plan cannot provide them timely, geographically accessible, and appropriate in-network care. Please take a few moments to submit your comments to HHS and to the NAIC with this important request. If your organization is interested in engaging more deeply on this issue, please contact Laura Colbert at lcobert@healthyfuturega.org to let us know you’re interested in collaborating.

GHF Around Town

It’s been a busy couple weeks for us here at GHF.  The Rural Hospital Stabilization Committee met to hear public comments two weeks ago and we were out in force!  We presented our report to the committee.  In addition, our own Laura Colbert and representatives from the Georgia Budget and Policy Institute, HealthSTAT, Jewish Community Relations Council, Georgia Legal Services, and Voices for Georgia’s Children all pressed how crucial closing the coverage gap is as a the first step to saving our rural hospitals. 

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The following week, the GHF team attended the 29th Biennial, a gathering of legislators and advocates from across the state.  GHF spoke with members on both sides of the aisle and encouraged conversations around closing the coverage gap to give hard working Georgians the access to care they deserve. 

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Start the New Year right with GHF!

January is an exciting month for GHF and Georgia! With the start of the legislative session, advocates across the state will be hard at work educating our legislators and working for the changes we need to improve the health of all Georgians. GHF is no exception!

HCU_dateOur 5th Annual Health Care Unscrambled event is January 15th. For more information on the event, sponsorship opportunities, and ticket prices, click here.




IMG_0778Coverage Day at the Capitol. Please join us on the morning of January 27th to talk with your legislators about why closing the coverage gap is important to you. If you haven’t spoken with your legislators before, we will provide training and talking points to help guide you through the process. If you would like to participate, RSVP to Laura Colbert at lcolbert@healthyfuturega.org.


georgia-capital-buildingWebinar: Health Care Policy and Advocacy for the 2015 Legislative Session, 2015. For those of you who can’t make it to Health Care Unscrambled for the unveiling of GHF’s 2015 policy priorities or want to know how to better advocate for health in Georgia, join us for our first-ever advocacy webinar! To register for the free webinar, click here.




Medicaid Minute


This week, Tennessee announced its intention to move forward with a plan to close the coverage gap!  In a statement, Governor Bill Haslam said “This plan leverages federal dollars to provide health care coverage to more Tennesseans, to give people a choice in their coverage and to address the cost of health care, better health outcomes and personal responsibility.”  We are thrilled for Tennessee and hope our own elected officials will take note and work to provide a Georgia solution for our hard working, uninsured families.


Infographic of the Week!

how is enrollment going













Nykita Navigates

IMG_9114One month down, two to go!  Already, nearly 2.5 million Americans already signed up for health insurance.  Early numbers show that about half of those who have signed up are new enrollees.  If you haven’t enrolled yet or want to shop around before selecting a new plan, there is still time!  Click here to see Nykita’s schedule for upcoming events in your neighborhood.  If you don’t see any close to home, please give her a call to set up a one-on-one appointment. 


Peach Pulse: December 4, 2014

Health Insurance Hot Topic Update: Network Adequacy

megaWith open enrollment in full swing, Georgia consumers are once again exploring their health insurance options and signing up for coverage. When consumers enroll in a health insurance plan, they gain access to a network of medical providers with whom their insurer has contracted. For health insurance to facilitate meaningful access to care, this network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits and services. In a recent issue of the Peach Pulse, we provided a primer on network adequacy, a hot topic in health policy (click here to get caught up on what network adequacy means and why it matters for consumers, advocates, and policymakers). In that overview, we promised to keep you updated on policy developments around network adequacy, in particular the ongoing process at the National Association of Insurance Commissioners (NAIC) to update its model law. This model law can provide a framework for states to establish and enforce standards to ensure that provider networks are adequate. At its fall meeting in November, the subgroup at the NAIC working on network adequacy announced it would take comments on an initial draft of proposed revisions for the model act until January 12, 2015. To learn more about this process and to see the draft, click here.

