Peach Pulse Archives
What’s New in Georgia
Legislative Update
The 2012 Legislative Session continues today as legislators meet for Day 26 of the 40-day Session. Crossover Day (Day 30), when a bill must pass at least one chamber to remain viable for the Session, will be March 7th. Here is what health care advocates are watching:- The House and Senate have both passed versions of the Amended FY 2012 Budget (HB 741); since there are minor differences, HB 741 now heads to conference committee. Notably, the Senate version added $1.2 million in the Department of Public Health budget for the Children 1st program to replace the loss of Supplemental TANF funds. This program provides screenings for newborns. Also in the Senate version, funds were added to the Department of Community Health budget to reflect projected need in Medicaid but there were also cuts to reflect the rounding down of co-payments to the nearest dollar. Meanwhile, work continues on the FY 2013 budget. Click here for the Georgia Budget & Policy Institute’s analyses of the implications for the state’s health care agencies on the governor’s proposed 2013 budget recommendations.
- HB 1166, sponsored by Representative Atwood, would restore child-only health insurance policies to Georgia’s individual market. Georgians for a Healthy Future, along with a range of child health advocacy groups, is in strong support of this measure to provide this option for families who need coverage for their kids. The bill is expected to be before the House Insurance Committee on Wednesday. You can learn more about this issue by downloading our fact sheet.
- HB 801 and SB 418 were introduced by Representative Gardner and Senator Orrock, respectively, as companion bills to establish a health insurance exchange in Georgia. While leadership in the House and Senate have indicated that there will not be movement on an exchange this year, please thank Representative Gardner and Senator Orrock for their leadership on this important issue. You can learn more about how a Georgia exchange could work by downloading our issue brief here. All information from the Governor’s Health Insurance Exchange Advisory Committee, which met throughout the second half of 2011 to develop recommendations on this issue, is available here.
- HB 1159, sponsored by Representative Pruett, is known as the New Parent Information Bill and would create a Joint Study Commission on Education for Parents with Newborn Children to determine how best to gather information, raise funds and create a comprehensive informational video. The video would include but not be limited to information on the prevention of childhood obesity; how to prevent SIDS, shaken baby syndrome, and other forms of child abuse; how to prevent death and injury and additional information which would assist parents to raise safe and healthy children. The bill is expected to be before the House Health and Human Services Committee this week.
Redesigning Medicaid and PeachCare
In the on-going efforts to redesign Georgia’s Medicaid and PeachCare programs, the Department of Community Health (DCH) is continuining to analyze and evaluate its options and has convened three taskforces to gather feedback from consumer advocates, providers and other stakeholders. The latest taskforce, focused on children and families will hold its first meeting on March 9th. GHF’s Outreach and Advocacy Director Amanda Ptashking will be there to represent health care consumers who currently access these programs or who will gain access through the Medicaid expansion in 2014. Part of the charge of this taskforce includes identifying:- Program features identified in the Navigant report that are most/least appealing to meeting the needs of families and children;
- Current features of the program that should be maintained;
- Largest unmet need of the current program;
- Better medical management and coordination for children in foster care;
- Additional insights not identified in the report; and
- Identification of critical design features needed to protect the needs of children and families
Final rules issued for new plain-language information and tools
A new survey shows that consumers aren’t satisfied with the level of customer service they receive from their health insurance plans. In fact, the industry ranked the lowest of any industry measured in this survey. Additionally, other studies have found that consumers often find health insurance jargon confusing, which makes it challenging for consumers to select a policy that best meets their needs, to know what is covered and what isn’t, and to understand their rights as consumers if disputes arise. While overshadowed by some of the other major reforms included in the law, the Affordable Care Act contains some exciting reforms for consumers in this area, including making available access to clear, plain language information about their insurance plans. The U.S. Department of Health and Human Services issued final regulations on February 9th requiring an easy-to-understand Summary of Benefits and Coverage and a uniform glossary of terms. These new tools will be available to consumers on September 23, 2012. More information is available here and here.Hospital infection rate information now online
The U.S. Department of Health and Human Services has made data on hospital-acquired infections, including data for Georgia hospitals, available online. Nationally, about one in twenty patients are affected by a hospital-acquired infection. While 27 states require disclosure of patient safety information such as data on hospital-acquired infections, Georgia does not, making this new online resource an important tool for Georgia consumers. Georgia Watch, which has spearheaded support for public disclosure of this information in Georgia for years, has more information here.Bump It Up a Buck Coalition Maintains Momentum in 2012
Members of the Bump It Up a Buck coalition (including Georgians for a Healthy Future) are working together to maintain the momentum needed to secure an increase in the consumption tax on cigarettes by $1. Experts say the measure would reduce smoking levels in the state, improve the health of all Georgians and conservatively generate more than $340 million in new tax revenue for the state each year. As part of our efforts to increase awareness of the issue, members of the coalition will participate in the first celebration of national Kick Butts Day to be held in Atlanta since 2008. The event will be held on Wednesday, March 21, 2012, and will include a rally on the steps of the Capitol and online activities as well. Georgia currently has the 48th lowest per pack tax in the nation at only 37 cents (national average: $1.46). You can show your support for the initiative by joining the hundreds who Like the idea at http://www.facebook.com/BumpItUpaBuck. MORE >What’s New in Georgia
2012 Legislative Session Update
Fifteen days of the 2012 Legislative Session have passed. Last week, the House passed the Amended FY 2012 budget with several changes to the Governor’s proposal. Both the House and Senate are continuing to hold hearings throughout the week on the FY 2013 budget.
