During the 2013 Georgia Legislative Session, our state’s policymakers enacted HB 198 into law, which requires state training, licensure, background checks, and continuing education for navigators. Georgians for a Healthy Future has some concerns about this law and the potential hurdles it sets up for community-focused nonprofits already facing an uphill battle to reach, educate, and facilitate enrollment for consumers who haven’t historically had insurance. As such, we reached out to the Georgia Department of Insurance with suggestions to make the implementation of the law less burdensome for navigators, and some of our input was incorporated.

The proposed rule was presented at a hearing held by the Department of Insurance on July 30th. The regulation implementing HB 198 is available here. Georgians for a Healthy Future was also featured in two recent news articles in the Atlanta Journal-Constitution about the navigator program, available here and here.  Additionally, the Center for Public Integrity just released an article focusing on various state licensure laws as they affect navigators.  That article can be found here. We will continue to monitor this process with an eye towards ensuring navigators and assisters aren’t impeded from carrying out their important work.

The 2013 Georgia Legislative Session has ended. The 2014 state budget and dozens of bills now go to Governor Deal for his signature or veto (the governor does have the authority to line-item veto parts of the state budget). Bills that did not pass this year are still viable in the 2014 Legislative Session, which will be the second year of a two-year session. Below is a summary of bills that passed the General Assembly this year that could impact health care consumers. For a complete rundown of how health care-related legislation fared, see Georgia Health News’s recap.

Legislation that could impact Medicaid and PeachCare beneficiaries

The final 2014 budget eliminated proposed rate cuts for health care providers (a 0.74% rate cut had been proposed for non-primary care providers within Medicaid and PeachCare for Kids), eliminated a proposed coding change that would have resulted in cuts for certain providers, and included funds for enrollment growth in Medicaid. This is good news for access to health care services; however, Medicaid, PeachCare, and other public health programs have sustained deep budget cuts in recent years. In future years, if we are to improve the state’s health, additional investments in public health and health care delivery will be needed.

HR 107 would create a joint study committee on Medicaid reform that would study current Medicaid policies and procedures, models in other states, and other aspects of the Medicaid program and report to the General Assembly and the Governor by December 31, 2013 with recommendations. HR 107 passed both the House and the Senate.

SB 62 would create a Federal and State Funded Health Care Financing Programs Overview Committee, a joint committee of the General Assembly. SB 62 has passed both the House and the Senate.

SB 24, which would authorize the Department of Community Health to levy a fee on hospitals to continue drawing down federal funds to support Medicaid and PeachCare for Kids, was passed by both the House and Senate and was signed into law by the Governor back in February. The current hospital fee had been set to expire on June 30, 2013. The renewal of the fee was essential to ensuring Medicaid and PeachCare’s solvency and preserving access to hospital care in Georgia.

Legislation impacting health insurance consumer protections and access to insurance

SB 236 would require insurance companies to send concurrently with any statements sent to consumers that provide notice of premium increases an estimate of the portion of any premium increase that is due to the Affordable Care Act. How this is determined would be left to insurance companies to calculate, and they would not have to disclose their methodology. There would also be no requirement to present information about any other factors leading to premium increases or to notify consumers about available tax credits that may more than offset premium increases or about any cost savings or benefit enhancements they are receiving as a result of the Affordable Care Act. As such, this bill would result in consumers receiving incomplete and potentially misleading information.  SB 236 has passed both the House and the Senate.

HB 198 would require licensing, certification, and training for health benefit exchange navigators and would restrict their ability to assist consumers. While ensuring that consumers receive accurate information from navigators about their health insurance options and protecting consumers is an important goal shared by Georgians for a Healthy Future, HB 198’s restrictive language and potentially duplicative training requirements could deter community-focused nonprofits, whose participation in the navigator program will be essential in reaching vulnerable populations who have historically faced barriers to enrolling in health insurance, from becoming navigators or from providing appropriate consumer assistance. Georgians for a Healthy Future looks forward to working with policymakers to ensure this bill is implemented in a manner that minimizes duplication and encourages participation from community-focused nonprofit organizations. HB 198 has passed both the House and the Senate.

HB 389 would allow insurance companies to terminate, cancel, or non-renew conversion policies or any health insurance policies offered through the health insurance assignment system when guaranteed issue becomes available (with a 90-day cancellation period and a 90-day open enrollment period into new health insurance options made available through the Affordable Care Act). HB 389 has passed both the House and the Senate.