To ensure the needs of consumers are considered in this process, the NAIC consumer representatives released a report featuring the results of a survey of state Departments of Insurance and recommendations for state policymakers, regulators, and the NAIC to consider as they work on updating network adequacy standards. These recommendations include:

  • Establish quantitative standards for meaningful, reasonable access to care, such as minimum provider-to-enrollee ratios, reasonable wait times for appointments based on urgency of the condition, and distance standards that require access to network providers within a reasonable distance from the enrollee’s residence.
  • Ensure consumers are provided sufficient information to identify and select between broad, narrow or ultra-narrow networks. In areas without sufficient choice, require health plans to offer at least one plan with a broad network or an out-of-network benefit, with limited exceptions to be determined by the Commissioner.
  • Require health plan provider directories to be updated regularly, publicly available for both enrolled members and individuals shopping for coverage, and include standards for information that must be included to provide consumers with information on network differences and the potential financial impact on consumers depending on which plan they choose.

There are 17 recommendations in all. For advocates interested in learning more about this issue and in speaking up for consumers in this process, see the full report here.

If you would like to weigh in at the state level, please contact Georgia’s Department of Insurance and ask the Commissioner to support the NAIC’s process to revise the model act and specifically to support the consumer recommendations described above.

If you are an individual consumer enrolled in a commercial health plan and the provider directory you were given was incorrect or if you have concerns about your ability to access covered services under your plan, please contact the Georgia Office of Insurance & Fire Safety, Consumer Services Division by calling (800) 656-2298 or use the Consumer Complaint Portal at www.oci.ga.gov/ConsumerService. Please also consider sharing your story with Georgians for a Healthy Future so we can get a better picture of what is happening in our state.

Rural Hospital Stabilization Committee: Your voice is needed!

hospitalWe’re hoping you read our report released two weeks ago to the Rural Hospital Stabilization Committee (RHSC) on how closing the coverage gap can help save our rural hospitals.  (And if you didn’t – here is it!)  This Friday, the RHSC is taking public comment and your voice is needed!  You may register to make comments when you arrive at the meeting. Comments will be presented on a first come, first serve basis. No power points, but handouts (should you be so inclined) are allowed.  If you interested in commenting, but are unsure of how to best shape your argument, feel free to reach out to Laura Colbert, GHF’s Community Outreach Manager.  Even if you aren’t comfortable speaking, please show up and show your support!  Details are below.

Location: Two Peachtree Street.  5th floor.  Located on the corner of Peachtree Street and Marietta Streets.  The Five Points MARTA Station is just south of Two Peachtree.

Time: 10:00 AM to 1:00 PM

Connecting Georgians to Coverage: GHF partners with the Bhutanese Association of Georgia to get people covered

Every Saturday morning, many Bhutanese immigrants gather at their temple in Clarkston for SAT prep, U.S. citizenship, and English classes.  Recently, Laura Colbert, Georgians for a Healthy Future’s Community Outreach Manager, joined them to provide information about health care coverage and the Affordable Care Act’s open enrollment period.  With the help of a translator, Laura spoke with approximately twenty community members about the benefits of health care coverage, how to get covered, and where to find affordable medical care if they were not eligible for coverage. She also answered their questions about health care coverage for their children and Medicaid.  (In return, Laura learned quite a bit about Bhutanese culture.)

This educational event was the product of a partnership with the Bhutanese Association of Georgia (BAG), which works to integrate Bhutanese refugees into life in Georgia. GHF and BAG have been working together over the past year to educate the Atlanta-based Bhutanese community about health care coverage and to increase health coverage enrollment.  In addition to educational events, several fact sheets have been created by GHF and translated into Nepalese to be distributed in the community.

Georgians for a Healthy Future continues to work to increase enrollment among all Georgians, especially in communities that may need extra education or encouragement to enroll.

Medicaid Minute: Who qualifies?

Each state has slightly different eligibility criteria for Medicaid.  When we talk about closing the coverage gap– as 28 other states have either through Medicaid expansion or a state-specific 1115 waiver – it’s important that we all know just who is (and isn’t) eligible for Medicaid today in Georgia and who could gain coverage if we close that gap.

