How marketplace health coverage keeps activist Saifa going

Sean “Saifa” Wall is an Atlanta-based intersex justice activist. He is currently enrolled in a health plan with Ambetter through the Affordable Care Act’s health insurance marketplace (also called healthcare.gov).

As an activist, Saifa’s income is generated exclusively through contractual work, which means that his employers do not provide health benefits. He talks to people about issues that affect the intersex community. He also serves as a public health researcher that consults with racial justice and domestic violence organizations.

Saifa enrolled in coverage in 2016 with the help of a GHF health insurance navigator after being uninsured for over two years. (He was also able to purchase dental coverage.) Saifa pays a premium of $63 per month after a $500 tax credit helped to lower his costs. His coverage allows him access to hormone therapy and behavioral health services, among other essential health benefits. He loves his medical provider and receives high quality treatment as an intersex person who is hormone dependent.

Saifa was recently diagnosed with osteopenia, which means his bones aren’t as dense as they need to be to prevent breaks and other injuries. Saifa will need comprehensive medical care as he works to build bone mass; much or all of that care will be covered by the comprehensive insurance plan he purchased through the ACA.

Like Saifa, 450,000 Georgians rely on the ACA marketplace to access comprehensive, affordable health coverage. Many more Georgians are eligible for marketplace coverage but remain uninsured for a variety of reasons.

Georgia’s new law, called the Patients First Act or SB 106, may bring changes to private health insurance in the state but Georgia leaders have not yet spelled out what changes they plan to seek. An effective way to use their new flexibility would be to maintain the protections and financial help that Georgia consumers enjoy while building a “reinsurance program” to bring down premiums for everyone. (This approach has been successfully tried in seven other states.) If premiums fall or remain steady, this could attract more Georgians to the marketplace and get more people covered.

When Saifa was asked what he would tell legislators about having health coverage, he replied: “As an intersex activist, I believe health care is a human right.” While this belief isn’t yet reflected in Georgia’s state health laws, the ACA allows consumers like Saifa to take advantage of comprehensive, affordable coverage options and protections from discrimination in the health system, among many other advances.


Tags:

Legislative Update: Patients First Act, the little budget, and HIV legislation

Legislative Update: Week 6
Patients First Act moves quickly through Senate committee

Last week, the Senate Health and Human Services (HHS) committee met to discuss and hear testimony on SB 106. Titled the Patients First Act, the legislation permits Georgia’s Governor to pursue two health care waivers that could make significant changes to health coverage for Georgia consumers. The bill passed out of committee with no changes and now sits in the Senate Rules Committee awaiting a vote to move to the Senate floor.

The legislation, as written, would allow the Department of Community Health to request an 1115 waiver to extend Medicaid coverage up to 100% of the federal poverty level (FPL). This would leave out thousands who would be covered under a full Medicaid expansion and will likely cost the state more to cover fewer people. Additionally, the bill allows the Governor to make potentially tremendous changes to private health insurance in Georgia through 1332 waivers with little accountability. This proposed legislation falls short of the promise to put a health insurance card in the pockets of all Georgians.

There is still time to ensure that this bill covers all Georgians in need of an insurance card in a fiscally responsible way. Join us this Thursday, February 28th, for Cover Georgia Day at the Capitol to talk with your elected officials about this important piece of legislation

(Can’t make it? Call or send an email to your state legislators today!)


General Assembly moves forward on budget bills
Budget progresses through General Assembly
The House and Senate are inches away from completing work on HB 30, the FY2019 supplementary budget which only needs a House “agree” to move to the Governor’s desk. The supplemental budget (also called the “little budget”) makes necessary, mid-year adjustments to the current state budget. The Governor’s proposed amended FY2019 budget provides $1 million for the Department of Community Health to hire an external consultant to draft the waiver options authorized in SB 106, if passed. The House Appropriations Committee has begun working on the FY 2020 budget, (also called the “big budget”). The FY2020 budget contains significant additions for health, including $8.4 million to fund a school-based mental health initiative called Project Apex, which aims to increase access to mental health services for children and youth.

Legislature prioritizes HIV prevention & treatment
Bills to increase prevention & treatment of HIV move forward in the House

Georgia now leads the U.S. in the number of new HIV cases diagnosed each year. State legislators have turned their attention to this problem with the introduction and passage of several bills aimed at preventing the further spread of HIV/AIDS and increased access to treatment for those living with the disease:

  • HB 158, sponsored by Rep. Deborah Silcox, requires that Medicaid recipients have the same access to antiretroviral regimens 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. The bill has passed the House and has been referred to the Senate HHS committee.
  • 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. This bill was passed by the House yesterday and now moves to the Senate.
  • 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. The House HHS committee passed HB 290 last week and now awaits a full vote by the House.

