Atlanta Journal-Constitution Op-ed on GA Uninsured Rate
GHF’s ED Cindy Zeldin took to the pages of theAtlanta Journal-Constitution last month to make the case for coverage:
“The clearest evidence we have shows us the decision by the majority of states (30 and counting) to expand Medicaid is foundational in transforming the health system. We cannot make progress as a state if 15 percent of our population is uninsured. Too many Georgians fall into a coverage gap our leaders can fix. Medicaid expansion should be on the table, not as a perfect solution, but as a necessary first step.”
During the 2015 Legislative Session, the State Senate established the Consumer and Provider Protection Act Study Committee. This committee will review and make recommendations around several health insurance practices, including network adequacy. GHF has identified network adequacy, or the sufficiency of the health care providers patients can access when they enroll in a health insurance plan, as an important emerging consumer health issue. Our Executive Director, Cindy Zeldin, is a member of the study committee and looks forward to bringing the consumer perspective to the committee’s work. Cindy also recently appeared on WABE and Top Docs Radio to talk about network adequacy and participated in a panel discussion along with several state legislators at the Medical Association of Georgia’s Summer Legislative Education Seminar to discuss this important issue. Stay tuned for study committee agendas, updates, and opportunities to weigh in!
Study Committee Schedule
September 14, 9:00 – 12:00
State Capitol
October 26, 2:00 – 5:00 Tift Regional Healthy System, Tifton
November 9, 9:00 – 12:00 State Capitol
Don’t Miss Out: GHF’s Consumer Health Impact Awards
You’re invited to Georgians for a Healthy Future’s First Annual Consumer Health Impact Awards! Please join us for a silent auction, dinner, and awards presentation on the evening on September 9th at Park Tavern. We look forward to gathering with friends old and new as we celebrate the work being done by those dedicated to ensuring all Georgians have access to quality, affordable health care.
Over the past 50 years, Medicaid has ensured that our family members, friends, and neighbors have the quality health care they need. Be it our seniors accessing long term care services, kids seeing a doctor, or people with disabilities living independently, millions of people are better off because of this critical program.
Medicaid has also shown itself to be an effective and cost-efficient program. Administrative costs are substantially lower than private insurance and because people using Medicaid have access to preventive services, small issues can be addressed before they end up as big, costly illnesses.
Children in particular benefit from Medicaid. Studies show that kids with coverage show up at school ready to learn, are more likely to graduate from college, and end up with more earning potential as adults. In fact, more than 1 million Georgia children (about 35% of kids in our state) currently get their health care coverage through Medicaid.
As we reflect on what Medicaid has meant for children and families here in Georgia, it has been nothing short of transformative. And while about 1.9 million Georgians overall benefit from the essential health care access that Medicaid provides, approximately 300,000 Georgians are still stuck in a coverage gap: they don’t qualify for Medicaid under its existing stringent standards, aren’t offered coverage at work, and earn too little to qualify for tax credits through the Health Insurance Marketplace. The majority of states have accepted federal funding to close this gap, but Georgia hasn’t yet taken that step. Closing this gap and extending Medicaid coverage to all low-income Georgians would be a powerful tool for improving the health of individuals and families throughout our state. At Georgians for a Healthy Future we are proud to advocate for the Medicaid program that has been proven to improve health and saves lives. For the millions of Americans, and many Georgians, whose quality of life has been improved because of Medicaid, we’re so happy to celebrate the 50th anniversary of the life-changing program.
Major life events, such as getting married, changing jobs, or having a baby, qualify for you a special 60 day enrollment period. So after the honeymoon is over, it’s time to #GetCovered!
If you need assistance, our health care Navigator, Pranay Rana, is here to help!
Once you have health insurance, Whitney Griggs, our Consumer Education Specialist, can help answer the questions you have about finding a provider, accessing preventive services, filing a complaint or appeal, or any other question you may have!
We’re here to help!
Georgians for a Healthy Future staff is available to come to your coalition or organization meeting to cover any of these topics!
Laura Colbert, Community Outreach Manager.Laura can present on topics like closing Georgia’s coverage gap, how you and your organization can get involved in health advocacy, the effects of health policies on the health of Georgians, and more. Pranay Rana, Health Insurance Navigator. Pranay can give presentations on the health insurance marketplace and what you need to know before enrolling in health insurance. Pranay is also available for individual enrollments.
Whitney Griggs, Consumer Education Specialist.
Whitney can present on health insurance literacy (a breakdown of important health insurance terms and concepts) and how to get the most out of your health insurance. This is especially helpful for groups and communities that have many newly insured members.
To celebrate Medicaid’s 50th Anniversary, advocates and consumers across the country participated throughout the web with#KeepingUsHealthy and #MedicaidAt50
Last month, the Supreme Court upheld subsidies for health insurance bought through the federal marketplace, leaving more than 400,000 Georgians secure in their coverage.
“We celebrate an important victory for health care consumers, and we are relieved that hundreds of thousands of Georgians can keep their coverage,” said Cindy Zeldin, Georgians for a Healthy Future’s Executive Director. “But there is still work to do. Georgia has the second highest rate of uninsured in the country, and three-hundred thousand Georgians fall into a coverage gap that was created by Georgia’s decision not to expand Medicaid.”
Now that the outcome of King v. Burwell is clear, we must not forget these workers, parents, and veterans in our state who still lack access to quality, affordable health insurance. It’s time to close the coverage gap.
Have you had a major life event recently, such as getting married? You may qualify for a special enrollment period. Pranay Rana, GHF’s health care navigator, is here to help you get covered! Email Pranay for an appointment or check out his schedule below.
Once you have health insurance, Whitney Griggs, our Consumer Education Specialist, can help answer any questions you may have about finding a provider, accessing preventive services, or filing a complaint or appeal.
Pranay’s Schedule:
Switzer Central Library
266 Roswell St, Marietta, GA 30060
Every Thursday 11 AM – 4:00 PM
Moving Forward
GHF surveyed and interviewed enrollment assisters across the state to understand not only the “what,” but also the “why” behind the second open enrollment period. The results of that research have led us to several policy recommendations to maximize health insurance enrollment and retention and to ensure that coverage translates to meaningful access to timely and appropriate medical services for Georgia health care consumers.
