As part of the Affordable Care Act, beginning in 2014 all new individual and small group health insurance plans must cover a core set of health care services and items across ten broad categories including hospitalization, prescription drugs, maternity and newborn care, and preventive services, among others. This core set of services and items is known as Essential Health Benefits.

The benefits that health plans are currently required to cover vary by state. To ease the transition to essential health benefits in 2014, the U.S. Department of Health and Human Services (HHS) set out a process for each state to select a benchmark health insurance plan (which would include all benefits currently mandated in that state) that would then be supplemented to fill in any gaps and ensure health benefits across all ten categories are covered.

Last week, HHS issued a proposed rule outlining each state’s benchmark plan.  HHS is accepting public comment on all states’ proposed benchmark plans, including Georgia’s benchmark, until December 26th, 2012 (instructions for how to comment are included within the proposed rule). You can view the proposed benchmark plan for Georgia here. For additional information about the Essential Health Benefits process, see a recent Health Affairs article here. For additional information through a Georgia lens, see a recent Georgia Health News story on Essential Health Benefits here.

Georgians for a Healthy Future is excited to announce that Jonathan Cohn of The New Republic will be the keynote speaker for our third annual Health Care Unscrambled policy breakfast on January 10, 2013! We hope you’ll join us for this important event that brings together health care consumer advocates, stakeholders, and policymakers for a look ahead to the biggest health policy issues facing Georgia in the coming year. Jonathan’s full bio is below.

Jonathan Cohn covers domestic policy and politics for The New Republic, with a particular emphasis on social welfare, labor, and health care. He is also the author of Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price.

Jonathan has been recognized in the pages of the Washington Post as “one of the nation’s leading experts on health care policy” and in the New York Times as “one of the best health care writers out there.” An item from Time suggested he “may be the smartest, most well-sourced health care writer in the country.”

Jonathan has won the Sidney Hillman and Harry Chapin media awards. He has also been a finalist for the Robert F. Kennedy Book Award, the New York Public Library’s Helen Bernstein Book Award, and the Livingston Award for Young Journalists. Jonathan, who is presently a member of the National Academy of Social Insurance, has been a senior fellow with Demos, a media fellow with the Kaiser Family Foundation, and a Griffith Leadership fellow at the University of Michigan. He is a frequent public speaker and radio/television analyst.

Jonathan grew up in South Florida, where he became a devoted fan of the Miami Dolphins, and graduated from Harvard University, where he became a devoted fan of the Boston Red Sox. But his biggest devotion is to his wife and two children, with whom he lives in Ann Arbor, Michigan.

Today, Georgians for a Healthy Future’s Executive Director Cindy Zeldin presented to the annual Georgia Women’s Assembly, organized by Georgia Women for a Change, on the Medicaid expansion and why it matters for women. We know that covering Georgia’s uninsured by implementing the Medicaid expansion will improve access to care, provide resources for the state’s health care delivery system, and bolster Georgia’s economy. But what about women in particular? Medicaid today provides a lifeline for many women, serving as a source of coverage for low and moderate-income pregnant women, low-income mothers, and low-income women diagnosed with breast or cervical cancer. Yet too many women are left out. Expanding Medicaid will extend that lifeline to more low-income moms and low-income women without children who aren’t eligible for Medicaid today.  More than two-thirds of uninsured women report difficulty accessing care, which tells us that too many women who want and need an entry point to the health care system to meet basic medical needs cannot get it today. The Medicaid expansion will help open that door. Another reason to Cover Georgia!

To download Cindy Zeldin’s power point presentation from the Georgia Women’s Assembly, click here.

Georgia policymakers are currently weighing the opportunity to cover an estimated 650,000 uninsured Georgians through an expansion of the Medicaid program. Under the Affordable Care Act, states can create a new category of eligibility for Medicaid to cover low-income individuals and families, financed almost entirely with federal dollars. Implementing this expansion is the only viable way to cover Georgia’s low-income uninsured, and it will pump resources into our state’s health care delivery system. We can’t miss this opportunity to improve access to health care and to strengthen Georgia’s health care economy, but we need your voice to make it happen.

Health care consumer and patient advocacy groups, providers, stakeholders, and community groups are coming together under the Cover Georgia umbrella to show support for expanding Medicaid, and we invite you to join us. If you are interested in getting involved in this discussion, please contact Amanda Ptashkin.