Health Insurance Exchange Stalls in Georgia
Georgia lags other states in progress towards establishing a health insurance exchange as authorized by the Affordable Care Act (ACA), despite the fact that Georgia stands to experience one of the largest drops in the uninsured as a result of the ACA reforms, according to an analysis by the Urban Institute. At our Health Care Unscrambled breakfast in January, a panel of Georgia policymakers discussed prospects for a health insurance exchange and indicated that exchange legislation would not move through the General Assembly in 2012. Nevertheless, Representative Pat Gardner has introduced HB 801 to establish a Georgia health insurance marketplace, or exchange. Please thank Representative Gardner for taking a stand on this important issue! For recent news articles on health insurance exchanges and Georgia, click here and here.
Modernizing Medicaid and PeachCare
The Department of Community Health recently released a long-anticipated Strategy Report from Navigant, the consulting firm hired to evaluate the state’s redesign options for Georgia’s Medicaid and PeachCare programs. The Strategy Report includes a national and Georgia-specific environmental scan of Medicaid and CHIP programs, as well as three delivery options for DCH to consider as it moves into the Procurement and Implementation Phases of the redesign process. To read DCH’s press release on the Navigant Report, click here. To read the report and appendices, click here.
The next part of the Recommendation Phase includes an analysis and evaluation of the Strategy Report with the goal of finalizing the redesign model by April 2012. DCH is soliciting feedback on the Strategy Report either through their Feedback Tool or by submitting a brief comment or question to MyOpinion@dch.ga.gov. The deadline for submitting detailed feedback, comments or questions is February 29, 2012, at 5 p.m. (ET).
In order to assist health care advocates as they respond to the Navigant report, Georgians for a Healthy Future has designed a mircosite to house all relevant information on this on-going process. Visit www.healthyfuturega.org/
Bump It Up a Buck
With the 2012 Legislative Session underway, the Bump it Up a Buck campaign is once again advocating for a $1 per pack increase in the state’s tobacco tax. Raising cigarette taxes is one of the most effective ways to reduce smoking, particularly among Georgia’s kids, and will raise important new revenue for the state. Georgians for a Healthy Future is proud to be a part of the Bump It Up a Buck coalition along with leading members the American Cancer Society, the Campaign for Tobacco-Free Kids, the American Heart Association, the American Lung Association, the Cancer Action Network of the American Cancer Society, the Georgia Society of Clinical Oncology, and the Georgia Public Health Association. To learn more and to get involved, visit www.BumpItUpaBuck.org.
Update on Essential Health Benefits
Georgians for a Healthy Future is monitoring developments at the federal level that will impact benefits and consumer protections for new individual and small group health plans in Georgia beginning in 2014. In December, the Center for Consumer Information and Insurance Oversight (CCIIO), the division of the U.S. Department of Health and Human Services charged with implementing the provisions of the Affordable Care Act (ACA) related to private health insurance, released a bulletin on the essential health benefits (EHB) that all new plans will need to include.
The bulletin allows states to select the EHB for plans in their state from ten benchmark plan options. These include: (1) any of the three largest Federal Employees Health Benefits Program (FEHBP) plans by enrollment, (2) any of the three largest state employee health benefit plans by enrollment, (3) the largest plan by enrollment in any of the three largest small group insurance products offered in the state, or (4) the largest commercial non-Medicaid Health Maintenance Organization (HMO) plan in the state.
Information about which plans these are in Georgia can be found here. Georgia has not yet made a benchmark selection from among these plans, and we are working to identify more specifics about the benefit packages within these plans. We will keep advocates informed as we learn more about this ongoing process. If you’re also monitoring developments around EHB, please share information with us so we can communicate it to a range of health care advocates.
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At Georgians for a Healthy Future, we envision a day in which all Georgians will have the quality, affordable health care they need to lead healthy lives and contribute to the health of their communities. Working towards this vision takes many forms: talking directly with local community members throughout Georgia about the health care issues they’re facing; partnering with other organizations to form coalitions to build and mobilize support for better health care policies to address these needs; and engagement with policymakers to extend health care coverage to more Georgians, expand access to care, and ultimately improve health outcomes. We couldn’t do any of this without YOU! Thank you for telling us your health care stories, for collaborating with us on shared goals, for volunteering with us, and for contributing your time and dollars to our health care advocacy efforts.
Please consider supporting Georgians for a Healthy Future with a financial contribution. As a nonprofit organization, our work is funded through foundation grants and contributions from supporters like you. Please provide your support and stand with us as we fight to improve health care for Georgia consumers.
Have a happy and healthy Holiday Season!
What’s New in Georgia
Georgians for a Healthy Future Executive Director Named as NAIC Consumer Liaison Representative
Our Executive Director, Cindy Zeldin, was named by the National Association of Insurance Commissioners (NAIC) as one of 28 consumer liaison representatives from across the country for 2012. The NAIC/Consumer Liaison Committee assists the NAIC in its mission to support state insurance regulation by providing consumer views on insurance regulatory issues and provides a forum for ongoing dialogue between NAIC Members and Consumer Representatives. This appointment comes at a critical time, as the NAIC has been delegated a central role in the implementation of the Affordable Care Act by establishing standards, definitions, and consulting on model regulations—policy choices that will have a big impact on health care consumers here in Georgia and around the country. The NAIC news release is available here.
Georgia Health Insurance Exchange Advisory Committee Issues Final Report
The Health Insurance Exchange Advisory Committee issued its final report this week, calling for the development of a small business health insurance marketplace outside the context of the exchange framework authorized by the Affordable Care Act but failing to explicitly recommend the establishment of a health insurance exchange for individual consumers. Georgians for a Healthy Future’s Executive Director, a member of the committee, wrote a minority report calling for Georgia to take advantage of the opportunity to cover the uninsured and improve our health insurance marketplace by building a Georgia exchange in 2012. You can read the committee report, the minority report, and all other supplemental materials here.