Close the coverage gap in Georgia. Approximately 300,000 Georgians fall into the coverage gap, meaning they do not qualify for Medicaid under existing income eligibility guidelines in Georgia but their income is still too low to qualify for financial assistance (tax credits) to purchase health insurance on the Marketplace. Eligibility for tax credits begins at 100 percent of the Federal Poverty Level, or $11,770 for an individual or $20,090 for a family of three in 2015, while Medicaid eligibility for most adults in Georgia cuts off at income much lower. Thirty states including DC have closed their coverage gaps thus far with promising results. We encourage Georgia policymakers to take this important step as well to ensure all Georgians have a pathway to coverage.
Set and enforce network adequacy and transparency standards. Many of the plans sold through the Health Insurance Marketplace are Health Maintenance Organization (HMO) plans that feature narrow provider networks. While these narrow networks can help keep premiums down, a trade-off many consumers may be willing to make, consumers do not currently have sufficient information to make this choice. There is no information available to consumers at the point of sale about whether a provider network is ultra narrow, narrow, or broad, and provider directories are routinely inaccurate. More transparency and oversight are needed to ensure that consumers have accurate and useful information to make these choices. It is also important that all provider networks allow for meaningful access to all covered benefits. To ensure this, we support putting in place and enforcing network adequacy standards.
Encourage public-private partnerships and remove unnecessary restrictions on consumer education and assistance. Many of the enrollment assisters we surveyed indicated that reducing barriers to partnering with state government organizations such as public colleges, universities, and health departments would lead to stronger and more effective partnerships. Specifically, many respondents indicated that improved coordination between enrollment assisters, the Marketplace, and the Georgia Department of Community Health (DCH) to better facilitate PeachCare for Kids and Medicaid enrollment would be helpful. The “Health Care Freedom Act,” passed in 2014 as part of HB 943, prohibits state and local governmental entities from operating a health insurance navigator program and places other limitations on governmental entities. This provision has been counterproductive, creating confusion around what educational and consumer assistance activities local entities can engage in as they work to serve their community members. We recommend lifting these restrictions.
GHF UPCOMING EVENTS
You’re invited to Georgians for a Healthy Future’s First Annual Consumer Health Impact Awards!
Please join us for a silent auction, dinner, and awards presentation on the evening on September 9th at Park Tavern. We look forward to gathering with friends old and new as we celebrate the work being done by those dedicated to ensuring all Georgians have access to quality, affordable health care. Tickets can be purchased below.
Do you know someone who should be recoginized for one of the below awards? Nominate them here! Nominations will be accepted through July 31st.
You can view sponsorship opportunities here, or if you have an item you’d like to donate for the silent auction, please email Anna.
Linda Smith Lowe Health Advocacy Award
The Linda Smith Lowe Health Advocacy Award is given each year to an advocate whos work advances access to quality, affordable health care in Georgia. Nominees can be either professional advocates or volunteer advocates and must place a focus on vulnerable populations in their work and must work to achieve policy change. This award is named in honor of Linda Smith Lowe. Linda has dedicated her career to serving as an advocate on behalf of underserved Georgians who need a voice on health and human services issues.
Community Impact Award
The Community Impact Award is given each year to an individual or organization who has made an exceptional contribution to the health of their community in the past year. The impact of this contribution can be either at the individual, local, or state level. Nominees must work with individuals or local organizations to drive advancements in the health of the population served. Nominees may be health care providers, enrollment assisters, health educators, or others.
Powerhouse Policymaker Awards
The Powerhouse Policymaker Awards are given each year to local or state policymakers in Georgia who have exhibited excellence and courage in championing health issues in the public policy arena. Award recipients will have a particular focus on consumers or vulnerable populations and will have worked to advance our vision of a day in which all Georgians have access to the quality, affordable health care they need to lead healthy lives and contribute to the health of their communities.
GHF IN THE NEWS
All eyes were on health insurance last month and we were excited to celebrate the victory with the press and with Georgia!
GHF welcomes a new staff member! Meredith Gonsahn is Georgians for a Healthy Future’s Health Policy Analyst. She joined Georgians for a Healthy Future in July 2015. In this role she identifies key issues in health policy and how they impact Georgia health care consumers. Meredith also monitors major trends in public and private health insurance, health system reform and other key policy areas to keep the organization abreast of emerging issues. Meredith comes to Georgians for a Healthy Future from the Atlanta VA Medical Center where she served as a Study Coordinator for a wound care clinical trial. Prior to this position, Meredith was a Research Associate for the Center for Health Policy and Health Services Research at Henry Ford Health System. In this role she identified and analyzed key health system reform policies at the Federal, state and local levels to shape the policy agenda for the System. She also served as a liaison to coordinate and submit Affordable Care Act demonstration project applications for System business units. Meredith has a Master’s of Public Health with a concentration in Health Policy and Management from Rollins School of Public Health at Emory University. She also has a Bachelor of Arts in History from Duke University.
GHF is also pleased to announce our Executive Director Cindy Zeldin’s appointment to the Senate study committee for SR 561, the Consumer and Provider Protection Act. Full information about study committee appointments can be found here.
The report covers how new health insurance opportunities created through the Affordable Care Act (ACA ) have led to historic reductions in the nation’s uninsured rate. Here in Georgia, more than half a million consumers signed up for health insurance during the open enrollment period that ended this past February, known as OE 2.
These strong enrollment numbers mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families. The reduction in our state’s uninsured rate, although smaller than that of the nation as a whole, also has positive implications for the vitality of local health care systems and communities throughout Georgia.
Too many Georgians, however, remain uninsured, either because
they are unaware that there are coverage options that can meet their needs and budget
face cultural, linguistic, financial, or other barriers to coverage; or
fall into the “coverage gap” that was created when Georgia declined to expand Medicaid as authorized under the ACA
The goals of this report are
to explain the role of in-person assistance on enrollment outcomes and consumers’ experiences
to explore best practices that helped achieve robust enrollment in Georgia
to identify any common challenges or barriers to enrollment that Georgia consumers faced during OE2
to highlight promising strategies and approaches to reach the remaining uninsured who qualify for affordable health insurance
to put forth policy recommendations that can help facilitate a positive experience for health care consumers, both for those who are newly enrolled and for those who remain uninsured.