  • Very low income parents. Medicaid is offered to parents who make up to 40% of the Federal Poverty Level (FPL).  For a family of four, parents with income up to $9,036 annually or $753 per month can receive health coverage through the Medicaid program.
  • Pregnant Women. Pregnant women who earn up to 220% FPL.  For a family of four, a pregnant woman with income up to $52,488 would be eligible for Medicaid
  • Most Children. Children are covered at varying income limits based on their age and family size. The Children’s Health Insurance Program (CHIP), known as PeachCare for Kids in Georgia, is layered on top of the Medicaid program. Together, these programs provide coverage to children in families with incomes up to 247% of the FPL.  For a family of four, that’s $58,932 annually.
  • The low-income elderly. In addition to Medicare, many, but not all, low income elderly adults whose income is less than $25,560 per year qualify for Medicaid.
  • Low-income women diagnosed with breast or cervical cancer.
  • Aged, Blind, and Disabled. With varying income limits, those who receive Social Security Income, live in a nursing home, or community care center qualify.
  • Qualified Medicare Beneficiaries. These are the aged, blind or disabled who have hospital insurance and have incomes below 100% FPL.  Medicaid will cover some of their Medicare expenses.
  • Low-income Terminally Ill. Those with an annual income of less than $25,956 and who are expected to live less than six months.

*Numbers are pulled from the GA Department of Community Health and Peach Care for Kids webpages.

Nykita Navigates

IMG_9114Nearly half a million people enrolled in health insurance through the federal marketplace in the first week of open enrollment!  The deadline for January 1st coverage is fast approaching: December 15th.  Don’t miss out!  If you need in person assistance, please see the below events or contact Nykita at 404-567-5016 or nhowell@healthyfuturega.org.

Upcoming events:

January 19:  15th Annual United Ebony Society MLK Day Celebration and Health Fair (Lawrenceville, GA)

Recurring events:

Cobb County Public Health (Marietta, GA) Every Tuesday, Starting November 18, 2014 and ending February 10, 2015 (with the exception of November 25, 2014)

Clarkston Library, DeKalb County (Clarkston, GA) Every Thursday, Starting November 20, 2014 and ending February 12, 2015

Fayette County Library Presentation (Fayetteville, GA) December 8, 2014; January 12, 2015, and February 2, 2015

Events are subject to change, and new events are added all the time – check back here regularly for updates!


Peach Pulse: November 13, 2014

Open Enrollment Starts Saturday!

megaIf you receive our Peach Pulse, there’s a good chance you already know that open enrollment for health insurance starts this Saturday, November 15 and goes through February 15.  Two important things to remember and share with your friends, family, colleagues, and community members:

  • Even if you enrolled last year, you should go to healthcare.gov and shop around as your plan and premiums may have changed, or you may qualify for more financial assistance.
  • Unless you qualify for an exemption, the penalty fee for not obtaining health insurance has risen to $325 or 2% of your income (whichever is higher).

If you have enrolled successfully through the Health Insurance Marketplace or remain uninsured and think you fall into the coverage gap (Not sure what that is?  Check out this Kaiser Family Foundation resource that explains the coverage gap!), please consider sharing your story.  Highlighting your stories is crucial to showing our lawmakers that the ACA is working and that we need to close the coverage gap so that no Georgian is left uninsured.

Nykita Navigates

IMG_9114With open enrollment starting this Saturday, our Navigator, Nykita, has been very busy!  GHF is excited to highlight some of Nykita’s materials, as well as some great work from our partner organizations.  The following materials are great to print out at home for your own use or if you’re helping others enroll.

  • Affordable Care Act Basics: Guide to the Marketplace – Your basic guide to the ACA and the health insurance market place
  • Marketplace Application Checklist – Your check list of what you should bring to your appointment with a Navigator (it’s longer than you think!).
  • Health Insurance 101 – Not quite sure the difference between an HMO and a PPO?  How about co-insurance and co-pay?  This brochure will answer your questions.
  • Enrollment Brochure – Important dates and numbers to remember throughout open enrollment.
  • Navigator Resource Guide – Georgetown University’s Center on Health Insurance Reforms (CHIR) has launched its web-based Navigator Resource Guide on Private Health Insurance and the Health Insurance Marketplaces.  Targeted at Navigators, this is an amazing resource to help answer the tough questions.

