Legislative update: Week 8

The GHF team prides itself on delivering timely and accurate updates to you on health care happenings at the Capitol. We hope that you enjoy reading our weekly legislative updates and that they help you stay informed and connected. If you enjoy them, please consider supporting our work with a donation today. Thank you for your continued support!

In this week’s update:

• Action alerts: Ask the House Rules Committee to prioritize mental health & substance use recovery today!
• Bills likely to receive a House or Senate vote today
• Approved last week: Emergency services, prior authorization, & the FY22 big budget
• Advocacy events this week: HIV decriminalization & Medicaid expansion advocacy day!
• U.S. Senate approves COVID-19 relief including extra Medicaid expansion funding for Georgia
• GHF’s got you covered this session!

Legislative Update: Week 7

The GHF team prides itself on being able deliver timely and accurate updates on health care happenings at the Capitol. We hope that you enjoy reading our weekly legislative updates and that they help you stay informed and connected. If you enjoy them, please consider supporting our work with a donation today. Thank you for your continued support!

In this week’s update:

• The General Assembly approves the calendar for the rest of session
• Action alerts: prior authorization, Medicaid expansion, & mental health & substance use updates!
• Legislation: telehealth, changes to nursing rules, & protecting the ACA 
• Advocacy events this week: transgender rights!
• Federal COVID-19 relief – including extra Medicaid expansion funding – passed by U.S. House
• GHF’s got you covered this session!

Legislative Update: Week 6

In this week’s update:

• Action alerts on childhood lead exposure and prior authorization bills
• Legislation on housing and Medicaid expansion!
• Advocacy events this week: housing & Asian Americans
• GHF’s got you covered this session!

Legislative Update: Week 4

Thank you for your readership and enthusiasm for GHF’s weekly legislative updates! The GHF team enjoys putting these updates together to keep you in the loop. We work hard to deliver this service to you in a complete and accurate way every week of Georgia’s legislative session. If you rely on these updates to keep you connected to the health happenings under the Gold Dome, please consider supporting our work with a donation today. Thank you very much!

In this week’s update:

• Take action to reduce the number of uninsured children in Georgia
• Legislation on vaccine administration, lead poisoning in children, prior authorization, and a Medicaid public option!
• Advocacy events for your calendar
• GHF’s got you covered this session!

Legislative Update: Week 1

The 2021 legislative session has begun

Last week, the Georgia General Assembly convened for the first time in 2021. The first four days of the 2021 legislative session were held with additional COVID-19 safety protocols in place. The attentions of legislators were mostly taken up with committee appointments, (including a change in leadership for the Senate Insurance Committee from Sen. Burt Jones to Sen. Dean Burke), Governor Kemp’s third State of the State address, and other annual traditions, including GHF’s own Health Care Unscrambled. 

This week will be primarily dedicated to budget hearings for the current (FY 2021 Amended) and next year’s (FY 2022) state budgets. The General Assembly will reconvene on Tuesday, January 26th for the fifth day of legislative session.

As Georgia faces the public health emergency of COVID-19, it can be hard to be optimistic about our health and our futures. However, Georgians for a Healthy Future believes that our state can successfully overcome this tremendous challenge if Georgians adhere to the advice of public health experts and our state’s leaders swiftly adopt evidence-based policies that protect the health and safety of all Georgians. At the same time, Georgia leaders must look ahead to ways they can promote the health and well-being of all Georgians in the economically challenging months to come. Georgians for a Healthy Future has identified policy priorities that we believe are necessary for success in addressing the immediate public health emergency and the emerging economic consequences. These are the policies that we will fight for as we continue our fight for the health and wellness of all Georgians.

Our recommendations are shaped by feedback from GHF’s board of directors, partner advocacy organizations, local groups helping Georgians in their communities, and stories from Georgians just like you. You can share your COVID-19 experiences with GHF here. Thank you for your generous input.

As the status of this crisis changes and we gather more information, you can find updates to these policy recommendations and actionable information here.