Getting Georgia Covered Event
On May 13, GHF hosted a lunch panel discussion on best practices, lessons learned, and policy recommendations from the second open enrollment period. During the event, GHF released it’s new report on the topic. You can download it here.
To see additional pictures from the even, please visit our facebook page!
Enroll America: Danté McKay, Georgia State Director
Georgians for a Healthy Future: Whitney Griggs, Consumer Education Specialist
US Department of Health & Human Services: Dr. Pamela Roshell, Region 4 Director
InsureGA: Sarah Sessoms, Executive Director
SEEDCO: Lisa Stein, Vice President Work and Family Supports
GHF in the News!
From the end of open enrollment to the looming King v Burwell decision to the ongoing need to close Georgia’s coverage gap, health policy continues to dominate the headlines, and GHF is at the forefront of the conversation! Check out the news coverage below to learn more about what’s happening in Georgia and how it impacts health care consumers in our state.
Open Enrollment Success, Lessons Learned, and Policy Recommendations
Whitney Griggs, a consumer education specialist with Georgians for a Healthy Future, speaks on A Closer Look with Rose Scott and Denis O’Hayer about the recently approved FLEX bus serving Cobb communities. (Photo/Brenna Beech)
Click the articles below to learn more about what worked well for consumers, what challenges and barriers they still face, and what changes can be made at both the community and policy levels to connect Georgians to health coverage and make sure that coverage translates to meaningful access to care.
“More than a half-million Georgians signed up for health coverage during the Affordable Care Act open enrollment period that ended in February. Many were previously uninsured. These robust enrollment figures show Georgia consumers strongly value health insurance and the access to care and financial security it can bring. An unmet demand is finally being met.
To gain a better understanding of this enrollment success story and what’s next for Georgia’s newly covered consumers, Georgians for a Healthy Future reached out to the enrollment assistance community – health insurance navigators and certified application counselors – and reviewed available data on plan offerings, premiums and enrollment. Three key themes emerged.”
“We can’t just close the door on hundreds of thousands of Georgians who finally had it opened for them.” Sometime in the next few weeks, the U.S. Supreme Court will hand down its decision in King v. Burwell, the high profile case that could place health coverage at risk for an estimated 430,000 Georgia consumers. Georgians for a Healthy Future has been monitoring the case closely and talked to the Atlanta Journal-Constitution about the need for Georgia policymakers to step in if the court rules for the plaintiff. This story was featured on today’s front page.
There have been several news stories over the past couple of weeks about a Medicaid pilot project under consideration by state policymakers. WSB-TV sat down with Georgians for a Healthy Future’s Executive Director last week to talk about whether this policy discussion brings us a step closer to closing the coverage gap in Georgia. Georgia Health News, the Atlanta Journal-Constitution, and Georgia Report are all tracking the issue. Click below for media reports featuring GHF and our partners!
At Georgians for a Healthy Future we strive to send you emails and content that are valuable to you and your work. To help in our efforts to improve our communications, please take this two question survey! Thank you!
ICYMI: We’re on Pinterest!
GHF in now on Pinterest! While you’re skimming pins for what you’re going to cook for dinner tonight or that next DIY project you are definitely going to do, let us be your daily dose of inspiration. Follow our boards for photos of people in the coverage gap, our Somebody Finally Asked Me campaign, and access to all the great infographics we share.
While Georgia has made little progress on closing its coverage gap, the subject is a hot topic elsewhere.
Montana has closed its coverage gap! As the 29th state to close the gap, Montana will provide 70,000 Montanans with quality, affordable health care coverage. The state is currently working with CMS to gain approval for its expansion proposal.
Face Off in Florida–The debate over closing the coverage gap is as hot as sunburnt skin after spring break! Floridians have seen a sudden and unexpected adjournment of the legislative session, a stand-off with HHS over the low-income pool (LIP), and their governor file suit against the federal government. The debate is far from over as the legislature plans to reconvene in June to complete their legislative responsibilities.
Policy makers in both Alaska and Louisiana are discussing if and how to close their coverage gaps. While their legislators debate whether or not to close the coverage gap during a special session, polls show that Alaskans are hugely in favor of the policy. In Louisiana, Gov. Jindal remains opposed to the idea of closing his state’s coverage gap, but legislators are discussing their options.
While Montana closes its gap and other states think through their options, more and more studies are revealing that closing the coverage gap is good for states! It saves money in state budgets and facilitates job growth, especially in the health care sector. Families USA summarized the new data in a recent blog post.
Need help enrolling or using your insurance?
Pranay Rana, GHF’s health care navigator, is here to help you get covered! Email Pranay for an appointment or check out his schedule.
Once you have health insurance, Whitney Griggs, our Consumer Education Specialist, can help answer the questions you have about finding a provider, accessing preventive services, filing a complaint or appeal, or any other question you may have!
Whitney and Pranay are both available to make educational presentations to community-based organizations in Georgia about how to enroll in health insurance and how to use coverage to access care once enrolled. If your organization would like to provide this type of presentation for your community members, please let us know! We can help!
Tax time special enrollment period a success!
The last chance to sign up for health insurance this year under the Affordable Care Act ended in April, when an extended deadline for enrollment expired. The extension was offered to give consumers who did not know they would owe a penalty if they did not have health insurance an additional opportunity to secure coverage. Thousands took advantage of the extension and, as of April 13th, about 68,000 people had signed up nationwide under the extension. Call centers had an average wait time of 10 minutes, showing consistent traffic. GHF’s navigator personally assisted over 30 people during the special enrollment period!
While the next open enrollment period doesn’t begin until Nov. 1, 2015 you may qualify for a special enrollment period throughout the year. For example, losing your health coverage because of the loss of a job, getting married, having a baby, or moving to a different state that does not offer your current plan could trigger eligibility for a special enrollment period.
If you have questions about owing a fine or special enrollment periods, please reach out to Whitney Griggs, our Consumer Education Specialist, today!
GHF Upcoming Events
Getting Georgia Covered: Lessons Learned from Open Enrollment 2
Hear from an expert panel on best practices and lessons learned during the second open enrollment period. We’ll learn about the successful strategies that enrollment assisters deployed in helping consumers, identify the challenges and barriers that remain for consumers, and discuss policy recommendations that can help get more Georgians covered. This is a free event.