Ready to get enrolled?  Check out Nykita’s schedule to see what events are happening in your neighborhood.  Check back often for updates.

Medicaid Minute

All eyes are on open enrollment, but for more than 400,000 Georgians, there still isn’t a health care option available.  Our elected state officials have the power to solve this problem. The health care law was designed to provide a path to health insurance to all Americans, but our state government has to opt in to make that a reality. Governor Deal and the state legislature have so far declined to use federal tax dollars that have already been set aside to provide coverage to those in the gap, but the opportunity to accept this money is still available.  We can opt in now by expanding Medicaid eligibility to all low-income Georgians who currently do not qualify.  Still need more details?  Click here to learn more.

It’s Not Too Late To Give!

GA Gives DayAs you know, Georgia Gives Day is in full swing!  The day isn’t over and as of sending time we are 30% of the way to achieving our goal of $1,000!  Your participation and support allows us to continue the work we do: educating the public and our lawmakers, providing valuable resources to partner organizations and leading the charge for closing the coverage gap in Georgia.  If you haven’t, please consider a small donation.  To donate, click here.


Peach Pulse: October 30, 2014

SBIRT: A Public Health Initiative


Yesterday, Georgians for a Healthy Future together with the Georgia Council on Substance Abuse unveiled our new initiative “Somebody Finally Asked Me…” at a benefit party held at the home of Iris and Bruce Feinberg.  This project aims to prevent and address youth substance use disorders through increased use of an evidence-based public health approach known as SBIRT (Screening, Brief Intervention, and Referral to Treatment).

To learn more about SBIRT, click here.

If you were unable to attend the event and would like to make a donation to help us reach our fundraising goal for this project, click here.

To watch a video about how alcohol and drug addiction impact the lives of youth and why we are committed to preventing addiction before it starts,click here.

Georgians for a Healthy Future awarded Robert Wood Johnson Foundation grant

Georgians for a Healthy Future (GHF) is excited to announce that we have been awarded a Consumer Voices for Coverage grant from the Robert Wood Johnson Foundation, the nation’s largest health philanthropy. Georgians for a Healthy Future will work in conjunction with Community Catalyst, who serves as the national program office for the Consumer Voices for Coverage program. As one of 18 state-based consumer health advocacy organizations around the country to receive a grant under the Robert Wood Johnson Foundation’s Consumer Voices for Coverage initiative, Georgians for a Healthy Future will develop and carry out collaborative and best-practice based strategies to maximize health insurance enrollment and retention, increase health insurance literacy, and create a more favorable policy environment for Georgia health care consumers. This project will have a particular emphasis on vulnerable and hard-to-reach populations in Georgia.

“We are honored to be part of the Consumer Voices for Coverage community and excited to deepen our work on behalf of Georgia health care consumers through this grant,” said Cindy Zeldin, Georgians for a Healthy Future’s Executive Director. “The health care policy landscape in Georgia and across the nation is rapidly changing, and it is critically important that there be a strong voice for consumers as these changes are determined and implemented.”

Georgians for a Healthy Future will draw upon our extensive experience and expertise in building and mobilizing coalitions as well as strong relationships with dozens of community organizations with deep reach across the state. These partnerships will be essential for outreach, dissemination of culturally and linguistically appropriate educational materials, and for soliciting feedback from diverse communities about the specific challenges faced regarding health insurance so that themes can be identified and shared with state policymakers and other key stakeholders and decision-makers.

About Georgians for a Healthy Future: Georgians for a Healthy Future’s mission is to build and mobilize a unified voice, vision, and leadership to achieve a healthy future for all Georgians.  Since our founding in 2008, Georgians for a Healthy Future has provided substantive health policy information to community leaders and advocates throughout the state, conducted seminars to equip consumers with the tools to become strong advocates, successfully injected the consumer perspective into dozens of health care stories in the media, and engaged with policymakers to spark policy change for a healthier Georgia.