Surprise billing legislation advances
Surprise billing legislation approved by Senate committee

SB 56, sponsored by Senator Chuck Hufstetler, was approved by the Senate Insurance and Labor Committee last week. The legislation addresses surprise out-of-network billing and aims to improve transparency. A surprise medical bill can occur when a consumer unknowingly encounters an out-of-network (OON) provider at an in-network facility and can have serious financial impacts on individuals and families. This bill would disallow surprise billing in emergency situations but does not prohibit surprise billing in non-emergency situations like when a physician uses an out-of-network laboratory for diagnostic tests. (For more details on the legislation, see our February 11th legislative update.) The bill was approved and now sits the Senate Rules Committee awaiting a vote.


GHF has you covered
Stay up-to-date with the legislative session

GHF will be 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.


Tags:

Five reasons Georgia should follow Virginia’s example

Last week, Virginia became the latest state to expand health care coverage to low-income adults when the Virginia legislature voted to close the its coverage gap and Governor Northam signed the new budget. More than 400,000 Virginians are expected to gain coverage as a result, and the state anticipates declines in uncompensated care costs for hospitals, an increase in people receiving needed health services, and greater financial security for those set to gain coverage. The vote comes after years of advocacy and engagement from constituents and advocates who worked to convey to legislators the importance of health coverage and the impact the change would have on the lives of hundreds of thousands of Virginians.

Unlike Virginians, 240,000 hard-working Georgians cannot yet look forward to putting a health insurance card in their pockets. These friends and neighbors make too little to get financial help to buy health insurance and don’t qualify for Medicaid in Georgia, leaving them stuck in the state’s coverage gap.

Georgia remains one of 17 states that is still refusing billions in federal health care dollars to provide health coverage to low-income adults in the state. As in Virginia, Georgia’s Governor and state legislature can choose to close the coverage gap at any time, and here are five reasons they should do so as soon as possible:

  1. Thousands of Georgians would gain health coverage–240,000 Georgians would gain the peace of mind, access to care, and financial protection that insured Georgians have. These Georgians make less than $12,140 a year  or $20,780 for a family of three. Most are working in sectors like retail, child care, construction, and food service, low-paying jobs that do not come with benefits.
  2. Georgia’s rural hospitals are economic anchor institutions–rural communities need their hospitals to provide accessible healthcare, sustain well-paid jobs, and facilitate economic stability. Closing the coverage gap would create at least 12,000 new jobs and $1.3 billion in new activity in Georgia’s rural communities each year.
  3. The resulting job growth is greater than what the state would gain by attracting Amazon’s HQ2–extending health coverage to more Georgians would create 56,000 new jobs across the state, more than the 50,000 jobs that Amazon is promising at its second headquarters. Even better, the new jobs would be scattered across the state rather than concentrated in and around Atlanta.
  4. Georgia’s tax dollars are currently sitting unused in Washington, D.C.–By refusing to extend health insurance to low-income Georgians, the state is missing out on $8 million per day ($3 billion dollars per year). Instead of giving up hard-earned tax dollars, Georgia’s policy makers could bring that money back to the state to help low-income parents, veterans, and workers put health insurance cards in their wallets.
  5. It is the biggest step Georgia can take to slow the substance use crisisOne quarter (25%) of Georgians who fall in the coverage gap are estimated to have a mental illness or substance use disorder. If they were covered by health insurance, treatment and recovery services would be within reach, allowing them to resume full, healthy lives. As a result, 36,000 fewer Georgians each year would experience symptoms of depression and the state could make significant progress in addressing its ongoing substance use crisis.

 

After five years of delay, Virginia’s leaders made the right decision and as a result, 400,000 Virginians will see healthier futures. Now is the time for Georgia’s decision makers to follow suite by putting 240,000 insurance cards in wallets all across the state.