#betterwithobamacare was trending on Twitter as we celebrated five years of the increased coverage and security that’s come with the Affordable Care Act.
#getcovered and #staycovered were the battle cry of OE2. Follow those hashtags to stay on top of the enrollment movement!
With Crossover Day behind us, we are fast approaching the 40th and final legislative day for the year, April 2nd. This week, GHF spoke with House Insurance Chairman Richard Smith about what he saw as the most important role he played as chairman. You might be surprised with his answer – click the image below to watch the video!
With just a little more than two weeks to go, here’s an update on health care legislation important to Georgia health care consumers. For a detailed chart of every health care bill we’re watching, click here.
The FY 2016 Budget passed the House of Representatives and is now in the Senate. The Senate expects to finish their revisions to the budget this week, possibly with some new revenue. They will then send it back to the House and then to a conference committee before it is finalized.
Medicaid Parity: The Senate proposed $5.9 million in increased reimbursements for certain OB/GYN services and $13.6 million for certain primary care services, which is an increase over the House of Representatives’ proposal ($2.96 million for OB/GYN and $1.5 million for primary care services). Because Medicaid parity has been shown to be an effective strategy for improving access to care for consumers, GHF supports raising Medicaid reimbursement rates to parity with Medicare rates. We are advocating for a higher appropriation amount for Medicaid reimbursement rate increases as the budget moves through the process. Click here to read Georgia Health News’s coverage of this latest development.
SBIRT Resolution: Senate HHS Chairwoman Renee Unterman officially introduced SR 487 to form a Senate Study Committee on preventing youth substance use disorders. Through GHF’s work with the Georgia Council on Substance Abuse, we are advocating for a public health approach to substance use disorders that focuses on prevention. This resolution gets the conversation started about how to do that in Georgia. Please take the time to thank Senator Unterman for her support of this effort and to let your elected officials know you support SR 487.
SB 158: (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee where it received a hearing on Wednesday, March 3. GHF provided testimony in committee, focusing specifically on the network adequacy component of the bill. GHF also met with committee members individually about the bill after the committee hearing to talk about why it is an important issue for consumers. While the bill is not expected to move in its current form this legislative session, there will likely be a study committee on the network adequacy component. GHF has identified network adequacy as an important consumer issue and plans to remain engaged on this topic as discussions move forward.
Closing the Coverage Gap: No hearings have been scheduled or are pending to address the possibility of expanding Medicaid in Georgia. Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians, an approach which GHF supports. Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither crossed over. Please thank the cosponsors of these bills, Rep. Rahn Mayo and Senator Vincent Fort, for their support and show your support by filling out a postcard that we’ll mail to your legislators!
Tobacco Tax: No additional standalone proposals have been made to increase Georgia’s tobacco tax (other than HB 445 as previously reported). The Senate however, may respond to the House proposal on transportation funding by including a tobacco tax increase to the regional average of around 68 cents. Importantly, Alabama’s Governor is proposing an increase in their state tobacco tax to $1.25 per pack, which would increase the regional average. GHF continues to advocate for an increase to the national average by raising our tobacco tax by $1.23. Such an increase would generate $585 million per year according to the fiscal note generated by the non-partisan fiscal office at GSU. Check out our fact sheet for more info!
Medicaid Minute
Opponents often argue that closing Georgia’s coverage gap would be too expensive for our state, but data from states that expanded their Medicaid programs in 2014 contradict that claim. According to a new study, closing the coverage gap produced big savings and increased revenues for states.
Early data from Kentucky and Arkansas show state budget savings that will offset the costs of covering the newly eligible Medicaid population beyond state fiscal year (SFY) 2021. Kentucky expects to see $820 million in net savings over the next seven years, while Arkansas expects to see $370 million over the same time period. The savings and increased revenues fall into three major categories: 1) State savings from using new federal funds; 2) State savings from enhanced federal matching; 3) Revenue gains from provider and insurer taxes/fees.
The full issue brief, complete with a summary table of Medicaid-related savings and revenues in both states, can be found here.
GHF Welcomes New Navigator!
Pranaya Rana joined Georgians for a Healthy Future this week as our new Navigator! In this role, Pranaya will work with consumers to help them enroll in health insurance through the Marketplace. Pranaya is a former Lieutenant from the Nepalese Army Elite Forces. He has served as a U.N. Peacekeeper in post-earthquake Haiti and as a Refugee Resettlement Program Officer in Connecticut before he came to Kennesaw State University, Georgia to pursue his Ph.D. in International Conflict Management in 2012. He has been working as a certified Healthcare Navigator in Metro Atlanta since the first open enrollment began in 2013. He recently completed his 6 months long Navigator’s term at Georgia Watch before joining Georgians For a Healthy Future. He specializes in refugees and international communities and has served a wide variety of international communities enroll into affordable healthcare using a community specific service model developed through continued outreach, education and needs assessment. He is Fluent in Nepali and Hindi besides English, and, speaks Urdu and intermediate French. If you’d like to contact Pranaya by email or at 404-567-5016.
Using your Coverage: Tax-Time Special Enrollment Period
Did you go without health insurance in 2014 and are now subject to a tax penalty? Good news! – You may still be able to enroll in coverage through the Health Insurance Marketplace. Starting last Saturday, March 15th, some people who are facing a fine on their taxes for not having coverage can now enroll in the Marketplace through a time-limited special enrollment period. To be eligible for this special enrollment period, you must not be currently enrolled in health insurance, attest that you owe the penalty for 2014, and attest that you first became aware of the penalty when you filed your 2014 taxes. This tax-related special enrollment period will run through April 30th, 2015. Click here to learn more about who can qualify for this special enrollment period.
Health Advocates Day at the Capitol – 3/25
Please join us on Wednesday, March 25, from 8:45 am to mid-day for a morning of advocacy! GHF will provide individuals and organizations with the opportunity to advocate for the important health issues that matter to you in the closing days of this legislative session. You may want to advocate for closing the coverage gap, Medicaid payment parity, raising the tobacco tax, rural health care access, or another health policy issue. You’re all invited to participate! We’ll provide breakfast, an advocacy training, and an opportunity to share and network with other health advocates.