Healthcare Unscrambled
Georgians for a Healthy Future’s 2nd Annual Policy Breakfast
Health Care Unscrambled, Georgians for a Healthy Future’s annual policy breakfast, brings together health care policymakers, stakeholders, experts, and advocates for an energizing look ahead at the top health issues facing our state as the 2012 Legislative Session gets underway. Please be sure to register today! This year’s breakfast will be on Thursday, January 12th from 8 AM to 10:30 AM and boasts:
• A panel discussion with Georgia legislators and state officials, including Insurance Commissioner Ralph Hudgens, Representative Pat Gardner, Representative Richard Smith, Senator Renee Unterman, and Senator Nan Orrock
• A keynote presentation from Dr. Len Nichols, one of the nation’s leading health economists
• Highlights from GHF’s forums and workshops with community leaders across the state
• GHF’s 2012 policy priorities announced
To purchase tickets or to become a sponsor of the event, click here. We hope to see you in January!
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What We Are Thankful For
At Georgians for a Healthy Future, we envision a day in which all Georgians will have the quality, affordable health care they need to lead healthy lives and contribute to the health of their communities. Working towards this vision takes many forms: talking directly with local community members throughout Georgia about the health care issues they’re facing; partnering with other organizations to form coalitions to build and mobilize support for better health care policies to address these needs; and engagement with policymakers to extend health care coverage to more Georgians, expand access to care, and ultimately improve health outcomes. We couldn’t do any of this without YOU! Thank you for telling us your health care stories, for collaborating with us on shared goals, for volunteering with us, and for contributing your time and dollars to our health care advocacy efforts.
Have a happy and healthy Thanksgiving!
What’s New in Georgia
Advocacy Demystified: Tools and Strategies for Effective Consumer Health Advocacy
Advocacy may seem overwhelming, but it’s a lot easier–and can have a bigger impact–than you might imagine. You already have the knowledge, passion, and commitment to be a successful and effective health care advocate. All you need are the right tools. Today we are releasing our latest issue brief: Advocacy Demystified: Tools and Strategies for Effective Consumer Health Advocacy, to arm you with the tools you need to advocate for health care change and empower you to start making a difference in your communities. This is a tool meant for sharing so feel free to send to any individuals or organizations who you think would find it useful. Click here to access the issue brief.
Georgia’s health insurance exchange committee finalizes work, receives national press
The final report of the Governor’s health insurance exchange advisory committee is expected on December 15th. The committee held its last full meeting on October 27th (click here for meeting minutes) and is now drafting the final report, which is expected to be the basis for legislation in 2012 reforming Georgia’s health insurance marketplace through the establishment of an exchange. The work of the committee received attention in the Washington Post and Kaiser Health News this week. Georgians for a Healthy Future is representing the consumer voice on the committee and will continue to provide updates and advocacy opportunities on this process as they arise. To see Georgians for a Healthy Future’s priorities for a consumer-friendly health insurance exchange, download our brief here.
Developing essential health benefits: Opportunity to provide input
Beginning in 2014, many health insurance plans, including those to be offered through the new state-based health insurance exchanges, must cover a minimum package of preventive, diagnostic, and therapeutic services and products comparable to those offered in a typical employment-based plan. The specifics of the package are being developed right now by the U.S. Department of Health and Human Services (HHS), and HHS has encouraged consumer advocates to provide input. Here is how to weigh in:
Step 1: Learn more about essential health benefits and this process by reading issue summaries here and here or by participating in an upcoming webinar hosted by the National Academy for State Health Policy here.
Step 2: Prepare and e-mail your comments to ExternalAffairs@HHS.gov. HHS has requested that comments address some or all of the following 5 points below:
- In keeping with the title of the Institute of Medicine report “Essential Health Benefits—Balancing Coverage and Cost,” how can the Department best meet the dual goals of balancing the comprehensiveness of coverage included in essential health benefits and affordability?
- How might the Department ensure that essential health benefits reflect an appropriate balance among the categories so that they are not unduly weighted toward any category?
- What policy principles and criteria should be taken into account to prevent discrimination against individuals because of their age, disability status, or expected length of life as the Affordable Care Act requires?
- What models should HHS consider in developing essential health benefits?
- What criteria should be used to update essential health benefits over time and what should the process be for their modification?
Events and Forums
Building a Healthy Georgia: Widening the Safety Net and Ensuring Greater Access to Care
On Wednesday, November 30th, Georgians for a Healthy Future is hosting a Building a Healthy Georgia Event in Savannah. The focus will be on widening the safety net and ensuring greater access to care for Georgians living in the Coastal Region. We’ll cover topics including:
- Local perspectives on the specific health care challenges facing the coastal region
- How the Affordable Care Act impacts the community and individuals; Georgia’s opportunity to customize
- Widening the safety net and expanding access to care
- Medicaid redesign and upcoming 2014 expansion
The event will take place at the Coastal Georgia Center from 4 PM to 6 PM. For more information and to register for the event, click here.
