“It will do monumental things for people who get covered and can go to the doctor and get prescriptions filled and have some peace of mind that they can take…
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.
An analysis conducted by Dr. Bill Custer of Georgia State University and released today by the Healthcare Georgia Foundation finds that, if Georgia policymakers choose to accept the $40.5 billion in federal funds available to the state between 2014 and 2023 to expand Medicaid, this infusion of resources would create more jobs in Pensacola FL and 70,000 jobs countrywide, adding an annual $8.2 billion to statewide economic output and generating $276 million in state and local tax revenue annually.
As part of the Affordable Care Act, states can create a new eligibility category for Medicaid for people with incomes up to 138 percent of the federal poverty level, or approximately $15,850 for an individual or $26,950 for a family of three. In Georgia, according to the report, about 694,000 people would gain health coverage under this expansion, mostly childless adults and some parents.
To date, Governor Deal has rejected the offer to expand coverage citing concerns about the cost to the state. As this new report details, however, expanding Medicaid would be an economic engine for Georgia. Of the more than 70,000 jobs that would be created, just over half would be in the health care sector; however, other industries such as real estate, food services, and wholesale trade businesses would also gain jobs. The report also shows the geographic distribution of jobs created throughout Georgia by state service delivery region. To read the full report, click here.
The 2013 Legislative Session continues at a swift pace, with legislators in session today for day 17 of the 40-day session (the legislative calendar is available here). Here are some key health care updates:
- Yesterday, the Health Subcommittee of the House Appropriations Committee heard from the Commissioners of the state’s health-related agencies, including the Department of Community Health and the Department of Public Health, about their proposed FY 2014 budgets. Today, the subcommittee will meet again from 2 – 4pm in Room 506 CLOB to take public comment on the proposed budgets. If you would like to comment, you must sign up in advance in Room 245 of the State Capitol. The Georgia Budget & Policy Institute has released an analysis of the 2014 proposed budget for the Department of Community Health, available here.
- 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 is expected to be signed into law by the Governor this morning. 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.
- HB 198 would require navigators to be licensed, place certain restrictions on their functions, and would give the Georgia Insurance Commissioner regulatory authority over them. Navigators are organizations or entities that apply for and receive federal grants authorized by the Affordable Care Act to provide individuals and small businesses with impartial information and assistance with enrollment in health coverage in the new health insurance marketplaces, or exchanges. While it is important that navigators are qualified to perform these functions and that there is adequate oversight to protect consumers, consumer advocates are also concerned that overly restricting navigators could have a chilling effect on the community-focused organizations whose participation in the navigator program will be critical in connecting hard-to-reach and vulnerable populations to coverage. Advocates worked with legislators to improve the bill, which passed the House Insurance Committee last week and was passed by the Rules Committee yesterday.
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.
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.
Each year, Georgians for a Healthy Future develops policy priorities that guide our advocacy work on behalf of health care consumers. Below are the legislative and policy priorities we are supporting in 2013.
Extend health insurance coverage to a substantial portion of Georgia’s uninsured by expanding Medicaid. Approximately 1.9 million Georgians are uninsured, many of whom are low-income working adults without access to an employer-sponsored health plan. An estimated 650,000 of these Georgians could gain health insurance coverage in 2014 at minimal state cost by extending Medicaid to those newly eligible through the Affordable Care Act. The infusion of federal Medicaid dollars into Georgia will both support our state’s health care delivery system and foster economic growth. Georgians for a Healthy Future supports expanding coverage through Medicaid to individuals and families with incomes up to 133 percent of the federal poverty level.
Preserve and strengthen consumer protections for Georgians in private health insurance plans through both federal and state advocacy. The private health insurance marketplace is rapidly evolving, largely as a result of changes spurred by the Affordable Care Act. As these reforms are implemented, it is critical that the consumer perspective is represented in the policy-making process and that rules and regulations incorporate consumer needs. Many of the decisions that would impact health care consumers are currently being made by the U.S. Department of Health and Human Services and the National Association of Insurance Commissioners. To that end, Georgians for a Healthy Future will monitor and advocate on behalf of Georgia consumers on issues including the development of a federal health insurance exchange, essential health benefits, and other private market reforms. At the same time, Georgia policymakers retain authority over many aspects of our state’s health insurance marketplace. Georgians for a Healthy future will continue to support efforts that preserve and strengthen patient and consumer protections and oppose state legislation that places these protections at risk.