 

Virginia State Capitol Image  – Skip Plitt – C’ville Photography


Tags:

New policy report: Getting Georgia Covered 2017

With four open enrollment periods completed and a fifth one beginning in the coming weeks, the Health Insurance Marketplace has become established as the avenue for purchasing coverage for thousands of Georgians who do not have access to have insurance at work. The fourth open enrollment period differed from the first three in several important ways, and understanding these variations will be important in ensuring that the Marketplace continues to serve consumers who seek access to affordable comprehensive health insurance. This report examines the characteristics of the consumers enrolled in the Georgia Marketplace, compares open enrollment 4 to the previous three enrollment periods, and provides a preview for open enrollment 5.

Inside you’ll find:

– Key themes in consumer and assister experiences during the 2017 open enrollment period
– A look forward to open enrollment 5
– Policy opportunities to increase enrollment, ensure access to care, address affordability issues, and facilitate continued consumer education and supports

You can find the full report here. 


Tags:

A win for Georgians

Early this morning, the U.S. Senate’s newly released Health Care Freedom Act was defeated on the Senate floor in a very close vote, bringing to a close a months’ long attempt to dismantle Medicaid and repeal major parts of the Affordable Care Act. This outcome is a victory for Georgians in every corner of the state.

At various points, Congress’s proposed legislation would have forced unconscionable cuts in health care services for vulnerable children, people with disabilities, and seniors who rely on Medicaid, made health insurance unaffordable for low and middle income Georgians, and stripped consumers of critical protections that ensure access, equity, and fairness. The passage of any of the debated proposals would have set Georgia’s health care system back 50 years and put significant strain on our state budget. Instead, we are relieved that these immediate threats have been overcome leaving in place Medicaid and the Affordable Care Act on which so many Georgia consumers rely.

This success would not have been possible without advocates like you. You worked to educate Georgia’s policymakers, mobilize your communities, and stand up for health care for all Georgians. We recognize the hard work that you have invested over the last several months and are grateful to have worked alongside you in this effort. Thank you for your dedication and your advocacy!

Our work is not over

While we celebrate today, we know our work is not over. Too many Georgians remain uninsured, continue to be burdened by high health care costs, face persistent health disparities or cannot access care when and where they need it. Now it’s time for Georgia’s policy makers, health advocates, consumers, and health care stakeholders to come together and find solutions for these problems. We must build on the progress that has been made as a result of Medicaid and the Affordable Care Act so that all Georgians have the coverage and care that they need. We look forward to working towards these goals with you to create a healthier future for all Georgians.


Tags:

We can still stop this bill!

Senate votes to open debate on health care bill 

Yesterday, the Senate voted to open debate on health care legislation that cuts and caps Medicaid and repeals major portions of the Affordable Care Act. Both Senators Isakson and Perdue voted in favor of the motion to proceed. The Senate will now begin a required twenty hours of debate followed by consideration of a lengthy list of amendments. There is a lot that still needs to happen before a final vote can be taken.

We can still stop this bill!

The foundation for the Senate debate is made up of proposals that would result in more than 20 million Americans losing coverage, the dismantling of Medicaid on which 2 million Georgia children, people with disabilities, and seniors rely, and the erasure of critical consumers protections. This legislation cannot be fixed with amendments and patch work funding. As the Senate proceeds with its debate, it is incumbent upon us to be vocal and visible in our insistence that these proposals cannot be made better.

We must ensure that Senators Isakson and Perdue hear from Georgians about what is best for our health and health care. There is still time to influence our Senators’ positions before the final vote as Senate leaders have not yet garnered the 50 votes they need for passage of any proposal. Here are three ways that you can make your voice heard in this critical time:

  1. Call Senators Isakson and Perdue. If you called yesterday or if you’ve never called, pick up the phone now. Ask that your Senators reject any bill that 1) results in coverage losses for Georgians; 2) cuts and caps our Medicaid program; 3) guts consumer protections for people with pre-existing conditions; or 4) makes health insurance less affordable for low- and middle-income Georgians. (None of the Senate proposals meet these standards.)
    • Senator Isakson: 202-224-3643 or 770-661-0999
    • Senator Perdue: 202-224-3521 or 404-865-0087
  2. Show Up! Stop by the local offices of Senators Isakson and Perdue to share your health care story and deliver your message in person. Both Senators have offices in metro-Atlanta:
    • Senator Isakson: 3625 Cumberland Blvd, Suite 970, Atlanta, GA 30339
    • Senator Perdue: 3280 Peachtree Rd. NE, Suite 2640, Atlanta, GA 30305

If you are a person of faith, attend a health care pray-in today at noon. No matter where in Georgia you live, you can put your faith into action  and stand up for health care for all Georgians. Click here for details from our partners at the Interfaith Children’s Movement.