Health system capacity and public safety

GHF supports:

• Statewide and local shelter-in-place orders and other aggressive social distancing practices to slow the spread of the COVID-19 virus
• Funding to quickly expand the capacity of Georgia’s Department of Public Health to test and monitor the spread of COVID-19
• Funding to purchase personal protective equipment for health care workers
• Funding to purchase equipment for patient care like ventilators and respirators
• Maximizing the scope of practice for all qualified and licensed health care providers (e.g. physicians assistants, advanced practice registered nurses, registered nurses)
• Expanding options and health coverage of telehealth and virtual visits in all medically appropriate circumstances

Access to quality, affordable health care for all Georgians

GHF supports:

• Maximizing Medicaid flexibility and funding to increase access to care by:
  • Expanding Medicaid to all poor and near-poor Georgians (those making less than 138 percent of the federal poverty line)
  • Taking advantage of emergency 1135 waivers to increase the number of providers who can see Georgians with Medicaid coverage
  • Adopting administrative changes to preserve coverage for current Medicaid members and to enroll Georgians who are already eligible but unenrolled, including the expansion of presumptive and retroactive eligibility and a halt on the annual renewal process
  • Expanding coverage of home- and community-based services and long-term services and supports
• Expanding access and protections in comprehensive private health coverage
  • Promoting enrollment for people who qualify for private insurance, especially among those who are eligible for financial assistance through the Affordable Care Act (ACA) by:
    • Establishing a new Special Enrollment Period for people who wish to purchase health insurance now
    • Easing the enrollment and paperwork requirements for people enrolling in coverage due to job loss or income changes
    • Prohibiting health insurers from canceling a consumer’s coverage, even if they fall behind on premium payments
  • Eliminating cost-sharing for COVID-19 testing (and related tests) and treatment
  • Limiting the sale of plans that do not offer comprehensive benefits or follow the standards set by the ACA
  • Establishing comprehensive surprise billing protections
• Promoting access to mental health services and substance use recovery supports for all Georgians
• Easing limits on prescription drugs so that consumers can more easily access 90-day supplies of medications

Equity at the center of the response

This pandemic will hit some Georgia communities harder than others. All federal and state policy remedies should endure to offer the most help to those who are disadvantaged due to income, race or ethnicity, disability or health status, age, geography, and other factors. Georgia’s response must proactively address health equity concerns. Among other strategies, this should include disseminating public health messages that include information about affected groups and communities in languages and contexts they understand and directing additional funding to community health centers and other providers that serve disproportionately impacted communities.

Meeting the basic needs of Georgians and their families

As evidenced by yesterday’s job loss statistics, it is imperative that the public health response to the COVID-19 crisis be followed by an ambitious economic response. GHF supports policies that provide equitable opportunities for stability, dignity, and well-being for all Georgia families. While not an exhaustive list, these policies include:

• Expanded access to Georgia’s unemployment insurance system, including 26 weeks of benefits and the easing of eligibility requirements and activities.
• A moratorium on foreclosures and evictions, the provision of rental assistance and mortgage forbearance, and other supports that keep Georgians in their homes
• Improved access to nutritious foods through SNAP, WIC, school system food programs, and other public programs
• Universal paid family leave that allows workers regardless of income to take time off to care for themselves and their loved ones in times of sickness and crisis
• A moratorium on utility shut offs, including internet access so that families can keep the lights on and children can continue to learn remotely

GHF will support partner organizations in their efforts to advocate for these policies and supports for Georgia families and individuals.

Some of these policies have been adopted or partially adopted by federal officials, Governor Kemp, and state agency officials. GHF thanks Georgia leaders for the actions they have already taken. In the coming weeks, GHF will track which policies are fully implemented, partially adopted, or not taken up at all, and will provide updates accordingly.

Thank you for your support and advocacy. We wish you health and safety!

In 2019 Georgia’s health advocacy community lost several colleagues and friends. As we mourn those who passed, we strive to honor their lives by continuing to build the healthy, equitable future they each envisioned.

This year’s Linda Smith Lowe Health Advocacy Award will honor the work of one such Georgian. Dawn Alford is this year’s award recipient for her advocacy on behalf of Georgians with disabilities.

Dawn Alford was the Public Policy Director for the Georgia Council on Developmental Disabilities from 2013 until her unexpected passing in July 2019. In this role, Dawn led advocacy efforts to improve and protect access to quality health care, increase opportunities for accessible education, and to expand opportunities for people with disabilities to live full lives in their communities.

Dawn brought her own life experience to her work. As she educated legislators on important policy issues, she told stories about her health care, education, and family supports to illustrate the need and impact of policy change. She regularly led efforts to bring Georgians with disabilities to the state Capitol to do the same. Dawn’s ability to create change by leveraging the power of her own and others’ voices illustrates why GHF has chosen to recognize her as this year’s awardee.

Dawn’s former colleague and friend Eric Jacobson submitted her award nomination and reflected on Dawn’s legacy:

“It now only makes sense that we promote young people with disabilities to take her role and build upon it. While only 41 when she passed, she had begun developing a network of young people with disabilities who saw her as a mentor, coach and friend. She prepared them not only to become better advocates but to take leadership roles in the Disability Rights Movement.