Mark your calendars! Please join GHF and Laura Colbert for a post-legislative session webinar. The webinar is free and will provide a review of bills, resolutions, and other actions taken by the Georgia General Assembly that will affect health care and health policy in our state.
Today is the 29th day of the 2015 Legislative Session. That means that tomorrow, Friday March 13, is crossover day. GHF Executive Director Cindy Zeldin on what crossover day is and what it means for the rest of the legislative session.
The day before crossover day is a day of uncertainties. Because of that, we will send out an email Monday with a full update and analysis on where legislation important to consumers’ health care stands. For a compete list tracking health related bills – click here.
More Good News about Georgia’s Open Enrollment Numbers!
Last month it was announced that over half a million Georgians enrolled in coverage through the Health Insurance Marketplace. Now a new report released by the Department of Health and Human Services contains even more encouraging data about the state of enrollment in Georgia. According to the report, 31% of Georgians that enrolled were between the ages of 18-34, which is a key age group since they tend to be healthier than older adults. Additionally, 90% of Georgians that selected a plan through the Marketplace received financial assistance in the form of Advanced Premium Tax Credits. The average monthly premium for Georgians using a tax credit was $73. Click here to see the full report. Georgians for a Healthy Future’s ED talked with the Augusta Chronicle about why these numbers are so encouraging for Georgia.
Using your coverage
Preventive Services
Did you know that thanks to the Affordable Care Act, you can receive certain preventive services at absolutely no cost? It’s true! One of the key requirements of the ACA is that insurance companies must cover recommended preventive services at no cost to the consumer – even if you haven’t met your deductible. These include services such as mammograms, annual physicals, colonoscopies, well-woman exams, cholesterol screenings, tobacco cessation, and many more. Click here for a full list of the preventive services that must be covered by all insurance companies. There is also an additional list of required services for women and a separate one for children. It’s important to take advantage of these no-cost preventive services to keep you and your family healthy. Evidence shows that preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they become complicated and debilitating conditions.
If you have any questions about your insurance, please contact our Consumer Education Specialist, Whitney Griggs by email or at 404-567-5016 x 5
Medicaid Minute
States across the country are closing their coverage gaps! The map above shows the 29 states (including DC) that have chosen to expand Medicaid. Seven additional states are in discussions – below is a quick update on those states and their debates.
Idaho: Governor Butch Otter’s Medicaid Redesign Workgroup voted in November 2014 to recommend pursuing total health care system transformation, which includes Medicaid expansion. In addition to the Governor’s support, the Idaho Association of Commerce and Industry is helping to draft Medicaid expansion legislation, and a coalition of hospitals, providers, and consumer groups is working to support that legislation.
Tennessee: In late 2014, Governor Bill Haslam announced he had reached a deal with CMS to close the coverage gap. Governor Haslam’s plan, Insure Tennessee, had the support of the hospital industry (who had agreed to fund any costs that would fall onto the state), the business community, and a strong consumer coalition. Unfortunately, Insure Tennessee failed to make it out of committee during special session in early 2015.
Utah: Governor Gary Herbert’s plan to close the coverage gap, Healthy Utah, has strong support from hospitals, businesses, county commissioners, the criminal justice community, and church leaders, and it recently passed in the Senate. However, the House has passed an alternative proposal, Utah Cares, that would provide much more limited coverage to only a portion of the population in the coverage gap. With just a few days left in the legislative session, it remains to be seen whether the legislature will reach a compromise that will close the coverage gap this year.
Maine: In 2013 and again in 2014, the Democratic-controlled legislature passed several bills to close the coverage gap, only to have them vetoed by Governor Paul LePage. Even though Republicans took control of the Senate in 2014, advocates believe there are still enough votes to pass compromise legislation. Hospitals, who had remained largely on the sidelines the past two years, are now fully engaged in the campaign to close the coverage gap there.
Alaska: Recently-elected Independent Governor Bill Walker announced plans to expand Medicaid, but there will likely be roadblocks in the Republican-dominated legislature. Hospitals are on board.
Montana: Governor Steve Bullock is strongly supportive of closing the coverage gap, and has his own proposal for doing so. It is unlikely that a bill will pass the Republican-controlled legislature.
Wyoming: Governor Matt Mead developed a plan to close the coverage gap in 2015, and a key House committee developed a competing plan. But just a few days after the special session to close the gap in Tennessee failed, the Wyoming Senate shot down Governor Mead’s expansion plan, and the House committee then pulled its bill.
Join us for Health Advocates Day at the Capitol!
Please join us on Wednesday, March 25, from 8:45 am to mid-day for a morning of advocacy! GHF will provide individuals and organizations with the opportunity to advocate for the important health issues that matter to you in the closing days of this legislative session. You may want to advocate for closing the coverage gap, Medicaid payment parity, raising the tobacco tax, the Family Care Act, rural health care access, or another health policy issue. You’re all invited to participate! We’ll provide breakfast, an advocacy training, and an opportunity to share and network with other health advocates.
Mark your calendars! Please join GHF and Laura Colbert for a post-legislative session webinar. The webinar is free and will provide a review of bills, resolutions, and other actions taken by the Georgia General Assembly that will affect health care and health policy in our state.
Yesterday marked the 27th day of the 2015 Legislative Session. 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 next Friday, March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.
It has been a big week for health care issues at the State Capitol. GHF brought the consumer perspective to Senate Insurance on Wednesday and shared with the committee through testimony from our Executive Director the challenges that consumers face in obtaining accurate information about provider networks at the time they sign up for health insurance and why setting network adequacy standards is important for consumers. Her testimony was provided as part of the discussion around SB 158. Also this week, legislation was introduced in the Senate that would establish a study committee on preventing youth substance use disorders, the Senate began its work on the FY 2016 budget, and a range of other health care bills were discussed.
The State Budget: The FY 2016 Budget passed the House of Representatives and is now in the Senate. The Senate expects to finish their revisions to the budget this week and send it back to the House and then to a conference committee.
Medicaid Parity: Last week, the House of Representatives added $2.96 million in the budget to increase reimbursement for certain OB/GYN services and $1.5 million for reimbursement rate increases for certain primary care services. Because Medicaid parity has been shown to be an effective strategy for improving access to care, GHF supports raising Medicaid reimbursement rates to parity with Medicare rates. We are advocating for a higher appropriation amount for Medicaid reimbursement rate increases as the budget moves through the process.