Ensure access to quality health care for Medicaid and PeachCare beneficiaries. The Medicaid and PeachCare for Kids programs provide health insurance for our state’s most vulnerable citizens. Georgians for a Healthy Future will monitor legislative and agency level activity and support proposals that facilitate continuous coverage and enrollment, preserve and expand access to care, and improve health outcomes. Because ensuring access to quality care for Medicaid and PeachCare beneficiaries also requires a Medicaid system that is financially sound, Georgians for a Healthy Future will support proposals that ensure the program is adequately funded and will oppose cuts to the program, including cuts to provider reimbursement rates, which jeopardize access to care. We will also continue to monitor the Georgia Department of Community Health’s Medicaid redesign process.
Strengthen Georgia’s public health system. Our state’s 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 these services and a growing awareness of the importance of social determinants to community health outcomes, Georgia’s per capita public health spending is among the lowest in the nation. Georgians for a Healthy Future supports a robust, adequately funded public health system to meet the 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 of at least a dollar per pack. Tobacco taxes are a proven strategy with the dual benefit of bringing in additional state revenue and improving the health of Georgians by reducing adult and youth smoking.
Support policies and practices that advance health equity. In addition to overall health outcomes and indicators that consistently place Georgia in the bottom tier nationally, our state has considerable health disparities between communities. Racial and ethnic minority communities, rural and low-income urban communities, and those with disabilities and chronic mental illness, all experience worse health and worse opportunities for health than their peers. Georgians for a Healthy Future will continue to support policies and practices that advance the opportunities for optimal health for all Georgians.
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 1st 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.
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.
By Dr. Harry J. Heiman and Cindy Zeldin
This column was originally published in the Athens Banner-Herald on August 26, 2011.
The recent debt-ceiling debate and prime-time display of our elected leaders’ inability to work together epitomized the challenges of advancing thoughtful and impactful public policies. Following the deal in Congress, news coverage quickly moved to speculation about the “super committee,” tasked with slashing an additional $1.2 trillion in federal spending over the next decade. Lost in the coverage, and seemingly in the discussion, has been the potential impact of the committee’s decisions on vital services for the most vulnerable in our communities. At a time when the number of people without health insurance continues to rise, Medicaid and other programs that support health care access for low-income children, families, and the disabled remain at risk.
Reduced federal and state funding for Medicaid and the health safety net would be particularly traumatic for Georgia, which has been hit hard by the economic downturn and suffers from high poverty, high unemployment, and high rates of uninsured people. Nearly two million Georgians — one in five — are uninsured, and more than one in six live in poverty. These numbers are even worse in many of Georgia’s rural and inner-city communities. At 37 percent, Athens-Clarke County has one of the highest rates of uninsured people in the state. The consequence of these worsening economic indicators is increased distress experienced by Georgia’s most vulnerable citizens. This distress is reflected in Georgia’s dismal health indicators: high obesity rates, high infant mortality rates and overall poor health outcomes.
Recent attempts within states to scale back vital health care programs for our most vulnerable citizens at a time when they are critically needed is cause for concern. The move began with Arizona Governor Brewer’s request to the federal government for a waiver from stability protections that prevent states from restricting eligibility levels for the Medicaid program. In response, Georgia Governor Nathan Deal’s spokesperson was quoted by Bloomberg news organization earlier today that while the Governor has not offered specific cuts, he “would happily work on such a proposal.”
Georgians for a Healthy Future recently joined 2020 Georgia—a broad alliance of community leaders and organizations—as an alliance partner. While members of 2020 Georgia range from small, community-based nonprofits to large, statewide organizations, all share the common goal of a balanced approach to state budget and revenue solutions that meet the short and long-term needs of our state and its people. In advance of the first meeting of the 2010 Special Council on Tax Reform and Fairness for Georgians, which has a charge to study the tax system and report to the General Assembly in January 2011, 2020 Georgia released a fact sheet on why tax reform matters for Georgia. It is below in its entirety.