It’s Time to Get Covered

lgbt_iconLearn about your options for health care coverage at the LGBT Health Insurance Town Hall

Join Georgia Equality, Georgians for a Healthy Future and The Health Initiative on Thursday, November 13th at 7 pm at the Rush Center.  Whether you still need health care coverage or you have coverage and want to re-enroll, you probably have questions about the upcoming open enrollment period.  Consumers, just like you, who got enrolled in health coverage last year will share their experiences and advice.  Navigators will be on hand to answer your questions about how to get covered or re-enrolled.  Bring your coverage questions, your uninsured friends and family, and your health coverage stories.  Open enrollment for 2015 coverage begins November 15, 2014 and ends February 15, 2015.

Bonus! We don’t know about you, but talking health care always works up our appetite – stop in at Radial Café before or afterwards to receive either 20% of your meal or order a special dinner for two for $30!

Click here to RSVP!

Not in Atlanta – We’ve still got you covered!

Because we know that many of you have questions about your coverage options and what to look for in a health insurance plan, we will also be live-streaming the town hall meeting. You’ll not only be able to watch the presentations in real time, you’ll also be able to ask your questions of our panelists and experts.

Click here to RSVP for the live-stream!

Children’s Health Insurance Program in Danger

The Children’s Health Insurance Program (CHIP) provides health insurance for children whose families make too much to allow the children to be covered by Medicaid, but make too little to be able to provide insurance for their children themselves.  CHIP covers 7.7 million children nationwide and 220,000 in Georgia.  Georgia’s CHIP program is called PeachCare for Kids (aka PeachCare).  . PeachCare is administered by the state of Georgia and jointly financed by the state and federal government.

PeachCare provides coverage for primary, preventive, specialty, dental and vision care for enrolled children ages 18 and under.  In addition, the insurance covers hospitalization, emergency room visits, prescription medications and mental health care.  PeachCare helps ensure the well-being of many Georgia children who may not be covered otherwise.

Future funding for the program is in danger.  Even though the program is legislated to exist until 2019, Congress has only approved funding for CHIP until next September.  By choosing not to approve federal dollars for CHIP in the 2016-2019 budgets, Congress would leave millions of children without access to health insurance and would shift the financial burden of covering our kids to the Georgia state budget.

Contact your Congressperson and ask them to make sure that Congress secures CHIP funding through 2019.

For more information visit Voices for Georgia’s Children and the Georgetown Center on Children and Families.

Medicaid Minute

Looking for more proof of why we should close the coverage gap?  A nonpartisan Kaiser Family Foundation analysis reported that states that have not expanded Medicaid and closed the coverage gap (like Georgia) will see a greater increase in spending than those that have.  In states like Georgia we can expect to see a 6.8 percent increase in tax dollars going to support Medicaid in fiscal year 2015.  That compares to a 4.4 percent rise in states that have closed the coverage gap already.

Nykita Navigates!

IMG_9114In the last edition of our Peach Pulse newsletter, we introduced you to Nykita Howell, Georgians for a Healthy Future’s new health insurance navigator. Nykita has hit the ground running in her new position in advance of health insurance open enrollment, which begins November 15!

If you are part of a community-based organization and would like to learn more about the types of health insurance options available to your community members and gain a better understanding of how to enroll in coverage, please feel free to contact Nykita to request a presentation. If you are an individual consumer in need of health insurance enrollment assistance, you can also contact Nykita to set up an appointment.

What does a navigator do, you might ask?

Health insurance navigators help consumers determine their eligibility for health insurance and for advanced premium tax credits through the Health Insurance Marketplace, provide enrollment assistance to consumers by helping them prepare their applications, and conduct outreach and education to raise awareness about the Marketplace. Navigators receive training and are certified at both the state and federal levels. They provide free and unbiased services to consumers.

Georgians for a Healthy Future is part of a consortium of 12 nonprofit organizations led by Seedco that received a federal navigator grant from the US Department of Health and Human Services. That funding supports this important service.