On Tuesday, February 19th, 2013, over 100 advocates, health care consumers, providers and others gathered at the State Capitol to deliver an important message to our elected officials: coverage matters.  Georgia has an unprecedented opportunity to drastically reduce the number of uninsured in our state by accepting the federal dollars and expanding coverage through Medicaid.  With nearly 2 million uninsured Georgians (that’s 1 in 5), it is likely you already know those people who would benefit from expanded coverage–they are your neighbors, your co-workers, and sometimes they are you.

There is still time to do your part: join the Cover Georgia coalition by helping us make the case for expanding coverage.  Pick up the phone and call your legislator and tell them why the decision to expand coverage through Medicaid is so important to Georgians like you.

Here are some key talking points:

• Expanding Medicaid in Georgia would create 70,343 new jobs and would infuse an additional $8.2 billion per year in economic activity into our state’s economy each year.
• This economic activity will result in an additional $276 million a year in state and local tax revenue.
• Money has already been set aside at the federal level to cover 100% of the costs of Georgia’s expansion for the first three years and at least 90% in future years. Should the federal reimbursement levels drop below this level, Georgia can pull out of the expansion at any time.
• Expanding Medicaid will bring an estimated $40.5 billion in federal funds into Georgia over a decade.
• Medicaid expansion will free up state dollars that are currently covering programs such as mental health, the Georgia AIDS Drug Assistance Program, the State Hemophilia Program, and indigent care.
• Hospitals lost $1.5 billion in uncompensated care in 2010. Increasing the number of insured patients by expanding Medicaid will help prevent struggling hospitals from closing and save Georgia taxpayers dollars that currently go toward covering uncompensated care.
• Medicaid improves access to care, health status, and financial security of enrollees who would likely otherwise be without coverage.
• Medicaid expansion in other states have reduced mortality, and based on an estimated 650,000 new enrollees, an approximate 3,693 lives could be saved each year in Georgia by expanding coverage through Medicaid.
• More than 38,000 new health care sector jobs will be created. Other industries such as real estate who can benefit from the hoa management greenville sc, restaurants, transportation, and other businesses will also benefit from more than 30,000 new jobs.
• Under the current Medicaid program, low-income childless adults and most low-income parents do not qualify for coverage, leaving many working Georgians without access to adequate health care.
• Georgia has one of the nation’s highest uninsured rates; expanding Medicaid will help cover more than 650,000 people.

To find your legislator’s contact information, click here.  Help us multiply our voice and our presence at the Capitol. Call your legislators now!

Last week, state agency heads presented Governor Deal’s proposed budgets for their respective agencies to the House and Senate Appropriations committees.

Access to care: the good news
Primary care providers will receive an increase in Medicaid reimbursement rates to parity with Medicare rates, funded entirely with federal dollars made available to Georgia through the Affordable Care Act. This can help preserve and strengthen access to care for Medicaid patients seeking primary care and prevention services.

Access to care: the bad news
The Department of Community Health’s proposed budget would reduce provider reimbursement rates within Medicaid by .74 percent for providers other than hospitals, primary care, FQHC, RHC, and hospice providers. This proposed rate cut, if implemented, could jeopardize access to care for Medicaid patients who require services such as dental care, obstetrics and gynecology, and oncology, among other non-primary care services.

The Department of Community Health’s proposed budget can be found here. Please contact your legislators and ask them to preserve access to care by restoring these important funds in the state budget.

Hospital fee renewal moves through the Legislature
SB 24, which would authorize the Department of Community Health to levy a fee on hospitals to continue drawing down federal funds to support Medicaid and PeachCare for Kids, has passed the State Senate and will be before the House of Representatives for a vote today. The current hospital fee is set to expire on June 30, 2013. The renewal of the fee is essential to ensuring Medicaid and PeachCare’s solvency and preserving access to hospital care in Georgia.