SAVE THE DATE: Healthcare Unscrambled 2012
Health Care Unscrambled, Georgians for a Healthy Future’s annual policy breakfast, brings together health care policymakers, stakeholders, experts, and advocates for an energizing look ahead at the top health issues facing our state as the 2012 Legislative Session gets underway. Please be sure to save the date! This year’s breakfast will be on Thursday, January 12th from 8 AM to 10:30 AM and boasts:
- A panel discussion with Georgia legislators and state officials, including Insurance Commissioner Ralph Hudgens, Representative Pat Gardner, Representative Richard Smith, and several more to be announced
- A keynote presentation from Dr. Len Nichols, one of the nation’s leading health economists
- Highlights from GHF’s forums and workshops with community leaders across the state
- GHF’s 2012 policy priorities announced
What’s New in Georgia
Reforming Georgia’s Health Insurance Marketplace: All About Exchanges
Earlier this week, Georgians for a Healthy Future joined with 150 health care advocacy organizations across the country to submit public comments to the U.S. Department of Health and Human Services (HHS) on their proposed federal rule regarding health insurance exchanges, the new state-level health insurance marketplaces that will take shape across the country in 2014. One of the most important pieces of this process is making sure that the exchange works for consumers and not just for insurance companies. That’s why we joined in recommending that HHS prohibit people with conflicts of interest from serving on the governing body and take steps to ensure adequate representation of consumer interests. You can read the full public comments here.
Department of Community Health’s Medicaid Redesign Project Continues, Advocates Weigh In
Over the last several weeks, Navigant, the consulting firm hired by the Georgia Department of Community Health to oversee the Medicaid Redesign assessment, has been conducting focus groups across the state as part of the environmental scan stage of the process. They have met with providers, consumers, advocates and vendors.
Opportunity to Provide Input to HHS on Essential Health Benefits
Upcoming Georgia Health Agency Meetings
The new Department of Public Health will hold its next monthly board meeting on November 8th. Details are available here. The Department of Community Health’s board meets on November 10th. Those meeting details are available here.
A New Resource Guide on Affordable Care Act Grants
The Affordable Care Act authorized a range of grants that states, communities, and other entities can apply to receive for certain health care initiatives such as prevention, public health, and provider workforce development. A new guide presenting clear, easy-to-find, accurate information on the pilot projects, grants, and workforce development initiatives is now available. It includes a directory of departments and offices in charge of administering the programs. Included is a grant description, application timeline, most recent appropriation and information on eligibility requirements. To access the guide, click here.
Events and Forums
Building a Healthy Georgia: The Impact of Health Care Reform on Central Georgia’s 50+ Community
On Tuesday, November 15th, Georgians for a Healthy Future and AARP of Georgia are hosting a Building a Healthy Georgia Event in Macon. The focus will be on the impact of health care reform on central Georgia’s 50+ community. We’ll answer questions like:
- What does the law means for uninsured adults aged 50+?
- How will the individual insurance market change?
- How will the law help me pay for my prescription drugs?
- What will it take to make the ACA work for all Georgia citizens?
The Prevalence and Toll of Diabetes on Georgia
On Tuesday, November 22nd, Georgians for a Healthy Future will hold a webinar training for D-ATLAS, a unique tool that enables health advocates and policymakers to map health disparities in diagnosed type 2 diabetes and obesity (BMI of 30 or greater). The D-ATLAS provides the prevalence of and cost associated with diabetes and the prevalence of obesity by race/ethnicity, age, or gender in the United States, by individual state, county or by legislative district. The ability to create customized maps that localize diabetes disparities is a compelling reference source and these maps may be generated and disseminated to support educational, advocacy, and public affairs initiatives. The webinar will take place from 10 AM to 12 PM. To learn more about D-ATLAS, click here. To register for the webinar, email Amanda Ptashkin.
SAVE THE DATE: Health Care Unscrambled 2012
What’s New in Georgia
Health Insurance Exchange Advisory Committee Issues Interim Report
The Governor’s Health Insurance Exchange Advisory Committee, charged with determining whether Georgia should establish a state-based health insurance exchange, issuedan interim report on September 15th, available here. Georgians for a Healthy Future’s executive director is a member of the committee and is currently participating on the governance and insurance markets subcommittees. GHF has also released an issue brief about the potential benefits of a well-designed exchange for health care consumers in Georgia, and we welcome your input to help us best represent the consumer voice on the committee. The next full meeting of the committee will be held on October 27th from 10am-2pm at the Department of Community Health (2 Peachtree St, 5th floor). All meetings are open to the public. Final committee recommendations are due to the Governor on December 15th per the Executive Order issued earlier this year.
New Department of Public Health Holds Initial Board Meeting
The newly-appointed nine-member Board of Public Health convened for the first time on September 26th. Over a period of nearly three hours, the members of the Board were provided a wide-ranging overview of the new Department of Public Health’s operations, including plans for trimming the FY2011 and FY2012 budgets. The new Department Of Public Health was established as a stand-alone state department on July 1, 2011, under legislation passed by the 2011 General Assembly. To view the slides from the meeting, click here.
Children Eligible for State Health Benefits Plan Can Now Opt for PeachCare
Starting in October, parents of children eligible for the State Health Benefit Plan (SHBP) can now opt to enroll their kids in PeachCare for Kids™ during open enrollment—a move that is expected to save money for parents as well as the state. The new option is expected to bring 40,000 Georgia children into the state’s PeachCare program. Currently, 200,000 kids are covered under PeachCare. To read a recent Georgia Health News article on the transition, click here.
Navigant Begins Stakeholder Focus Groups
As part of the environmental scan that consulting firm Navigant is tasked with undertaking as part of their Medicaid Redesign contract, in a few weeks they will begin convening stakeholder focus groups across the state. To be invited to one of these sessions, interested stakeholders must have registered on the DCH website back in September. For those not selected to attend the focus groups, Navigant has launched an online survey for consumers, patients, providers and vendors to weigh in on the process. Click here to access the survey.
Events and Forums
Medicine and Society Lecture Series Event This Friday
On Friday, October 7th, GHF executive director Cindy Zeldin will be presenting “The Affordable Care Act: Implications for Georgia” to attendees of the Medicine and Society Lecture Series at Grady Hospital. Presented in collaboration with Emory’s Department of Medicine, the Urban Health Initiative, and Social Medicine Work Group, this event will inform future health professionals about the intricacies of the ACA, how it will unfold through the implementation process, and what it means for medical professionals. For more information, contact Jada Bussey-Jones.
