GHF is excited to welcome Lois Hairston as the organization’s new Story Collection Coordinator. In this role, Lois will work to collect, develop, and share the stories of Georgia individuals and families as part of GHF’s Close the Gap initiative.

Lois is a graduate of Old Dominion in Virginia, where this past year, she served as the Communication and Membership Chair for the University’s Black Alumni Chapter. Her professional background includes experience with marketing agencies in Virginia and the District of Columbia, where she managed direct marketing campaigns for clients such as the Democratic Governors Association and the HealthWell Foundation. Recently, in her role as Communications Manager for Youth Entrepreneurs, Lois managed the creation of branded content and acted as the public relations liaison for the national nonprofit.

Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times.

We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.

Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.

We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.

Legislative Update: Week 10

Risky health care waiver bill passed by House committee

Last Wednesday, the House Special Committee on Access to Quality Health Care held a hearing on SB 106, the Patients First Act. GHF’s Executive Director, Laura Colbert and several Cover Georgia coalition members testified and emphasized the need for changes in the bill. Read Laura’s full testimony here.

As we have previously reported, the legislation allows for an 1115 waiver to extend Medicaid coverage to some adults making up to 100% of the federal poverty level ($12,100 annually for an individual). GHF and its partners requested that the income cap be lifted to 138% FPL so that it would cover more Georgians at a lower cost to the state. As currently written, the bill would leave out thousands of Georgians who earn just above the poverty line and who would be covered under a traditional Medicaid expansion or a broader 1115 waiver. SB 106 also allows the state to make potentially dramatic changes to private health insurance in Georgia through 1332 waivers with little accountability. The bill now sits in the House Rules committee and is expected to receive a vote on the House floor sometime next week.

There is still time for the House to make changes to SB 106 so that it covers more people and costs less. Read more about SB 106 CoverGA.org and then contact your state representative to let them know that we need to amend this bill to cover every eligible Georgian!

Behavioral health commission passes in both chambers

Georgia Mental Health Reform and Innovation Commission passed by Senate

The Senate passed an amended version of HB 514 on Thursday. This bill, 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. Changes to the bill in the Senate included additions to the make-up of the Commission so that it includes a professional who specializes in substance abuse and addiction, and a representative of a community service board to serve as a nonvoting member of the 23-member panel. The bill will now return to the House to receive an “Agree” on the changes made in the Senate and will then go to the Governor’s desk to be signed.

HIV prevention & treatment bills move forward in the Senate

Two HIV-related bills move forward in Senate committee

Two significant pieces of HIV-related legislation passed the Senate Health and Human Services committee last week. HB 217, which would decriminalize the act of working or volunteering for a syringe services program and HB 290, which would would establish a pilot program to provide preexposure prophylaxis (PrEP) drug assistance or services to persons at risk of being infected with HIV will now go to the Senate Rules Committee to await a vote by the full Senate. A third bill, HB 158 would improve Medicaid coverage but has not yet been taken up by the Senate HHS committee. Georgia currently leads the U.S. in the rate of new HIV cases diagnosed each year and all three bills would contribute to the slowing of the epidemic by preventing new infections and improving care for people currently living with the condition. (For more details on all three pieces of legislation, see our February 26th legislative update).

What happened last week

Recess legislation passes in Senate committee

The Senate Education and Youth committee voted to pass HB 83 last Thursday. This bill 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.

Healthy housing legislation makes progress in Senate

Georgians for a Healthy Future is a member of the Healthy Housing Georgia coalition because evidence shows the strong and direct influence housing has on a person’s health. The coalition supports HB 346 which passed with amendments by the Senate Judiciary committee last week. This bill would 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. Georgia is the only state in the country that does not protect tenants against unsafe and uninhabitable housing conditions with a “warranty of habitability.” The Senate Rules committee will now decide when the legislation may receive a vote on the Senate floor. (For more details on the legislation, see our March 5th legislative update.)

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.

• 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.)

GHF’s Executive Director Laura Colbert provided testimony to the House Special Committee on Access to Quality Health Care on SB 106 and the risks this legislation poses for consumers as it is currently written.

Testimony of Laura Colbert, GHF’s Executive Director
March 20, 2019

“Thank you Chairman Smith and members of the committee.  My name is Laura Colbert and I am the ED of GHF. We represent health care consumers across Georgia and work to build a future in which all Georgians have the quality, affordable health coverage and care they need to live healthy lives and contribute to the health of their communities.

First, we want to thank Governor Kemp, Senator Tillery and Representative Lott for your work on this bill. We are excited that this very important conversation is moving forward. We appreciate your open door and on-going dialogue with us on this issue.

Like my colleagues before me, GHF agrees with the goals of this bill and we are pleased by the prospect of meaningful coverage for 240,000 Georgians who live below the poverty line. We are to balance that with our consternation that 200,000 uninsured Georgians who make just more than the poverty line may remain uncovered by this bill as it’s written.

Georgians with insurance coverage are healthier, better able to work and go to school, have less medical debt and better credit scores, and have healthier families, among other benefits. While Georgians below the poverty line are sure to reap these benefits after gaining coverage, those just above it likely will not if SB 106 is not amended to specifically include them.

Based on other states’ coverage expansions and the affordability information provided to you by Ms. Haynes at Georgia Watch, it is clear that many near-poor constituents are likely to face significant cost-related barriers to health care, even with the ACA’s financial assistance. While Georgians in this income range can afford more than those below the poverty line, it is unrealistic to expect them to pay as much as 20% of a person’s $14,000 yearly wage or a family of four’s $30,000 salary for health care. An investment that large for families barely making ends meet effectively keeps them locked out of the health care system, only experiencing the benefits of coverage in emergency situations. The financial protection and access to care provided by Medicaid can better serve as the stepping stones for these families to climb into Georgia’s middle class.