She was an extraordinary advocate for people with disabilities who fought so that all Georgians with disabilities could live full and meaningful lives in the community.”

For her advocacy work on behalf of Georgians with disabilities, we are proud to honor Dawn Alford with the Linda Smith Lowe Health Advocacy Award.

We hope you will join us on January 14^th as we recognize Dawn! RSVP here.

In March 2019, Georgia lawmakers approved SB 106, the Patients First Act. The new law allows Georgia to use two kinds of health care waivers to make changes to health coverage in the state. These waiver plans could affect you, your friends, family, neighbors, and Georgians all across the state and the way you access and pay for health care.

(Waivers allow a state to set aside or “waive” certain requirements imposed by the federal government and try new models of providing health coverage and care.)

The state has hired Deloitte as a consultant to work with state leaders to develop the waiver plans. Georgia’s decision-makers have proposed an aggressive timeline and aim to finalize the waiver plans by the end of 2019.

Two types of waiver plans

Two types of plans are being developed by state leaders: an 1115 waiver and a 1332 waiver. An 1115 waiver allows Georgia to make changes to the state’s Medicaid program. Medicaid is the state’s health insurance program that covers kids, some low-income parents, seniors, and people with disabilities, and pregnant women. SB 106 limits the 1115 waiver to cover people making up to the poverty line (about $12,000 a year for an individual or $26,000 for a family of four). Medicaid expansion, which GHF has advocated for, would extend public coverage to people with incomes just above the poverty line (138% of the federal poverty line.) A successful way to use an 1115 waiver would be to cover everyone under the poverty line and exclude barriers to coverage such as burdensome paperwork requirements, confusing cost-sharing, or counterproductive lock-out periods.

A 1332 waiver allows the state to make changes to private insurance and the health insurance marketplace. About 450,000 Georgians buy their health coverage through the marketplace. Most of these Georgians receive federal tax credits to cover some or all of their premium costs. (Another 827,600 of Georgians are eligible for private coverage and financial help to buy it but have not yet enrolled.) A successful way to use a 1332 waiver is to establish a “reinsurance program” to reduce premium costs. This waiver should also ensure all plans continue to cover the essential health benefits (like prescription drugs) and maintain protections for people with preexisting conditions.

You can weigh in!

Now is the time to ensure that Georgia gets a plan that will provide comprehensive coverage to as many people as possible. Thousands of Georgians across the state could gain health care coverage through the Patients First proposals. While positive intentions have been expressed by Georgia’s elected officials about the forthcoming waivers, none has yet committed to ensuring all Georgians have a pathway to comprehensive, affordable coverage.

For every 1115 and 1332 waiver that the state wants to pursue, Georgia’s policymakers must seek input from the public. Because there are required state and federal public comment periods for each waiver proposal, there will be at least four public comment periods (a state and federal period for an 1115 waiver and a state and federal period for a 1332 waiver). These are your chances to help shape and influence health care in Georgia!

GHF and our Cover Georgia partners will let you know when the public comment periods begin and end and we will provide an easy way for you to have your say. Make a plan to submit comments during every public comment period so that state leaders know how their ideas will impact you and your family! Your story can help make a difference for thousands of Georgians and can support positive changes in health care coverage.

To learn more, visit coverga.org and download our new Happening Now fact sheet! Follow #CoverGA on FaceBook and Twitter for the most current updates!

In late 2018, Georgians for a Healthy Future was awarded a General Operating Support grant from the Community Foundation for Greater Atlanta. The Foundation works to connect the passions of philanthropists with the purposes of nonprofits. Awards were given through a highly competitive process and we are excited about this partnership as we continue to work to ensure quality, affordable health care for all Georgians.

GHF was one of twenty-nine nonprofits to have received this highly competitive General Operating support grant from the Community Foundation for Greater Atlanta. Seven nonprofits, including GHF, were awarded grants to support well-being and “ensure a healthy region where all residents have access to quality health care and nutritious food.”

With the support of the Community Foundation for Greater Atlanta, GHF continues to offer Georgians the tools and information they need to become effective health advocates for themselves and their communities, inject the consumer perspective into health care stories in the media, and convene partner groups in coalition to strengthen our collective ability to advocate for the needs of Georgians across the state. We are ecstatic to have been among the select organizations who share our vision and drive to improve the lives of the people of Georgia. We look forward to continuing our work as the voice for Georgia health care consumers with the support of the Community Foundation for Greater Atlanta.

Read the Foundation’s December 2018 press release.

The 2019 Georgia legislative session is over but we are not finished! 