Interdisciplinary Care in Action: Meeting Tomorrow’s Health Care Needs
On Thursday, October 13th, HealthSTAT is coordinating an interdisciplinary professional panel to discuss how today’s students can prepare themselves to be tomorrow’s interdisciplinary leaders. Outreach and advocacy Director Amanda Ptashkin will be on the panel to discuss the important role of health professionals in helping to shape the future of our health care system. To learn more about the event, click here.
State of Public Health Workforce
On Tuesday, October 25th, Foothills Area Health Education Center (AHEC) is hosting a webinar, the “State of the Public Health Workforce in the State of Georgia.” This program will provide an overview of the challenges and strategies to increase the public health workforce and activities that support the professional development of the public health workforce in the State of Georgia. For more information about the webinar, click here. To register, click here.
What’s New in Georgia
Health Insurance Advisory Committee Recommends Creation of Georgia Exchange
Throughout the summer, the Governor’s Health Insurance Exchange Advisory Committee has been meeting regularly to study whether Georgia should develop a health insurance exchange. At the August meeting, the committee voted to recommend legislation for a Georgia exchange in 2012 and created subcommittees around governance, insurance markets, operations, and contingency plans to begin exploring design options for an exchange. Minutes from this meeting are available here.
Authorized by the Affordable Care Act, health insurance exchanges are state-level competitive health insurance marketplaces that hold the potential to transform our broken health insurance system into one that is transparent, competitive, and that provides consumers with the information, tools, and access to tax credits that can make health insurance more understandable and affordable. But only if we get it right. As this process unfolds, we need your voice to build support for an exchange that will work for all of Georgia’s health care consumers and not one that will work just for the insurance industry.
You can learn more about this issue by downloading Georgians for a Healthy Future’s issue brief about how to build a consumer-friendly exchange here. You can also read additional news reports on the exchange here, here, and here. A list of subcommittee members is available here. The next meeting of the full exchange committee is scheduled for September 22nd at 10am, location TBD. To see how Georgia’s progress compares to that of other states, click here for a spreadsheet describing progress across all states compiled by state refor(u)m.
New Information and Tools for Georgia Consumers Subject to Proposed Health Insurance Premium Increases
Georgia insurance companies proposing to increase health insurance premiums by 10 percent or more must now submit information to the Georgia Insurance Department, which will operate a rate review program to determine if the proposed rate increases are justified. The requirement, which went into effect on September 1st, is part of the Affordable Care Act, and Georgia has chosen to implement a rate review program in compliance with this provision. Consumers will also have access to information about the proposed rate increases, including the rationale behind them, and an opportunity to file comments through a tool on healthcare.gov beginning in mid-September. A preview of this tool is available here. Information about Georgia’s decision to operate a rate review program is available here and here.
Medicaid Redesign Process: Upcoming Stakeholder Forums
At the end of July, the Department of Community Health (DCH) awarded the Medicaid redesign assessment contract to Navigant Consulting. As part of the contract, Navigant will hold up to 30 stakeholder focus groups across the state, in cities yet to be announced. Part of the state environmental scan, the intent of these focus groups is to provide a forum for Georgia-specific input from providers, other agencies, advocates, and others affected by Medicaid and PeachCare to provide useful information to both Navigant and DCH as this process unfolds. If you or your organization wouldlike to participate in these focus groups, you can submit an application online here. To learn more about DCH and Navigant’s plans, click here. The deadline for submissions is September 13th.
2012 and 2013 Budget Update
DCH announced last week that Georgia’s Medicaid and PeachCare programs are facing budget shortfalls of more than $200 million in the current fiscal year (FY 2012) and more than $350 million next year (FY 2013). The agency is not proposing any cuts to manage the shortfall; rather, the department is simply seeking new money from the Governor’s Office of Planning and Budget (OPB). Left unsaid is what would happen if new funding is not made available to DCH. Significant provider reimbursement rate cuts would likely be necessary.
In addition to the funding request, the DCH proposal includes provisions to allow (currently ineligible) state employees to enroll their children in Georgia’s PeachCare program (if they meet existing income-eligibility guidelines). This proposal would lead to higher state costs in the PeachCare program, though these costs would be more than offset by state savings in the State Health Benefit Program.
The DCH Board is expected to act on the department’s proposed budget in September, after which the request would be submitted to OPB. To read the Georgia Budget & Policy Institute’s overview of the FY 2012 budget and budget trends, click here.
DCH Awarded Grants for PeachCare Outreach and Enrollment and Public Health Infrastructure Strengthening
Georgia’s Department of Community Health (DCH) recently received two federal grants from the Department of Health and Human Services to improve outreach and enrollment for Medicaid and PeachCare as well as improve the public health infrastructure in Georgia. The first grant, worth $2.5 million, will allow DCH to use technology solutions to better coordinate enrollment and renewal in Medicaid and PeachCare programs. The second grant, worth $499,738, will go to strengthening public health infrastructure for improved health outcomes and to help train and educate public health workers. To learn more about these grants, click here and here.
Events and Forums
Building a Healthy Georgia Started in Augusta and Continues in Butler
Last week, Georgians for a Healthy Future, Voices for Georgia’s Children and Health STAT kicked off our Building a Healthy Georgia campaign in Augusta. With a focus on children’s access to care and health care workforce issues, more than 60 local community leaders, key stakeholders, health care professionals and members of the academic community participated in the event and brought their expertise and passion to the conversation. We are looking forward to working collaboratively to address our most pressing health care issues in Augusta and we look forward to continuing that dialogue in other cities across the state. You can view the power point presentation from the forum here, and see photos from the event here.