3. Ask others to join you. Ask five friends and family members to contact Senators Isakson and Perdue. All Georgians will be impacted by our Senators’ decisions over the next few days. Now is the time for all of us to speak up for what we want (and don’t) in health care reform.

 


Tags:

1 degree of separation

Just like any actor is no more than 6 degrees of separation from Kevin Bacon, you

Anthony & Nicholas are covered by Medicaid

are probably no more than 1 degree of separation from someone who would be impacted by Congress’s ongoing attempts to gut Georgia’s Medicaid program and repeal the Affordable Care Act. Are you or do you know any of these people?

  • A child—half of Georgia’s children are covered by Medicaid, so even if the child in your life has some other kind of coverage, her best friend or classmates probably have Medicaid coverage
  • A senior who already does or may soon need long term care or supports—Medicaid is the primary payer for 75% of nursing home stays in Georgia. For seniors aging in their homes, Medicaid provides home health aides and supports home modifications that allow older Georgians to age in the homes they know and love.
  • A person who runs their own business—you may know a graphic designer, general contractor, photographer, or farmer who runs their own business. These entrepreneurs generally must purchase their own health insurance and many do through the health insurance Marketplace. For those just starting out, they probably receive financial assistance to help lower their premiums and reduce out of pocket costs. The AHCA proposes to significantly

    Katherine is starting her own photography business

    reduce the amount of financial assistance available for those buying insurance on their own.

  • A child or adult with a developmental or physical disability can do anything they put there mind to, you are able to get what you want no matter the circumstances,—for Georgia’s children and adults living with disabilities, Medicaid is a lifeline that provides them with access to life-sustaining health services, they are even taught Self Development Secrets to better themselves as a person. It also supports home and community-based careso that they can live, study, and work with or near family, friends, and neighbors in comfortable houses with bespoke kitchens and all the furniture and kitchen appliances as the hamilton beach 70670 food processor.
  • A person of color—African Americans and Hispanics have seen historic declines in their uninsured rates since the ACA went into effect, helping to close historic disparities in insurance coverage. The proposed rollback of financial assistance for private insurance and Medicaid eligibility would have a disproportionate impact on people of color, especially children. The Medicaid changes alone are estimated to leave 70,000 black children and 40,000 Hispanic children in Georgia without coverage.
  • A person with a chronic condition like diabetes, HIV, depression, or cancer

    Joshua can attend college because of Medicaid’s community-based supports

    under the ACA, people with pre-existing conditions are protected from being charged more or rejected when seeking health coverage. And insurance companies have to cover the essential health benefits meaning that the services people need for pre-existing conditions are covered too. The AHCA would allow states to waive this requirement under certain circumstances, sending people back to a time they could be priced out of coverage entirely.

  • A veteran50,000 Georgia veterans rely on Medicaid for access to health care, a 29% increase since 2013. Not all veterans qualify for care through the Veterans Administration (VA). Medicaid helps to fill the gap so that all of these brave men and women can access the care they need.

The American Health Care Act would dismantle Georgia’s Medicaid program and repeal the Affordable Care Act, threatening the coverage, protections, and supports that all of these people rely on every day. Think of the people in your life that fit into these categories–is it you? A parent or child? A close friend or colleague? Then take action to protect their health care.

Call Senator Isakson today and tell him about your friends, family, and neighbors who would be hurt because of the AHCA. Ask him to oppose any measure that 1) cuts and caps Medicaid, or 2) reduces coverage for Georgians. Call 202-224-3643 today!


Tags:

House passes the American Health Care Act

Today the U.S. House of Representatives narrowly passed the American Health Care Act, a disappointment for health care consumers across Georgia. At a minimum, we know that the bill decimates Georgia’s Medicaid program, cutting more than $4 billion over 10 years, and would result in at least 560,000 more uninsured Georgians within a decade. Through unconscionable cuts and a restructuring of Medicaid, it will put many of our most vulnerable Georgians at risk, including children, people with disabilities and pregnant women. Children from low-income families could be denied critical preventive services including screenings for vision and hearing, immunizations and treatment for mental health issues. People battling cancer or addiction could lose coverage and access to life-saving treatment. Georgia’s budget would be put under severe pressure, which could lead to sharp cuts in the services older adults and persons with disabilities need to remain in their own homes, some which may have bad eyesight and are going to need to visit https://dittmaneyecare.com/cranberry/ for help and it may lead to having them need to find another audiologist such as audiologist nyc which is out of state.