Yesterday was Sine Die at the Georgia General Assembly – the last day of the 2019 legislative session. This year’s session saw the approval of several bills that will surely impact consumers’ health and finances in positive ways if approved by the Governor. Efforts to address step therapy so patients have access to needed therapies and housing so that families can be assured of safe, healthy places to live have been multi-year efforts by consumer and family advocates. These bills now move to the Governor’s desk for his consideration and signature.

The impact of other bills is less certain. SB 106 may bring sweeping changes to Georgia’s health care landscape but the details have yet to be laid out. The passage of legislation is only the first step in a health reform process in which your voice and advocacy will be needed. (Learn more about the next steps and what to expect in our latest blog post and in the section below.)

Check out our summary of the more notable health bills of the 2019 session below and a full list of health care-related legislation at GHF’s legislative tracker.

Our priorities

Governor Kemp signs Patients First Act into law but its impacts on Georgians still uncertain

SB 106, the Patients First Act, moved quickly through the Georgia General Assembly this session and was signed into law by Governor Kemp last week. As we have reported, the bill allows the state to pursue an 1115 waiver to make changes to Georgia’s Medicaid program that may include expanding coverage to more poor adults and a 1332 state innovation waiver to make changes to private insurance in the state.

Now that the bill is signed, what’s next? You are critical to ensuring that the waivers created from SB 106 lead Georgia to the healthy future that we all want. Your advocacy, stories, and input are necessary. Read our new blog so you know what to expect and how you can help ensure all Georgians have meaningful, affordable health coverage.

Step therapy legislation approved

HB 63, sponsored by Rep. Sharon Cooper, will require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. Step therapy is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the higher-cost treatment prescribed by a patient’s physician. The bill received final approval by the House on Tuesday

Call Governor Kemp at 404-656-1776 and ask that he sign HB 63.

Surprise billing legislation fails to cross the finish line

Surprise billing legislation faced familiar roadblocks this year when provider groups and insurers could not come to agreement about payments for out-of-network care. There were late efforts to revive some or all of HB 84 and SB 56 but neither succeeded. (Both bills are covered in detail in our Februrary 11th legislative update.) We are grateful to Chairman Richard Smith and Chairman Hufstetler for their work on this important issue and hope to find a resolution for consumers in the next legislative session.

Healthy housing legislation passes

GHF, as part of the Healthy Housing Georgia coalition, supported HB 346. This bill will prohibit retaliation by a landlord against a tenant for complaining to Code Enforcement about unsafe or unhealthy housing conditions like the presence of mold, radon, rodents, insect infestations, or lead. If the Governor signs the bill into law, Georgia will join the ranks of forty-one other states that have already implemented similar legislation to protect tenants against retaliatory evictions. (For more details on the legislation, see our March 5th legislative update.)

Call Governor Kemp at 404-656-1776 and ask that he sign HB 346.

Sine Die Recap

HB 30: Amended FY 2019 Budget | SIGNED BY GOVERNOR

HB 30 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2019. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on Tuesday, March 12th.

HB 31: FY 2020 Budget | PASSED

HB 31 is the budget document for the coming state fiscal year which will run from July 1, 2019 to June 30, 2020. The budget includes several new investments in behavioral health and mostly maintains funding for other health care programs and priorities. For more information on the health care highlights in the proposed FY 2020 budget, read the Community Health and Behavioral Health budget overviews from the Georgia Budget & Policy Institute.

HB 37: Expand Medicaid Now Act | DID NOT PASS

HB 37, sponsored by Rep. Bob Trammell, expands Medicaid in Georgia as envisioned by the Affordable Care Act by increasing Medicaid eligibility for adults up to 138% of the federal poverty guidelines (FPL). This is equivalent to $17,236 annually for an individual and $29,435 for a family of three.

HB 158: Improve Medicaid patient access to effective HIV treatment | DID NOT PASS*

HB 158, sponsored by Rep. Deborah Silcox, requires that Medicaid recipients have the same access to antiretroviral drugs used to treat HIV and AIDS as to those included in the formulary established for the Georgia AIDS Drug Assistance Program. This change would allow for increased continuity of care for people living with HIV/AIDS in Georgia. *Although HB 158 did not get a Senate vote, it received favorable comments in the Senate Health Committee, after passing the House unanimously. In recognition of the broad support of this effort, Georgia’s Medicaid agency has committed to the bill sponsor to implement the intent of the legislation.

HB 217: Needle exchange | PASSED

HB 217, sponsored by Rep. Houston Gaines, decriminalizes the act of working or volunteering for a syringe services program, a step towards legalizing the programs. Distributing clean hypodermic syringes and needles to people who use injection drugs (e.g. heroin) helps to prevent the spread of HIV and Hepatitis C, and does not increase the likelihood that people will newly take up injections drug use.