Next Thursday, September 8th from 3 PM to 5:30, Georgians for a Healthy Future, the Georgia Budget & Policy Institute and the Georgia Rural Health Association will be in Butler, Taylor county for Building a Healthy Georgia: Workforce Development and the Value of Ensuring Access to Quality Health Care. The focus is on economic and workforce development issues, particularly as they relate to both local fiscal and physical health. You can find out more about the Butler event by clicking here.
MORE >What’s New in Georgia
Georgia Department of Community Health Awards Medicaid Redesign Contract to Navigant
The Georgia Department of Community Health has announced that it has hired Navigant Consulting to conduct an assessment and present options for restructuring Georgia’s Medicaid and PeachCare for Kids (CHIP) programs. The assessment will address quality, access, and appropriate utilization of resources within these programs. It will include an environmental scan at both the state and national levels to identify what has worked well and what has not worked well and will be complemented by up to thirty stakeholder forums to gain Georgia-specific input from providers, other agencies, advocates, and members. The assessment phase begins immediately and runs through December. The Department has provided an e-mail address, Navigant@dch.ga.gov for anyone who wishes to directly weigh in with the Department about this process. A recent news article about this issue is available here.
Potential Good News for Consumers: Georgia Insurance Department to Review Proposed Health Insurance Premium Increases in Compliance with the Affordable Care Act
In recent years, Georgia consumers have seen their health insurance premiums increase more quickly than their earnings, placing a strain on household budgets. Meanwhile, insurance companies just posted a surge in profits for the second quarter of 2011. Georgia consumers historically haven’t had access to adequate information to know if premium rate hikes are justified based on underlying medical costs or if they are simply going towards profits. Thanks to requirements and resources available through the Affordable Care Act, Georgia’s Insurance Department has expressed its intent to operate a rate review program to scrutinize proposed insurance premium rate increases of ten percent or more in compliance with the law. Insurance companies will have to provide evidence that these proposed premium increases are based on reasonable factors like a change in medical costs, utilization, or benefits. This is an opportunity to spur insurers to operate more transparently and more fairly in the market. Georgians for a Healthy Future will continue to monitor this issue as the Insurance Department implements the new requirements. Georgia’s intention to operate rate review was first reported by Georgia Health News. The link is available here. The Atlanta-Journal Constitution also reported on this issue here.
Next Meeting of the Governor’s Health Insurance Exchange Advisory Committee is August 16th
The Health Insurance Exchange Advisory Committee, charged with determining whether Georgia should establish a state-based health insurance exchange, will hold its third meeting on August 16th from 12pm to 3pm in the 5th floor of the Department of Community Health at 2 Peachtree St. The meetings are open to the public. More information about the work of the committee and upcoming meetings is available here.
New Issue Brief from Georgians for a Healthy Future: Building Georgia’s Health Insurance Exchange
Georgia is currently weighing options to determine whether it should establish a health insurance exchange. Authorized by the Affordable Care Act, the goal behind these competitive health insurance marketplaces is to better facilitate competition and choice for health care consumers. Earlier this week, Georgians for a Healthy Future released an issue brief entitled Building Georgia’s Health Insurance Exchange that outlines how a health insurance exchange can benefit Georgia consumers and makes recommendations for our policymakers as they weigh design options for an exchange.
Building Georgia’s Health Insurance Exchange addresses the following questions:
- Who is eligible for the health insurance exchange?
- What types of insurance plans will be available on the exchange?
- How will consumers afford the products offered on the exchange?
- What will Georgia’s exchange look like?
- How will the exchange benefit Georgia consumers?
- What should policymakers focus on to build a successful exchange?
- What is the timeline for implementing an exchange?
Building Georgia’s Health Insurance Exchange recommends the following policy goals for an exchange:
- Create a governance structure that can transparently and effectively oversee the exchange without any conflict of interests; insurance companies or other businesses that have a direct financial stake should not serve on the governing body
- Provide structured choices that supply the information and tools consumers need to make optimal purchasing decisions, including quality and customer satisfaction ratings as well as information about price and benefits
- Create incentives for insurance companies to compete based on value rather than by selecting the healthiest applicants: consider leveraging volume within the exchange to drive better deals with insurance companies; consider crafting exchange participation rules to allow the highest quality and value plans to participate; and align regulations inside and outside the exchange to eliminate incentives to steer consumers outside the exchange
- Serve as an easy-to-use, one-stop-shop and provide navigation assistance to programs like PeachCare for KidsTM and Medicaid where appropriate to ensure that all individuals and families eligible for these programs enroll
- Develop a robust outreach and enrollment mechanism to ensure that low-income and minority communities that historically have had the highest rates of uninsurance are engaged and that consumers in rural areas, without internet access, or with limited English proficiency can still enroll in the plan that best meets their needs
The full issue brief is available here.
The Debt Crisis and What it Means for Health Care
The recent raising of the debt ceiling spared both Medicaid and Medicare from cuts, but that may be temporary. With the formation of the bi-partisan “Super Committee” and both parties gearing up for an uphill battle, drastic decisions will be debated, and we must call, email or fax our Congressional delegation and explain how important it is to protect programs like Medicaid and Medicare that help and serve some of Georgia’s most vulnerable citizens.
To see a brief analysis on how the current budget deal will affect health care programs like Medicaid and Medicare, check out Community Catalyst’s blog on the topic. For now, here is what you need to know:
- In the first stage, caps are immediately placed on discretionary spending, saving $917 billion over 10 years.
- For now, both Medicaid and Medicare have been spared from cuts.