In November, the Cover Georgia campaign will unveil a website full of resources to help you better understand and advocate for the Medicaid expansion with policymakers and in your community. In the meantime, please visit Families USA’s Medicaid Expansion Center, with links to studies and reports about the value of Medicaid, and the Center on Budget and Policy Priorities’ Tool Kit for State Advocates on the Medicaid expansion.

#CoverGeorgia

Gaining health care coverage through Medicaid improves access to care, reduces financial strain, and saves lives. Those are some of the takeaways from an engaging and enlightening forum hosted this morning by the Georgia Budget and Policy Institute. The featured speakers, Dr. Heidi Allen and Dr. Benjamin Sommers, presented research findings on the impact of gaining Medicaid coverage on health status and participated in a panel discussion moderated by GBPI’s Tim Sweeney and Georgians for a Healthy Future’s Cindy Zeldin about the implications for Georgia as our state’s policymakers weigh the costs and benefits of covering the uninsured in Georgia through an expansion of Medicaid. The audience was live tweeting the event under #covergeorgia, allowing those who missed to hear what the audience was saying as it was happening. You can read their tweets here. Georgia Health News also reported on the event (story here). To get involved with Cover Georgia, the emerging educational and advocacy effort to make the case for expanding Medicaid to cover Georgia’s uninsured, please e-mail Georgians for a Healthy Future’s Outreach & Advocacy Director, Amanda Ptashkin.

Here are some photos from today’s event.

This commentary originally appeared in the Atlanta Journal-Constitution on September 6th, 2012.

By Cindy Zeldin

Nearly 2 million Georgians are uninsured; that number is among the highest in the nation.

Georgia policymakers have long recognized this problem 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.

Until now, however, they haven’t had the tools and resources to comprehensively address it.

What has changed?

The Affordable Care Act  put in place a basic framework to ensure that all Americans have a pathway to affordable health care coverage. This framework has three key components. First, those of us who get health insurance at work as an employee benefit will continue to do so.Second, new health insurance marketplaces, or “exchanges,” will come on line in just over a year to help consumers who don’t have employee coverage at work find an affordable health plan that meets their needs. Third, a new category of eligibility for Medicaid was created for the lowest-income consumers, many of whom work in low-wage jobs that don’t come with health insurance, yet earn too little money to afford a private health insurance policy.

In June, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act but ruled that states could choose whether or not to implement that third component, the Medicaid expansion.

Covering the lowest-income uninsured through Medicaid will provide access to basic prevention and treatment services that uninsured Georgians lack today. A landmark study published last year by the National Bureau of Economic Research found that people who gained coverage through Medicaid were more likely to access preventive services and have a usual source of care than their uninsured counterparts. A study published in the New England Journal of Medicine found that states that expanded Medicaid saw lower mortality rates, even after taking into account a range of other factors, than their neighboring states who did not.

In other words, if you want to improve health care outcomes, expanding Medicaid is a proven way to accomplish this goal.

The benefits to Georgia of expanding Medicaid go far beyond the 650,000 uninsured Georgians who stand to gain coverage. Because the Medicaid expansion is financed almost entirely with federal dollars, an infusion of resources will be pumped into our state’s health care delivery system.

If Georgia expands Medicaid, we stand to draw down approximately $14.5 billion in federal funds over the six-year period between 2014 and 2019, according to an analysis by the Urban Institute. In fact, Georgia taxpayers are already contributing towards the cost of the Medicaid expansion. It’s just a question of whether some of that money comes back to Georgia or whether we leave it on the table and allow it to be diverted to other states.

Last week, Gov. Nathan Deal announced that he did not intend to move forward with the Medicaid expansion, expressing concerns about the federal government’s long-term fiscal outlook. Just last month, states received word that they have an important element of flexibility: They can implement the Medicaid coverage expansion and, after a few years, if it isn’t working for them, they can withdraw.

There is no reason why Georgia can’t take advantage of the tools and resources before us to invest in our state’s health care economy today  and revisit our participation periodically to ensure that the federal government is meeting its end of the bargain and that the program works.

We have an unprecedented opportunity to improve the health of Georgia patients and consumers, strengthen our state’s health care delivery system, and bolster the state’s economy by moving forward with the Medicaid expansion.

Georgia policymakers should seize the moment and invest in our future.