HB 290: PrEP pilot program | PASSED

HB 290, sponsored by Rep. Sharon Cooper, would establish a pilot program to provide preexposure prophylaxis (PrEP) drug assistance or services to persons at risk of being infected with HIV. PrEP is a medication taken by people who are HIV-negative to reduce their risk for infection. The pilot program would provide PrEP to people in counties identified by the Centers for Disease Control & Prevention as at risk of HIV outbreaks due to a high rate of opioid use and participants would receive regular HIV testing and related support services.

HB 83: Recess legislation | PASSED

HB 83, sponsored by Representative Demetrius Douglas, would require a daily 30-minute recess for all students in grades K-5 unless they have already had a physical education class or structured activity time in the day. This bill now sits in the Senate Rules committee and awaits a vote on the Senate floor. To learn more about the impact of recess on children’s physical and mental health, read this fact sheet from Voices for Georgia’s Children.

HB 321: Medicaid financing program | PASSED

HB 321, sponsored by Rep. Jodi Lott, would extend the sunset provision of the hospital provider fee for five years. The hospital payment program, which draws down additional federal funding, provides almost $1 billion annually to the state’s Medicaid budget. More information about HB 321 is available here.

HB 514: Georgia Mental Health Reform and Innovation Commission | PASSED

HB 514, sponsored by Rep. Kevin Tanner, would create the Georgia Mental Health Reform and Innovation Commission which would work to analyze and offer improvements to the state’s mental health system and run through at least June 30, 2020. Within the Commission, several subcommittees would be established to include Children and Adolescent Mental Health; Involuntary Commitment; Hospital and Short-Term Care Facilities; Mental Health Courts and Corrections; and Workforce and System Development.

SB 16: Interstate Medical Licensure Compact Act | PASSED

SB 16, sponsored by Sen. Kay Kirkpatrick, would allow Georgia to enter the “Interstate Medical Licensure Compact” which allows health care providers to more easily obtain licenses to practice in multiple states. It also provides Georgia’s Medical Board with easier access to investigative and disciplinary information about providers from other states, an important protective measure for Georgia patients.

HB 233: Pharmacy Anti-Steering and Transparency Act | PASSED

HB 233, sponsored by Rep. David Knight, would prohibit pharmacies from sharing patient data for commercial purposes and prohibit pharmacy benefit managers (PBMs) from steering patients to PBM-owned pharmacies. It also requires such pharmacies to file an annual disclosure statement of its affiliates. Pharmacy benefit managers are companies that manage the prescription drug benefit of your health plan.

SB 195: Prescription Drug Benefits Freedom of Information and Consumer Protection Act | DID NOT PASS

SB 195, sponsored by Senator Chuck Hufstetler, this bill would make it easier for consumers to know what prescription medications are covered by their health insurance plan and better understand the likely costs by requiring health insurers to conspicuously post on their website information about their drug formulary in a current and searchable format. A drug formulary is the list of prescription medicines that your health insurer agrees to pay for or partially pay for. SB 195 would also standardize and speed up the process for consumers and providers to request prior authorization for necessary prescription drugs.

HB 186: Certificate of Need Reform | PASSED

HB 186, sponsored by Rep. Ron Stephens, will create a new category for general cancer hospitals as part of an agreement with Cancer Treatment Centers of America that would allow more Georgia patients to be seen. This bill will also limit who can object to a provider’s Certificate of Need application for expanding hospital services. The change would limit objections to only come from health care facilities that provide similar services and are located within a thirty-five mile radius.

HB 197: Establishment of Strategic Integrated Data System | PASSED

HB 197, sponsored by Rep. Katie Dempsey, will establish the Strategic Integrated Data System through the Office of Planning and Budget. The data system would capture de-identified information about the physical and mental health and social services beign provided to Georgians across the state. The goal of the system is to provide a central source of date about state services that can be used by state agencies, lawmakers, and researchers to make programs more effective and cost-efficient.

HB 323: Regulation and licensure of pharmacy benefits managers | PASSED

HB 323, sponsored by Rep. David Knight, will provide a good first step in drug transparency from pharmacy benefits managers (PBMs.) PBMs will have to report how much they receive in rebates from pharmaceutical manufacturers to the Department of Insurance and how much of those savings are being passed on to customers, although the information are not required to be reported to the legislature or the public.

GHF has you covered

Stay up-to-date with the legislative session

GHF has been monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide. (Contact Michelle Conde at mconde@healthyfuturega.org for a printed copy.)