SBIRT Resolution: Senate HHS Chairwoman Renee Unterman officially introduced a resolution (SR 407) to form a joint House and Senate Study Committee on preventing youth substance use disorders. Through GHF’s work with the Georgia Council on Substance Abuse, we are advocating for a public health approach to substance use disorders that focuses on prevention. This resolution gets the conversation started about how to do that in Georgia. Please take the time to thank Senator Unterman for her support of this effort and to let your elected officials know you support SR 407.
SB 158 (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee where it received a hearing on Wednesday, March 3. GHF Executive Director Cindy Zeldin testified in committee, focusing specifically on the network adequacy component of the bill. GHF also met with committee members individually about the bill after the committee hearing. While the bill is not expected to move in its current form this legislative session, there will likely be a study committee on the network adequacy component. GHF has identified network adequacy as an important consumer issue and plans to remain engaged on this topic as discussions move forward.
Closing the Coverage Gap: No hearings have been scheduled or are pending to address the possibility of expanding Medicaid in Georgia. Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians, an approach which GHF supports. 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, Rep. Rahn Mayo and Senator Vincent Fort, for their support and show your support by filling out a postcard that we’ll mail to your legislators!
Tobacco Tax: No additional standalone proposals have been made to increase Georgia’s tobacco tax (other than HB 445 as previously reported). The Senate however, may respond to the House proposal on transportation funding by including a tobacco tax increase to the regional average of around 68 cents. Importantly, Alabama’s Governor is proposing an increase in their state tobacco tax to $1.25 per pack, which would increase the regional average. GHF continues to advocate for an increase to the national average by raising our tobacco tax by $1.23. Such an increase would generate $585 million per year according to the fiscal note generated by the non-partisan fiscal office at GSU.
Other Bills of Interest
Below is a summary of bills that may impact health care consumers in Georgia, with information about where they are in the legislative process.
SB 1 (Sen. Bethel) provides certain insurance coverage for autism spectrum disorders. SB 1 has passed the Senate and is in the House Insurance Committee.
HB 1 (Rep. Peake) would allow for the limited use of medical marijuana for conditions including cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, crohn’s disease, mitochondrial disease, fibromyalgia, parkinson’s disease, and sickle cell disease. HB 1 passed the House of Representatives and is now in the Senate Health and Human Services Committee.
Yesterday marked the 23rd day of the 2015 Legislative Session. We are getting closer to Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015. Crossover Day is set for March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.
As part of this week’s legislative update, we sat down with Representative Debbie Buckner and spoke with her about access to care in rural communities, Georgia’s coverage gap, and other health care issues on her mind this Legislative Session.
To watch the video, click on the image below.
The State Budget
The FY 2016 Budget passed the House of Representatives this week and now heads to the Senate for hearings. Of note, the House of Representatives added $2.96 million in the budget to increase reimbursement for certain OB/GYN services, $1.5 million for reimbursement rate increases for certain primary care services, $1.3 million to increase the hourly rate for personal support services under the Independent Care Waiver Program, and $500,000 to increase reimbursement for air-ambulance services for adult patients. The House also added in $3 million to implement the recommendations of the Rural Hospital Stabilization Committee. The House removed $22.8 million for new treatment medications for patients with Hepatitis C and $12.1 million for costs to launch a new case management program for enrollees eligible under the Aged, Blind, & Disabled program. Also of note, the House reinstated health coverage for non-certificated part-time school employees; however, local school districts and not the state would be responsible for those costs. Click here for an analysis of the health care provisions in the budget that passed the House from our friends at the Georgia Budget & Policy Institute.
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, Rep. Rahn Mayo and Sen. Vincent Fort, and show your support for closing the coverage gap by filling out a postcard that we’ll mail to your legislators!
Tobacco Tax
HB 445 (Carson) represents the first additional or alternative funding proposal to the transportation funding bill (HB 170). While the overall bill includes regressive provisions including an increased sales and grocery tax combined with a reduction in the income tax that GHF does not support, it is notable that a tobacco tax is in the mix in the bill. This keeps the tobacco tax on the radar and provides an opportunity for health advocates to continue to push for an increase to the national average in the tobacco tax to curb smoking rates and bring in much-needed revenue.
Other Bills of Interest
Below is a summary of bills that may impact health care consumers in Georgia, with information about where they are in the legislative process.
SB 1 (Sen. Bethel) provides certain insurance coverage for autism spectrum disorders. SB 1 has passed the Senate and is the House Insurance Committee.
SB 158 (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee.
HB 1 (Rep. Peake) would allow for the limited use of medical marijuana for conditions including: cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, crohn’s disease, mitochondrial disease, fibromyalgia, parkinson’s disease, and sickle cell disease. HB 1 passed the House of Representatives and is now in the Senate Health and Human Services Committee.
HB 195 (Rep. Cooper) and SB 51 (Burke) provides parameters for substitutions of interchangeable biological products. HB 195 passed the House Health and Human Services Committee and is expected to come out of the Rules Committee next week, and Senate Bill 51 has passed the Senate and has been assigned to the House HHS committee, but is not expected to get a hearing until after crossover day.
HB 482 (Rep. Willard) seeks to eliminate two of the requirements that the Cancer Treatment Centers of America are currently subject to when they were allowed into Georgia as a destination hospital.
HB 416 (Rep. Rogers): Routinely referred to as the badge bill, HB 416 seeks to provide clarity and transparency for the patient as to the qualifications of the provider that they are seeing. The bill calls for providers to identify the health care practitioner’s name and the type of license or educational degree the health care practitioner holds. The bill will be heard in the House HHS committee on Monday March 2, 2015 at 3 PM.
HB 34 (Rep. Dudgeon) is known as the “Right to Try” bill and calls for patients with advanced illnesses and in consultation with their doctor to use potentially life-saving investigational drugs, biological products, and devices.
Georgia’s Plan to Strengthen Rural Hospitals
Earlier this week, the Rural Hospital Stabilization Committee (RHSC), created by Governor Deal to address the needs of struggling rural hospitals and find solutions that address those needs, issued its final report. The recommendations in the report include:
A four site “Hub & Spoke” pilot program
Maintenance and protection of Certificate of Need laws
Expanded scope of practice for non-physician providers, like physicians assistants and nurse practitioners
More support for school-based health centers
The committee’s work shines a spotlight on the health care access challenges that rural Georgians face and puts forth constructive recommendations. While we support these recommendations whole-heartedly, we are also disappointed that the committee did not address the coverage gap and Medicaid expansion in its report.