- That may not be the case moving forward since the bill authorizes a bipartisan joint committee of 12 legislators to come up with an additional $1.2 trillion in cuts to be agreed on by the House and Senate or suffer a “trigger” that would institute across the board cuts.
- If the trigger is activated, Medicaid is still protected from cuts whereas Medicare would be susceptible to cuts to providers and insurers.
- As the committee makes its decisions, both Medicaid and Medicare are fair game and thus at risk.
- It is unclear if the committee will be able to reach a consensus but if they cannot or their efforts do not amount to the total reduction necessary, the trigger will be activated and across the board cuts will result.
Between now and November (the committee’s deadline to have a plan drafted) the health advocacy community must rally behind these important programs and spur outreach to our elected officials to remind them:
Don’t jeopardize Georgia’s fragile economic recovery and the health and economic security of seniors, people living with disabilities and low-income families by simply shifting costs onto individuals, families and the state. Don’t cut Medicaid or Medicare.
If you don’t know who your member of Congress is, you can find out this information here.
As tough decisions are being made, we must continue to tout Medicaid’s value not only as a means to help low-income children, elderly, and disabled Georgians get health care services; but also one that invests in Georgia’s health care system and its local economies. For more specifics on the effect that cuts in Medicaid would mean for Georgia, you can download a fact sheet from Georgians for a Healthy Future and the Georgia Budget and Policy Institute here. Families USA also has a Medicaid calculator which allows you to determine the economic impact of proposed cuts to Georgia’s program here.
MORE >Join Our Building a Healthy Georgia Campaign
Georgians for a Healthy Future, along with several coalition partners, invites your participation in our “Building a Healthy Georgia” Campaign. Two events are already scheduled and accepting registrants and more are on the way in this effort aimed at fostering a dialogue on the most pressing health care issues in local communities, and we hope you’ll get involved. In order to ensure that we have the right people in the room to have a constructive dialogue on local pressing health issues, we want to identify and engage health care leaders, community leaders, health care providers, small business owners and health care consumers. This may be you or someone you know. If it’s you, sign up to attend the events and if it’s not, be sure to invite the key players you work with who will add to the dialogue and help us collectively build a healthy Georgia!
Between now and the end of the 2012 Legislative Session, we will hold forums in 9 cities: Alpharetta, Athens, Butler, Macon, Rome, Savannah, Gainesville, Augusta and Tifton. Each event will have a different focus in order to address most pressing health care issues in these communities. As these events are scheduled, we will be sure to share the details as well as an opportunity to participate.
Additionally, if you are planning an event of your own and would like to incorporate information from the health care consumer lens, we are always happy to come and speak to your group or to provide materials. Please contact Amanda Ptashkin if you would like to include Georgians for a Healthy Future in your upcoming event!
Upcoming Events
AUGUSTA
Building a Healthy Georgia: Exploring Policies and Practices to Improve Children’s Access to Health Care ServicesGeorgians for a Healthy Future, along with partnering groups HealthSTAT and Voices for Georgia’s Children, invites you to participate in a community conversation centered around the barriers that children in your area face when accessing vital health care services. With your active engagement, the goal of this symposium is to catalyze a statewide effort to advocate for policy and practice changes to remove existing access barriers and strengthen the overall health care delivery system in Georgia.
EVENT DETAILS:
WHEN: Thursday, August 25th, 1 PM to 3 PM
WHERE: The Salvation Army Ray and Joan Kroc Corps Community Center of Augusta
CONTACT: For questions, please contact Amanda Ptashkin. To RSVP, click here. While we request RSVP, please note that there is no cost to attend this event.
SPEAKERS:
Sandra Mobley, PhD, RN, Assistant Professor, Dept. of Obstetrics and Gynecology, Georgia Health Sciences University
Joann Yoon, JD, Assoc. Policy Director for Child Health, Voices for Georgia’s Children
Denise Kornegay, MSW, Program Director,AHEC Network
Michelle Putnam, MPH, Executive Director, HealthSTAT
Amanda Ptashkin, JD, Outreach and Advocacy Director, Georgians for a Healthy Future
To learn more about this event, click here.
BUTLER
Building a Healthy Georgia: Workforce Development and the Value of Ensuring Access to Quality CareGeorgians for a Healthy Future, along with partnering groups Georgia Budget & Policy Institute and the Georgia Rural Health Association invites you to participate in a community conversation centered around how the state is bolstering workforce development, what new opportunities are available through the Affordable Care Act and how business owners, health care providers, community leaders and health care consumers can take advantage of upcoming opportunities to improve health care and access in Georgia.
EVENT DETAILS:
WHEN: Thursday, September 8th, 3PM to 5:30 PM
WHERE: South Crescent Technical College, Taylor County Campus
CONTACT: For questions, please contact Amanda Ptashkin. To RSVP, click here. While we request RSVP, please note that there is no cost to attend.
SPEAKERS:
Melvin Everson, Executive Director, Governor’s Office of Workforce Development
Rick Goddard, Retired Major General USAF, Senior Advisor, 21st Century Partnership, Robins Air Force Base
Patty Bentley, Taylor County Commissioner, District 1
Tim Sweeney, Senior Health Care Analyst, Georgia Budget & Policy Institute
Nancy Peed, CEO and Administrator, Peach Regional Medical
Charlie Hayslett, CEO, Hayslett Group LLC., Partner Up for Public Health
Amanda Ptashkin, JD, Outreach and Advocacy Director, Georgians for a Healthy Future
To learn more about this event, click here.
Even if you cannot make it to either of these events, please think of your colleagues, friends and family in the Augusta and Butler region and extend the invitation to them as well. We want to ensure that we have the right people in the room to have a truly constructive dialogue so if you know someone who has an interest in these subjects, pass along the invite!