On Thursday, January 31st, Georgians for a Healthy Future’s Outreach and Advocacy Director Amanda Ptashkin presented at the Families USA Health Action 2013 Conference–an annual gathering of state advocates, national advocacy organizations, and health care and policy professionals that takes place in Washington DC every January. Speaking on a panel entitled “Getting to Yes on the Medicaid Expansion,” Amanda shared her thoughts on our state’s approach to health reform implementation as well as the work of the Cover Georgia coalition, aimed at getting our state to accept the federal dollars to expand coverage for thousands of Georgians.  To view her presentation, click here.   The conference goes on until Saturday, February 2nd, and includes advocates from around the country sharing their health care obstacles and successes.  Follow the conversation on twitter, #ha2013, and learn about the great work taking place across the country.

Please join us at the Capitol for “Cover Georgia Day” on Tuesday, February 19th from 9AM to 1PM. 

Cover Georgia is a coalition of consumer and patient advocates, providers, and industry stakeholders who have come together around a common goal: covering Georgia’s uninsured by expanding Medicaid.

• We will meet at 9am at Central Presbyterian Church (201 Washington Street, across from the State Capitol) for a training on the importance of health coverage and the opportunity that expanding Medicaid provides for hundreds of thousands of uninsured Georgians.
• Following the training session, we will walk across the street to the State Capitol to meet with our individual State Representatives and State Senators to ask them to support the Medicaid expansion
• At 11:30am, we will reconvene for a press conference and demonstration of support for the Medicaid expansion. We will also hear from individuals whose lives will be affected by this important decision.
• After the press conference, we will walk back over to Central Presbyterian Church to debrief and share information about our individual conversations with legislators.

Don’t miss out on this important event–please join us and make a difference. Help us Cover Georgia.  There is no cost to attend but please RSVP so we have the necessary materials on hand.

To learn more about Cover Georgia and to join the coalition efforts, go to www.coverga.org.

Each year, Georgians for a Healthy Future releases A Consumer Health Advocate’s Guide to the Georgia Legislative Session to provide you with the information you need to take action! Our 2013 guide is now available and features an overview of the legislative process in Georgia; contact information for all state legislators; descriptions and listings for each legislative committee with jurisdiction over health care issues; contact information for state agencies and officials; contact information for health care organizations and associations active in Georgia; key media contacts; and tools and strategies for effective consumer health advocacy. You can either download the guide here or request a hard copy of the guide by e-mailing Georgians for a Healthy Future’s Outreach & Advocacy Director here.

Nearly two million Georgians have no health insurance at all, among the highest in the nation. This problem has long been recognized as a tragic reality for the one in five Georgians who struggle to access medical care when they need it, as a strain on our state’s health care delivery system, and as a weight on Georgia’s economy. Georgia has the ability to comprehensively address this problem thanks to approximately $33 billion in new federal funding over 10 years to cover low-income uninsured Georgians through Medicaid. As these dollars filter through Georgia’s economy, they will have an estimated economic impact of $72 billion.

But Governor Deal is still saying no to the Medicaid expansion, even as other states across the country are saying yes and even though Georgia would be responsible for zero cents on the dollar for the first three years and no more than ten cents on the dollar thereafter. Georgia cannot afford to maintain the status quo while other states invest heavily in their health systems with federal tax dollars paid by Georgians.

Last week, Georgians for a Healthy Future and more than forty organizations joined together to launch the Cover Georgia campaign in support of the Medicaid expansion, but policymakers also need to hear from their constituents. Here is what you can do:

• Please call Governor Deal at 404-656-1776 and ask him to support expanding Medicaid in Georgia to people with incomes up to 133 percent of the federal poverty level.

• Please visit www.coverga.org to learn more about Medicaid and sign the petition in support of the Medicaid expansion.

• Find out who your legislators are here and ask them to support expanding Medicaid.

• Please share this information with your friends and neighbors and ask them to join you in supporting the Medicaid expansion by contacting their elected officials and signing the petition.

Georgians for a Healthy Future and more than 40 organizations launched an education and advocacy campaign this week is support of expanding Medicaid in Georgia. Below is our announcement about Cover Georgia’s launch. Please contact us if you’d like to join the coalition.

COVER GEORGIA COALITION LAUNCHES EFFORT TO ENSURE THAT THE STATE MOVES FORWARD WITH THE MEDICAID EXPANSION

ATLANTA, Ga., January 10, 2013 – More than 40 organizations – including healthcare providers, hospitals and healthcare advocates – announced today the creation of a coalition in support of expanding Medicaid to Georgians with incomes below 133 percent of the federal poverty level as authorized by the federal health care reform law, the Affordable Care Act (ACA).