Georgia Health News interviewed Georgians for a Healthy Future’s Executive Director on this issue (click here to read the full article), and in that article she pointed to the early success of states like Kentucky, which recently reported improvements and coverage rates and in health care access due to Medicaid expansion. She also encouraged policymakers to take a comprehensive approach that includes closing Georgia’s coverage gap to help get people into health insurance and provide a reimbursement stream for rural hospitals.
Back in December, Georgians for a Healthy Future, together with several consumer and community-focused organizations including the Georgia Budget and Policy Institute, Georgia Watch, and Families First, submitted a report and provided public comment to the committee making a detailed case for such an approach. You can read that full report here.
Medicaid Minute
Medicaid provides health insurance to low-income families and vulnerable populations in states across the country, allowing them to access necessary health care services. In states that have opted to implement the Medicaid expansion, people are enrolling in the program and uninsured rates are plummeting. Nationwide, 10.8 million Americans gained coverage through Medicaid just between October and December 2014. Unfortunately, these coverage gains vary widely among states. According to the US Department of Health and Human Services, states that expanded Medicaid saw a 27 percent increase in Medicaid and CHIP enrollment in the last year, while non-expansion states saw only a 7 percent increase. Too many Georgians are still stuck in the coverage gap. Fill out an e-postcard that we’ll send to your legislators letting them know that it’s time Georgia fixed this problem and closed its coverage gap.
What is a 1095-A? And other burning questions about health insurance and tax filing?
If you are a consumer who enrolled in health insurance through the Marketplace with a tax credit, you likely received a 1095-A form in the mail. You may also have some questions about how to complete the health insurance information on your tax filing form. If your organization works directly with consumers, either providing enrollment assistance or helping them with tax preparation, you may also be hearing about the 1095-A and may have some questions about how health insurance and tax filings intersect. Below is a primer, replete with flow chart, which breaks it all down for you.
Where consumers get their coverage—Marketplace, employer, Medicaid—will determine the impact coverage has on their taxes. Consumers who have health insurance through their jobs will likely see no changes when they file their taxes – they just check the box on their tax forms indicating they had coverage throughout the year. The same thing applies to consumers who are covered by Medicaid, Medicare, or their parent’s health plan. Pretty simple!
During this year’s open enrollment period, 536,929 Georgians purchased health insurance through Healthcare.gov and about 90% received financial assistance to help lower the cost of their premiums. To keep that tax credit, they’ll have to fill out Form 8962, which asks questions about their health insurance and their income. To help complete that form, all consumers that received a tax credit should have received Form 1095-A in the mail from the Marketplace. Consumers can also find this form on their Healthcare.gov account.
The health insurance tax credit is based on income and household size. When consumers applied for coverage, they estimated their income for the coming year and that amount was used to determine their tax credit. If a consumer misestimated their income, the credit they received may be too high or too low. During the tax filing process, the difference between estimated and actual income is reconciled, and the corresponding tax credit may be adjusted up or down. This means some consumers may get a refund and some consumers may have to pay back part of their tax credit. If a consumer did not apply for a tax credit previously, they can apply for a credit to be included in their tax refund.
If a consumer went without health care coverage at any point in the year, they may need to fill out an additional Form 8965 to determine whether or not they will need to pay a fine. This year the maximum fee per family will be $285, but fines will increase each year, up to 2% of a person’s annual income. If a person falls into Georgia’s coverage gap, they will not have to pay the fine, but will need to file the appropriate documents to prove they do not have access to affordable coverage
Household, family, and income changes should be reported throughout the year to Healthcare.gov in order to avoid surprises at tax time.
If you have questions about how your health coverage may affect your taxes, consult a tax professional. Our partners at Georgia Watch can connect you with free tax preparation help—just click here.
So You Have Coverage…Now What?
If you have recently gained health insurance through the Health Insurance Marketplace, it may seem like you need to learn a whole new language to understand your coverage. Health insurance can be confusing, especially if you have never had it before or haven’t had it in a while. Just understanding a few key terms, such as premium, deductible and co-pay, will go a long way in helping you use your health insurance effectively. Click here for a simple guide to help you understand your new coverage. Additionally, if you are having trouble using your health insurance you can contact Whitney Griggs, GHF’s Consumer Education Specialist, at wgriggs@healthyfuturega.org or at (404) 567-5016, extension 5.
Action Alert: CHIP in Danger
Federal funding for the Children’s Health Insurance Program (CHIP), known as PeachCare for Kids in Georgia, expires in September 2015. More than 200,000 Georgia kids rely on this program for access to health care services. The U.S. Congress has signaled that it is willing to consider extending CHIP funding. This is great news. However, some of the discussion include provisions that provide access barriers. Some concerning provisions include the removal of protections that were included in the ACA, an optional 12-month waiting period for coverage, and cuts to CHIP funding for certain groups of children in some states. (Click here for a full analysis of the draft plan.) You can help by telling your legislators to pass a clean renewal of CHIP funding that does not impose barriers to enrollment and coverage for kids. Here are some ways to get in touch:
Write a letter or call your congressman. Click here to see suggested language from our partners, Voices for Georgia’s Children. Click here to find your congressman, senator and their contact information.
Tweet at your representatives in congress. See the list below for their Twitter handles. Use the hashtags #ExtendCHIP #keepkidscovered and #CHIPWorks
Share this image from Voices for Georgia’s Children (@georgiavoices) on social media to spread the word.