Action Alert
Tell Your Member of Congress and Georgia’s Senators: Medicaid Matters!
As Congress debates deficit reduction proposals, Medicaid is under threat of being cut. The Ryan proposal, passed by the House of Representatives, would make drastic cuts to Medicaid, such that in 10 years Medicaid would be cut by 33%. To put this into context, if a cut of this size were put into effect today, it would translate to $1.9 billion in lost federal funding for Georgia and place $4.4 billion in Georgia business activity and more than 38,000 jobs related to our state’s health care economy at risk.
Medicaid cuts would not only threaten Georgia’s fragile economic recovery, but also threaten access to health care and health outcomes for low-income families, seniors, and people with disabilities. In fact, a landmark study released last week by a team of top-notch researchers led by Harvard and MIT using a randomized control design, the gold standard for health services research, has found that having Medicaid coverage results in improved access to care, improved financial security, and improved reported health status relative to being uninsured. More details about the study are available here and here, and the full report can be downloaded by clicking here.
Please contact your member of Congress and send the message: Don’t jeopardize Georgia’s fragile economic recovery and the health and economic security of seniors, people living with disabilities and low-income families. Don’t cut Medicaid. If you don’t know who your member of Congress is, you can find out this information along with contact information here.
What’s New in Georgia
Georgia Health Insurance Exchange Advisory Committee Work Continues
The Health Insurance Exchange Advisory Committee, charged with determining whether Georgia should establish a state-based health insurance exchange, held its second formal meeting on July 12th. During the morning session, the committee heard from two existing small business exchanges, HealthPass in New York and Florida Health Choices, to help inform the committee’s work. In the afternoon session, the committee discussed potential pros and cons of developing a small business and/or individual health insurance exchange in Georgia. Committee meetings are open to the public, and the next committee meeting will be held on August 16th (time and location TBD). There are also two upcoming small business listening sessions, one taking place in Albany on July 20th and one in Dalton on 26th of July. For more information on these sessions, email Amanda Ptashkin. The committee is to make preliminary recommendations to the Governor by September 15th and final recommendations by December 15th. Georgia Health News covered this week’s meeting (article here), and all meeting materials are posted on the state’s health reform website here. This week, the federal Department of Health and Human Services released a proposed rule on exchanges, providing additional flexibility for states as they move forward with their exchange planning. Information about the rule is available here, and a summary analysis from the Health Affairs blog is available here.
Medical Loss Ratio Update: Ensuring Value for Georgia’s Consumers
Health care consumer advocates in Georgia are on standby as the Center for Consumer Information & Oversight (CCIIO) reviews the Georgia Insurance Commissioner’s application for an adjustment to the new medical loss ratio (MLR) rules that require insurance companies to spend at least 80% of the premiums their customers pay on medical services and quality improvement activities, as compared to administrative expenses, or else provide rebates to consumers. Designed to spur insurance companies to operate more transparently and to provide value for the paid premium dollar, the new rules are a step forward for consumers. When Georgia’s application is complete, CCIIO will accept public comment. Georgians for a Healthy Future will be filing comments in collaboration with a range of other groups, and when the comment period opens, we will keep you updated as to sign-on opportunities on this important issue. Kaiser Health News has a video explaining MLR here, and Georgia Public Broadcasting has a story about Georgia’s adjustment request here.
Community Health Board Approves Provider Reimbursement Rate Cuts
The Georgia Department of Community Health Board met earlier this week and approved a .5 percent cut in reimbursement rates for providers participating in the Medicaid and PeachCare for Kids programs (final adoption of rules). The board also proposed increasing co-payments for Medicaid patients and adding co-payments for the first time for PeachCare for Kids patients ages 6 and older (initial adoption of rules). Both changes reflect decisions made by the General Assembly during the 2011 Legislative Session. However, there is concern among advocates and health care providers that these changes will diminish access to care. For more information about these changes, see a recent Georgia Health News article here and a recent AJC article here. For materials from the Department of Community Health board meeting and information about upcoming meetings, click here.
F as in Fat: Georgia Rankings
According to a new report released by the nonprofit Trust for America’s Health and Robert Wood Johnson Foundation shows that Georgia is the 17th most obese state, with an adult obesity rate of 28.7% and a children’s obesity rate of 21.3%. To read that report, click here. To read a recent AJC article on the report, click here.
Events
What Health Care Reform Means for Small Businesses in Georgia
This week, Georgians for a Healthy Future and Small Business Majority held the first in a series of presentations focused on small business owners and how health care reform will affect them, their families and their bottom line. From the tax credits that are already available for businesses who filed 2010 tax returns to the creation of the small business exchange, health care reform will have a positive impact on many of Georgia’s small businesses.
To learn about an upcoming webinar or educational forum, email Amanda Ptashkin. To view the power point presentation from this week’s webinar, click here.
Building a Healthy Georgia: Augusta
If you live in the Augusta area and have an interest in policies and practices aimed at the obstacles to accessing care for children in the region, join Georgians for a Healthy Future, Voices for Georgia’s Children and Health STAT for our symposium, “Building a Healthy Georgia: Exploring Policies and Practices to Improve Children’s Access to Health Care Services.”
Event Details:
WHEN: Thursday, August 25th, 1:00 PM to 3:00 PM
WHERE: The Salvation Army Ray and Joan Kroc Corps Community Center of Augusta
CONTACT: For questions, please contact Amanda Ptashkin or at 404-890-5804.
While we request RSVP, please note that there is no cost
For more information about the event, click here. Don’t live in Augusta? Think of at least one person who you know in the area who would be interesting in being involved in this conversation and tell them about it! Stay tuned for more information about upcoming events in a town near you!
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