Called Cover Georgia, the coalition is spearheaded by Georgians for a Healthy Future and is comprised of a wide range of healthcare stakeholders, including the Georgia Rural Health Association, the Georgia Academy of Family Physicians, AARP Georgia, the American Cancer Society, among many others.

Enacted by Congress in 2010, the Affordable Care Act included the Medicaid Expansion provision, which would provide the states with billions of dollars in new federal funds to enroll currently uninsured citizens in their Medicaid programs.  In Georgia, expanding the program is projected to cover approximately 650,000 Georgians and to bring approximately $33 billion in federal funds into the state over ten years.  For the first three years of the expansion, the federal government will fund 100 percent of the new cost; after that, the states would be required to cover no more than 10 percent of the total cost from 2020 onward.

Cover Georgia will make the case that expanding Georgia’s Medicaid program and leveraging the billions of dollars in federal resources will improve access to care, strengthen the state’s health care delivery system, and bolster Georgia’s economy.  “This is an unprecedented opportunity to impact the lives of hundreds of thousands of Georgians and we simply cannot pass up this opportunity,” said Amanda Ptashkin, outreach and advocacy director for Georgians for a Healthy Future, the organization spearheading the coalition work.

 
When the U.S. Supreme Court decided the constitutionality of the ACA in 2012, it ruled that states could not be compelled to participate in the Medicaid Expansion.   So far, Governor Deal has said he does not plan to move forward with the expansion in Georgia, expressing concerns about the state budget and the long-term fiscal outlook at the federal level.

“Cover Georgia is a statewide education and advocacy campaign focused on spotlighting both the critical role that Medicaid plays within Georgia today and the opportunity that implementing an expansion of the program presents for consumers, the health care system, and our state’s economy,” said Cindy Zeldin, executive director of Georgians for a Healthy Future. “Covering the lowest-income uninsured through Medicaid will provide access to the basic prevention and treatment services that uninsured Georgians lack today and will pump an infusion of federal dollars into our state’s health care economy.”

“Other states across the country are saying yes to the Medicaid expansion and are investing in their state’s health care delivery systems with federal taxpayer dollars paid by Georgians. Georgia cannot afford to maintain the status quo while other states invest heavily in their health systems. Doing so will further compound regional health disparities and limit Georgia’s ability to compete in the long-run.”

Matt Caseman, of the Georgia Rural Health Association, agrees that in addition to the overall economy, the expansion will help rural Georgia. “Expanding Medicaid will provide thousands of rural Georgians, who don’t have health insurance, access to a primary care doctor and preventative medicine. It will help reduce the burden of uncompensated care and keep the doors open for our safety net providers. This initiative is critical to not only the health of Georgia’s rural communities, but our state’s overall economic success as well.”

Tim Sweeney, of the Georgia Budget & Policy Institute, believes that access to affordable health coverage is one of the most pressing health care issues facing the state. “Expanding Medicaid to cover hundreds of thousands of low-income Georgians is one of the most cost-effective ways to address the issue. Implementing the expansion will enable more Georgians to access needed health care, while boosting Georgia’s economy by bringing billions in new federal funding for doctors, hospitals, pharmacies and other health care providers throughout the state.”

The consequences of this decision will affect hundreds of thousands of Georgians.  AARP Georgia State Director, Greg Tanner, points out that, “there are 127,000 Georgians in their 50s or early 60s who make less than $15,000 a year and have no health insurance. Expanding Medicaid to cover them would make them more productive and in the first three years pump $8 billion into Georgia.  That money will go directly to doctors, hospitals, clinics and other health care providers.  We can’t afford not to expand coverage.”

If the state decides to forgo expanding the Medicaid Expansion, those individuals who earn more than our current eligibility levels but less than 100% FPL (Federal Poverty Level) will have no options for coverage and would not qualify for subsidized coverage in the state’s health insurance exchanges.  Those individuals will fall into a coverage gap.

The Cover Georgia coalition will continue to work on educating the public, key decision-makers and others on the importance of the expansion and what it means for our citizens.  Individual consumers, health care professionals, policy-makers and others can learn more about Georgia’s Medicaid program and what the expansion would mean for thousands of Georgians by visiting Cover Georgia’s website at www.coverga.org.