Events in the next two weeks:

  • Community Church of God and Christ (Atlanta, GA), November 15, 2014  1pm to 4pm  

Infographic of the Week!



Peach Pulse: October 17, 2014

Navigators and the Consumer Experience


Georgians for a Healthy Future partnered with Seedco at a briefing in Atlanta on October 16 to present and discuss findings from a comprehensive evaluation of the impact of health insurance navigators on consumer experiences during the first open enrollment period. The evaluation was conducted by a team of researchers at the University of Georgia, and its key findings include:

  • Navigators succeeded in assisting consumers from diverse communities and in reaching those in need of affordable health services
  • Rates of achieving enrollment or application success with navigators differed by region, by demographics, and by consumer financial status
  • Navigator interpersonal communications, and especially follow-up, was the biggest factor in consumer satisfaction

As we gear up for the next open enrollment period, which begins on November 15, 2014, the findings from this report can inform the work of enrollment assistance personnel and community-based organizations in Georgia and across the country. Selected recommendations from the report include:

  • Continue partnering with community agencies that serve diverse populations
  • Publicize the navigator role and concrete ways to access free in-person assistance
  • Follow up with consumers after they receive in-person assistance

For a summary document highlighting and describing these and other key findings and recommendations, click here. To read the full study, click here.

Georgians for a Healthy Future Met the Press!

GHF’s Executive Director Cindy Zeldin met last week with the Kaiser Family Foundation’s (KFF) Media Fellows and shared her perspective as a consumer health advocate with the group. The KFF Media Fellows are highly regarded health care journalists from major national and local publications who spent three days in Georgia discussing and learning about the implementation of the Affordable Care Act (ACA) and other health policy issues in the state from local experts, advocates, academics, and practitioners. Georgians for a Healthy Future was honored to be a part of their agenda.

The fellows prepared for their visit to Georgia by reading KFF’s new “The Georgia Health Care Landscape.”  This document provides a comprehensive overview of Georgia’s population health, the implementation of the ACA in Georgia, and Georgia’s health care infrastructure.  It is an excellent primer for those who want to know more about Georgia’s health care landscape or who want to have key Georgia health care stats at your fingertips.  Some facts in particular stand out from the issue brief:

  • As of January 2014, 22% of uninsured Georgians were in the coverage gap, meaning they were ineligible for Medicaid because Georgia has not expanded its program and earned too little to qualify for premium subsidies for private coverage.
  • 87% of Georgians who enrolled in health coverage through the Marketplace received premium subsidies to purchase coverage.
  • Georgia has many Health Professional Shortage Areas and a high level of unmet need for care. As of August 2014, only 59% of the primary health care need in Georgia was being met. Even worse, only 45% of the need for mental health care services and 28% of the need for dental services were being met.
  • More than one in five non-elderly people in Georgia is uninsured, and high unemployment rates and poorer than average health care outcomes for many measures suggest a greater need for health coverage among many low-income Georgians.

Georgia Gives day is 26 days away!

We’re hoping for a big turnout for Georgia Gives Day on November 13th for Georgians for a Healthy Future (GHF), but there’s something you can do between now and then and it takes almost no time!  Take a picture, like the one below, and tell us why you support our work and quality access to health care.  Include the hashtags #GAGivesDay and #unselfie and tag us on Facebook or include our twitter handle @healthyfuturega to enter us to win $500 from GA Gives Day!  It’s a competition, so go to GA Gives Facebook page and vote for your favorite GHF submission!


Your support and participation doesn’t just support GHF but it supports accessible, quality and affordable health care for all Georgians.  Don’t forget to check back with us on November 13th to make a donation and show your support for health equity and for GHF!