The 2012 Legislative Session continues today as legislators meet for Day 27 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 1^st 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.

Don’t forget to download our Consumer Health Advocate’s Guide to the 2012 Georgia Legislative Session to help you navigate the Capitol! A limited number of hard copy guides are available. Please contact us if you’d like a copy.

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. If you are a beginner make sure to check out our glass bongs for sale section first to get a good impression of everything available on the market today. Are your more of a clumsy smoker? 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.

Just in time for the 2012 Georgia Legislative Session, Georgians for a Healthy Future has a new resource for advocates: A Consumer Health Advocate’s Guide to the 2012 Georgia Legislative Session: Information for Action. Our legislative guide walks you through the legislative process; identifies the committees with jurisdiction over health care issues, which legislators sit on them, and how to contact them; provides contact information for a range of health care organizations, associations, and advocacy groups as well as key health care reporters; and provides other tools to help you be a strong and effective advocate. The guide is available here.

Georgians for a Healthy Future is a non-profit, non-partisan health policy and advocacy organization that addresses health care issues through a consumer lens. Our 2012 policy priorities were developed with broad input from community stakeholders. We will work collaboratively with our community partners to advance these priorities.

Maximize opportunities and benefits presented by the Affordable Care Act for Georgia health care consumers. Georgians for a Healthy Future will continue to monitor legislation and agency-level activity to implement the ACA and support Georgia laws and regulations that establish structures and systems that maximize benefits for consumers in this process.

Preserve consumer protections for Georgians in private health insurance plans. State laws and regulations provide a basic level of protections and benefits to consumers who buy private health insurance plans. These protections ensure that consumers who purchase these plans obtain meaningful health insurance that covers essential medical services in the event they get sick. Georgians for a Healthy Future will continue to support efforts to preserve and strengthen consumer protections and oppose legislation that would place consumer protections at risk.

Modernize Medicaid and PeachCare by utilizing best practices to improve coverage rates, access to care, and health outcomes. The Medicaid and PeachCare for Kids programs provide health insurance for our state’s most vulnerable citizens. The Georgia Department of Community Health is currently weighing options to redesign these programs. Georgians for a Healthy Future will monitor this process as well as legislative activity and will support policy changes that facilitate continuous coverage and enrollment, preserve and expand access to care, and improve health outcomes. Georgians for a Healthy Future will oppose policy changes that restrict access to vital health care services for Medicaid and PeachCare beneficiaries.

Establish a consumer-friendly health insurance exchange. A well-designed health insurance exchange can add transparency to the health insurance marketplace, spur competition and choice, help make insurance more affordable and available, and give consumers the information they need to make optimal purchasing decisions. Georgians for a Healthy Future will support a health insurance exchange compatible with the American Health Benefit Exchanges (AHBE) authorized by the Affordable Care Act that provides consumers with the appropriate information, tools, and navigation assistance to make optimal purchasing decisions and a governance structure that can effectively and transparently oversee the exchange without conflicts of interest.

Restore child-only health insurance plans to the private health insurance market. Due to a recent change in federal law, insurance carriers in the individual market can no longer deny coverage to a child with a pre-existing condition. Even though insurers may still medically underwrite these policies, insurance carriers in Georgia stopped issuing these policies altogether. Georgians for a Healthy Future will support legislation to restore these plans to Georgia’s health insurance marketplace.

Strengthen Georgia’s public health system. Our public health system plays a critical role by vaccinating children, monitoring and preventing epidemics, ensuring safe food and water, and providing both clinical and community-based preventive services. Despite an increasing need for services, Georgia’s per capita public health spending is among the lowest in the nation. The establishment in 2011 of the new Department of Public Health presents an opportunity to rebuild our public health infrastructure and to place renewed focus on the critical role of public health. Georgians for a Healthy Future supports a robust, adequately funded public health system to meet the critical needs of our state.

Increase the tobacco tax. The current funding environment demands evidence-based policy solutions that both advance the health of our state and generate needed revenue. In recent years, even the most basic, vital, and cost-effective programs have been subject to deep budget cuts. Georgians for a Healthy Future opposes further cuts to these vital programs and supports budget solutions such as a substantial increase in the state’s tobacco tax. Tobacco taxes are a proven strategy with the dual benefit of bringing in additional state revenue and increasing the health of Georgians by reducing adult and youth smoking.

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.