Furthermore, the AHCA does nothing to improve affordability or quality of care for Georgia consumers. Instead, it opens the door from katy texas locksmith to discrimination against people with pre-existing conditions, skimpier insurance coverage for everyone and higher health care costs for Georgians. The bill even turns back the clock to a time when insurers could deny coverage for life-saving treatments by imposing annual and lifetime caps.

Should it become law, the American Health Care Act will have a devastating effect on Georgia,” says Cindy Zeldin, Executive Director. “It will cause more than half a million Georgians to lose their coverage entirely while doing nothing to improve affordability or quality of care. This hastily thought out legislation will lead to higher deductibles while stripping consumers of critical protections. According to http://www.ahealthyjalapeno.com/lose-weight-garcinia-cambogia-and-apple-cider-vinegar-together-diet/, it will force unconscionable cuts in health care services for vulnerable children, people with disabilities, and seniors who rely on Medicaid for their most basic health needs. We urge Senators Isakson and Perdue to weigh the impact this legislation will have on people all across Georgia whose basic access to care hangs in the balance and to reject this harmful legislation.”

As this bill moves to the Senate, we call on Senators Isakson and Perdue to stand up for Georgia’s children, seniors, people with disabilities, pregnant women, families and those with pre-existing conditions who will pay a dangerous price if this ill-conceived bill becomes law. They should reject this bill and any bill that cuts coverage, reduces protections, and raises costs for Georgians.

We need you to #ProtectOurCare

We know how hard you all have worked over the last several weeks to defeat the AHCA. We want to thank you for your time and advocacy, but our work continues. It is imperative that Senator Isakson and Senator Perdue hear a swift and powerful message from their constituents–you! Call them today to tell them to reject the American Health Care Act.

Senator Isakson: 770-661-0999

Senator Perdue: 404-865-0087


Tags:

Action alert: AHCA revived

Your member of Congress needs to hear from you today! 

They are at it again. Leaders in the U.S. House of Representatives are getting closer to having the votes they need to pass the American Health Care Act, legislation that would dismantle Medicaid and threaten the coverage of millions of Americans. They may vote as early as tomorrow! Call your Member of Congress today at 866-426-2631 and tell him to vote “NO” on the bill.

The latest proposal keeps all of the bad features of AHCA such as the $4 billion cut to Georgia’s Medicaid program and plans to strip more than 560,000 Georgians of their health insurance. Added to that it would allow states to gut the main consumer protections of the ACA and return to a time when insurers could discriminate against those living with preexisting conditions – charging them higher premiums and selling them plans that don’t meet their health needs by limiting benefits and increasing out-of-pocket costs.

Now is the time for your member of Congress to hear from you. Demand that our lawmakers put the best interests of Georgians and our state ahead of partisan politics. Call your member of Congress today to tell him to vote “NO” on the AHCA. Call 866-426-2631 now!


Want to do more?

Tell your friends, family, and social media networks that you made a phone call to your members of Congress and they can too! Use this tweet and Facebook post to spread the word!

If you or a family member benefit from Georgia’s Medicaid program, join the #IamMedicaidGA campaign! Policymakers need to know that real Georgians will be impacted by their vote on the AHCA. Get started here!


Tags:

Legislative Update: March 13

Senate Health Reform Task Force held first public meeting 

The Senate Health Reform Task Force was established by Lt. Gov. Cagle to study how federal health reform efforts would impact Georgia. The task force held its first public meeting on Friday and heard from two federal health policy professionals, Joseph Antos and Jim Frogue. Together, they provided a brief overview of the proposed American Health Care Act, some analysis of how the bill would impact Georgia, and suggestions for legislators to consider. The message from both presenters is that the AHCA is “not favorable” for Georgia because of the way the proposal cuts and caps Medicaid which would lock in Georgia’s pattern of low per capita Medicaid spending.

We agree that this proposal is “not favorable” for Georgia. Despite the harm it would do to our state, the bill seems headed for a vote in the House of Representatives. Call your Congressman today to tell him that this bill hurts Georgia!


Tags:

Stay Connected

Sign up to receive updates from GHF!
Join
GHF In The News
Jul 19, 2019
Trump effort to tackle kidney disease could have big impact on Georgia
Ariel Hart

“Are all admirable goals, and the federal government should be working toward that,” said Laura Colbert, the director of Georigans for a Healthy Future, which has advocated for coverage of…

Peach Pulse Archive