GHF Welcomes New Staff: Health Insurance Navigator Nykita Howell

IMG_9114Georgians for a Healthy Future is excited to welcome Nykita Howell, our new Health Insurance Navigator, who joined us this week!  In this role, Nykita provides Marketplace enrollment assistance to Georgia health care consumers. Prior to joining Georgians for a Healthy Future, Nykita worked in the fields of clinical and community based research and as a navigator for the first open enrollment period of the national Health Insurance Exchange. Her research efforts have been on studies focused on retention strategies for an NIH-funded cohort based at Umass Medical School, and a church-based diabetes project housed at Mercer University. Her work as a navigator prior to joining Georgians for a Healthy Future included building community partnerships and educating consumers over a seven county area. She holds an MPH from Mercer University School of Medicine and is a Certified Health Education Specialist. Prior to her graduate studies, Nykita received her B.S. in Biology from Clark Atlanta University, in Atlanta, GA.  If you or anyone you know needs assistance navigating the health care system, please contact Nykita at nhowell@healthyfuturega.org or 404-567-5016.  Remember, open enrollment begins Nov. 15th—just one month away!

Medicaid Minute: 60% Support Closing the Coverage Gap!

A new report on consumers’ experiences and views on health care found that 60% of Georgians disapprove of the state’s decision not to expand Medicaid, which includes 43% who strongly disapprove.  Over 90% of Georgians think Medicaid is important – and we agree!  It’s time to close the coverage gap and provide a pathway to coverage for all Georgians. Follow @healthyfuturega on Twitter to stay up-to-date about our efforts to #coverga.

Infographic of the Week

From our partners at Enroll America!










Join us for a benefit party!

Benefit Party1

Please join Georgians for a Healthy Future (GHF) and the Georgia Council on Substance Abuse on October 29 from 6 to 8 PM for our SBIRT (Screening, Brief Intervention, and Referral to Treatment) Benefit Party to launch our new public advocacy campaign – Somebody finally asked me! The project seeks to prevent youth substance use disorders through the implementation of universal screening.  In addition to launching our SBIRT project, we have been challenged to raise $30,000 in Georgia to help support this work—a big opportunity to leverage the national dollars coming into Georgia through the Hilton Foundation.  We hope you will join us and make a gift that is meaningful to you as we work together towards this goal.  To learn more about this project click here.  To RSVP now, click here.

GHF Executive Director is honored by the League of Women Voters

Georgians for a Healthy Future’s Executive Director Cindy Zeldin was honored last week by the League of Women Voters with an Empowerment Award at their annual lunch.  GHF is so proud of Cindy’s dedication to health advocacy throughout the last five years!

cindy award

john lewis


Peach Pulse: October 6, 2014

Next in Health Care: Network Adequacy Explained

question When consumers enroll in a health insurance plan, they gain access to a network of medical providers. Insurance companies contract with a range of providers, including both primary care and specialty physicians, to deliver health care services included within the plan’s benefit package. This network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. This is what is meant by network adequacy.  More specifically, to be considered adequate, a network must provide adequate numbers, types, and geographic distribution of providers; must ensure that access to care is timely; and must include essential community providers that serve predominantly low-income, medically underserved individuals. Additionally, accurate information about providers must be made available to consumers.

Network adequacy has become a hot topic over the past several months because many consumers who enrolled in new health plans through the Health Insurance Marketplace found that their plan came with a narrow network of providers. Provider directories weren’t always accurate or up-to-date, and consumers expressed a fair amount of confusion over which providers were in their plan’s network.

At the same time, the National Association of Insurance Commissioners (NAIC), which develops model laws and rules that states often adopt, has been working to update its network adequacy model law. Stakeholders ranging from insurers to medical providers to patient and consumer advocates are weighing in on this process, making network adequacy a hot topic in the policy arena too. Georgians for a Healthy Future has been monitoring this process through the participation of our executive director as one of the consumer representatives to the NAIC. Earlier this summer, the consumer representatives submitted comments to the NAIC focusing on developing a stronger standard and better oversight of network adequacy, an end to “balance billing” by out-of-network providers in in-network facilities, and greater transparency of provider networks.

Georgians for a Healthy Future will continue to monitor this process and will advocate at all levels, in conjunction with state and national partners, to ensure consumers have meaningful access to care.