Senate
Johnny Isakson
@SenatorIsakson 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
David Perdue
@sendavidperdue 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
House
Buddy Carter (1st District)
@RepBuddyCarter 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Sanford Bishop Jr. (2nd District)
@SanfordBishop 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Lynn Westmoreland (3rd District)
@RepWestmoreland 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Hank Johnson Jr. (4th District)
@RepHankJohnson 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
John Lewis (5th District)
@repjohnlewis 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Tom Price (6th District)
@RepTomPrice 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Rob Woodall (7th District)
@RepRobWoodall 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Austin Scott (8th District)
@AustinScottGA08 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Doug Collins (9th ,District)
@RepDougCollins 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Barry Loudermilk (11th District)
@RepLoudermilk 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Rick Allen (12th District)
@RepRickAllen 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
David Scott (13th District)
@repdavidscott 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Tom Graves (14th District)
@RepTomGraves 200,000 GA kids rely on PeachCare to receive the critical care they need. #ExtendCHIP so we can #keepkidscovered #CHIPWorks (Click here to tweet this)
Today marked the 19th day of the 2015 Legislative Session (almost at the halfway point)! 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.
As part of this week’s legislative update, we caught up with Senator Chuck Hufstetler and spoke with him about his proposal to increase the state’s tobacco tax by $1.23, which would bring Georgia up to the national average. According to a fiscal note released this week by Georgia State University at legislative request, this increase would yield more than $500 million in new revenue. To read more about the tobacco tax, download our one pager. To see the media coverage, check out our “In the News” page.
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
This week, the House Appropriations Health Subcommittee held a hearing on the FY 2016 Budget. A range of organizations and individuals provided testimony in support of payment parity, citing the evidence that shows provider rate increases result in better access to care for patients and consumers. Georgians for a Healthy Future spoke in support of payment parity at the hearing.
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!
More than half a million Georgians enroll in Marketplace health insurance
Open Enrollment for the Health Insurance Marketplace ended Sunday and over half a million Georgians enrolled in plans through the Marketplace! Georgia’s enrollment was the fourth highest of states using the Federally Facilitated Marketplace, trailing only behind Texas, Florida, and North Carolina. The state’s enrollment numbers passed the 500,000 mark in large part due to a last minute surge in sign-ups. This year’s enrollment numbers greatly exceed last year’s exchange enrollments of 316,543. Nationally, 11.4 million Americans selected plans or were automatically re-enrolled through the Marketplace. Click here to learn more about Georgia’s enrollment numbers.
For Georgians who begun the enrollment process prior to the deadline but, due to issues with either healthcare.gov or call centers, were unable to complete their enrollment, CMS has extended a Special Enrollment Period (SEP). These people are “in line” and still eligible to enroll this year. This SEP will end February 22nd. If you or someone you know thinks they qualify for this extended enrollment period visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596.
Miss open enrollment? You may still be able to get coverage!
Open Enrollment has officially ended but some Georgians that missed signing up during the three month period may be able to still get coverage. Those “in line” during this last three days of Open Enrollment who were unable to select a plan due to long call center wait times or technical issues have until Sunday, February 22 to enroll. In this circumstance, coverage will begin March 1st. Otherwise, consumers who have a “qualifying event” may be able to get coverage through a Special Enrollment Period. Special Enrollment Periods can occur at any time during the year and are usually triggered by specific events. These events include life changes such as a marriage, birth, change in eligible immigration status and a permanent move. Another type of event that could qualify consumers is a loss of other health coverage. These types of events could include an involuntary loss of employer coverage, loss of Medicaid coverage, and a death or divorce that results in a loss of coverage. In most cases, the Special Enrollment Period lasts for 60 days after the qualifying event occurs. To learn more about what types of events could trigger a Special Enrollment period, click here. If you think you may qualify, visit https://www.healthcare.gov/get-coverage or https://localhelp.healthcare.gov/ to find in-person assistance in your area.
Additionally, the Centers for Medicaid and Medicare Services just announced a Special Enrollment Period for tax season for consumers who were penalized for not having coverage in 2014 and are not currently enrolled in health insurance. To qualify for this Special Enrollment Period consumers must also attest that they were not aware of the penalty for not having health insurance until after the end of Open Enrollment (February 15th , 2015) because they filed their 2014 tax return after that date. This Special Enrollment Period will begin March 15th and end April 30th, 2015. Click here to learn more about the announcement.
GHF welcomes new Consumer Education Specialist
Whitney joined Georgians for a Healthy Future this week as our Consumer Education Specialist. In this role, Whitney will educate consumers who have questions about how to understand and use their health insurance as well as assist consumers who encounter problems with their insurance plan. Whitney will also be on the lookout for patterns that can help inform GHF’s policy and advocacy work in the area of private health insurance. Whitney comes to GHF from the Healthy Mothers Healthy Babies Coalition of Georgia, where she was lead health navigator. As a health insurance navigator, Whitney provided enrollment assistance for the Health Insurance Marketplace to consumers in rural Georgia. In this role she also conducted extensive outreach throughout the state to inform consumers about the Affordable Care Act and the new health insurance options available under the law. Prior to her role as a navigator, Whitney worked for Healthy Mothers Healthy Babies as an Information and Resource Specialist for their health care referral service, called the Powerline. In this position she helped find and verify health care providers throughout the state for the referral line. Whitney has also worked in the Child Life Division at Children’s Healthcare of Atlanta. Whitney earned her B.S. in Psychology with a focus on Biological Psychology from Clemson University. Whitney can be reached at wgriggs@healthyfuturega.org. Please welcome her to Georgians for a Healthy Future!
National partner features our collaboration with the Diverse Elders Coalition and the Bhutanese Association of Georgia
Check out Community Catalyst’s blog featuring the collaboration between GHF, the Diverse Elders Coalition, and BAG to help Bhutanese refugees living in Clarkston, Georgia enroll in health insurance!
Medicaid Minute
New data released from Kentucky show the success of Kentucky’s Medicaid expansion program. Here are a few quick highlights.
375,000 Kentuckians got covered
Hospitals gained more than $500 million in just the first year
12,000 new jobs were created (with an additional 28,000 jobs expected over the next 7 years)
Uncompensated care in hospitals fell 60%
Estimated costs of expansion in current and subsequent biennial budget are more than offset by savings and new revenues generated from economic activity resulting from new health care spending
Choosing not to expand would have cost the state about $100 million
Fill out our survey and tell your legislators know it’s time for Georgia to close its coverage gap!
GHF’s ED Cindy Zeldin took to the pages of theAtlanta Journal-Constitution last month to make the case for coverage:
Major life events, such as getting married, changing jobs, or having a baby, qualify for you a special 60 day enrollment period. So after the honeymoon is over, it’s time to #GetCovered!