If you are an individual consumer enrolled in a commercial health plan and the provider directory you were given was incorrect or if you have concerns about your ability to access covered services under your plan, please contact the Georgia Office of Insurance & Fire Safety, Consumer Services Division by calling (800) 656-2298 or use the Consumer Complaint Portal at www.oci.ga.gov/ConsumerService. Please also consider sharing your story with Georgians for a Healthy Future so we can get a better picture of what is happening in our state.

For more information on network adequacy, please see the following reports and resources:

From Georgetown Center on Health Insurance Reforms: Reforming State Regulation of Provider Networks: Efforts at the NAIC to Re-Draft a Model State Law

From Robert Wood Johnson Foundation and Georgetown University Health Policy Institute: ACA Implications for State Network Adequacy Standards

From Families USA: Network Adequacy and Health Equity: Improving Private Health Insurance Networks for Communities of Color

Connecting Georgians to Coverage

The ACA and people living with HIV/AIDS: what you need to know

PrintThe Affordable Care Act (ACA) makes health insurance more affordable, more accessible, more understandable, and more complete for all Georgians. Health care and health insurance are especially important to people living with HIV/AIDS (PLWHA) so that they can stay healthy and well.  PLWHA often have very specific needs and questions regarding their health coverage and care options.  To answer them, Georgians for a Healthy Future and Georgia Equality have created a fact sheet that breaks down the biggest concerns and decisions for PLWHA.  The fact sheet details new rights and protections under the ACA, walks through important questions to ask prior to choosing a health plan, and provides contacts for further assistance.

This fact sheet was made to be shared! You can view and download this new fact sheet on the GHF website. If you would like hard copies to distribute to your members, clients, or community partners, please contact Laura Colbert, GHF’s Community Outreach Manager at lcobert@healthyfuturega.org.

Georgia Gives Day

GA Gives DayGeorgians for a Healthy Future works hard every day to bring about our vision of a day when all Georgians have access to the health care services they need to lead productive lives and contribute to the health of their communities. Whether we’re enrolling people in health insurance, advocating on behalf of health care consumers at the state capitol, working to address substance use among young adults, or convening a coalition to expand Medicaid, we are focused on you and your health.

November 14th is Georgia Gives Day.  This is a day for Georgians across the state to express their support for the non-profit organizations that enrich our lives.  We hope that you will put November 14th on your calendar and take a few minutes out of your day to support Georgians for a Healthy Future by making a small contribution.  Look for alerts leading up to the day and please follow us on Facebook and Twitter as we celebrate and work toward our vision of a healthy Georgia.

Stories that Cause Change: How you can make a difference!

The public discussion around the Affordable Care Act is often about its politics. What the pundits miss is that each person’s experiences-whether it is the elation, relief, and sense of security that come with enrolling in health insurance for the first time or the frustration that comes from finding out you fall into the coverage gap–is important.  Whatever your story, we want you to share it with us!

Volunteer!  Throughout open enrollment we will be talking to consumers throughout the state.  You can help us in this important effort by attending an event in your neighborhood and talking to consumers.  We will prepare you with supplies and materials, a how-to guide, and more.  If you would like to help out, please email our outreach manager, Laura Colbert.

Share your story and encourage others to do the same. If you or someone you know has successfully enrolled in a health insurance plan through the marketplace, tell us about it.  If you fall in the coverage gap, let us know.  If you are able to access care that you couldn’t afford before, we want to hear about it.  Tell us your story by contacting our communications coordinator, Anna Cullen.

Together we can make a change.

Medicaid Minute: Uncompensated Care Cost

ER-Hospital-SignLast week, HHS released a report highlighting one way Georgia can help our hospitals and reduce uncompensated care costs: closing the coverage gap by expanding Medicaid.  In states that have expanded, uninsured/self-pay admissions as well as uninsured/self-pay emergency visits have fallen.  Those same states have seen hospital admissions for patients with Medicaid increase.  In short, they have more paying customers.  And Georgia is getting left out.  The report shows a $5.7 billion savings to hospitals in uncompensated care because of the Affordable Care Act.  $4.2 billion (74%) of those savings will be to states that have expanded.  Just one more reason why closing the coverage gap is the best option for Georgia’s economy and Georgia’s people!