Georgia is at the table now, and we have the opportunity to get this right for all Georgians on the first try.

That is why we recommend that this committee amend the bill to expand eligibility to 133% FPL and cover more Georgians for fewer state dollars. Georgia is at the table now, and we have the opportunity to get this right for all Georgians on the first try. Or consider removing the percentage provision altogether so that the bill is silent on the exact income limit, providing flexibility to the state to negotiate the waiver specifics that work best for Georgians and Georgia’s budget, particularly in the likely event that CMS is unable to provide an enhanced match rate for a partial expansion.

I also want to briefly turn to the second part of the bill concerning Section 1332 State Innovation waivers. A 1332 waiver to establish a reinsurance program would help thousands of Georgians by reducing insurance premiums and attracting more insurers to the marketplace. GHF stands in support of such efforts. However, the legislation as currently written is so broad that it leaves the door open to many more changes, some of which could destabilize Georgia’s marketplace and jeopardize access to care for Georgians covered by individual or small-group health insurance.

We recommend that this committee consider narrowing the scope of an allowable 1332 waiver by specifying that the state is authorized to establish a reinsurance program or, if other proposals may be considered, lay out criteria that any innovation waiver must meet. Georgians for a Healthy Future has laid out four criteria that we believe are critical to ensuring that any 1332 waiver benefits consumers without putting vulnerable groups at risk.

We appreciate your consideration of our suggestions and hope that we can act as a resource for the state as it drafts these waivers. Thank you very much for your time and your efforts on behalf of all of the health care consumers in your districts.”

Legislative Update: Week 8

Crossover Day brings legislative action late into the night

Last Thursday was the 28th day of the Georgia legislative session, which is also referred to as Crossover Day. Crossover Day is the final day for a bill to cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. This week’s legislative update provides a rundown of consumer health legislation: which bills made it through and which did not. You can see a list of all the bills we’re tracking here. (Note: After a flurry of activity last week, we are still working to update our legislative tracker with the current status of each bill. So while many of the bills are updated, it is best to find the bill you are interested in and click through to find the full information on the bill’s statis on legis.ga.gov.

Our priorities

Surprise billing legislation moves forward

SB 56, sponsored by Senator Chuck Hufstetler, received approval by the full Senate on Wednesday and may be considered by the House Insurance Committee in the coming weeks. The legislation aims to improve transparency for consumers who may be subject to a surprise out-of-network bill. 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. This bill now sits in the House Insurance committee. (For more details on the legislation, see our February 11th legislative update.)

Legislation to fully expand coverage stalls; Patients First Act advances

HB 37, the Expand Medicaid Now Act, and SB 36 sponsored by Representative Bob Trammell and Senator Steve Henson respectively, did not receive hearings and did not cross over last week. Each bill was written to expand Medicaid in Georgia as envisioned by the Affordable Care Act.

Meanwhile SB 106, the Patients First Act, has moved quickly through the Senate in the weeks before Crossover Day. The legislation, as written, would allow the Department of Community Health to request an 1115 waiver to extend Medicaid coverage to adults making up to 100% of the federal poverty level (FPL) ($12,490 annually for an individual). This “partial expansion” would leave out thousands of new-poor Georgians who are meant to be similarly covered according to federal health law 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. The bill will now awaits a hearing from the House’s Special Committee on Access to Quality Healthcare.

Healthy housing legislation moves to Senate committee

Georgians for a Healthy Future is a member of the Healthy Housing Georgia coalition because evidence shows the strong and firect influence housing has on a person’s health. The coalition supports HB 346, which would 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. Georgia is the only state in the country that does not protect tenants against unsafe and uninhabitable housing conditions with a “warranty of habitability.” This bill now sits in the Senate Judiciary committee. (For more details on the legislation, see our March 5th legislative update.)

Crossover day recap

HB 30: Amended FY 2019 Budget | CROSSED OVER

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 Saturday, March 9th.

HB 31: FY 2020 Budget | CROSSED OVER

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. The Senate will continue to hold hearings on the “big budget” this week. 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 CROSS OVER

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 63: Step therapy legislation: CROSSED OVER

HB 63, sponsored by Rep. Sharon Cooper, would 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.

HB 84: Provider network transparency | DID NOT CROSS OVER

HB 84, sponsored by Rep. Richard Smith, increases transparency related to possible surprise medical bills. The legislation requires that information on billing and the providers that a consumer may encounter during a course of care must be provided to the consumer at their request. In circumstances where a consumer receives a surprise bill, HB 84 also allows for arbitration between the consumer and the health care provider, the specifics of which would be determined by Georgia’s Department of Insurance.

HB 158: Improve Medicaid patient access to effective HIV treatment | CROSSED OVER

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.

HB 198: Eliminate certificate of need requirements | DID NOT CROSS OVER

HB 198, sponsored by Rep. Matt Hatchett, would change the certificate of need process that is used to regulate health care facilities. The bill also included requirements for increasing transparency of hospital financial information and an increase in the rural hospital tax credit from $60 million to $100 million.

HB 217: Needle exchange program | CROSSED OVER

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 | CROSSED OVER

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 321: Medicaid financing program | CROSSED OVER

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 | CROSSED OVER

HB 514, sponsored by Rep. Kevin Tanner, would create the Georgia Mental Health Reform and Innovation Commission 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 | CROSSED OVER

SB 16, sponsored by Sen. Kay Kirkpatrick, would allow Georgia to enter the “Interstate Medical Licensure Compact Act” 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.

SB 74: Eliminate certificate of need requirements | DID NOT CROSS OVER

SB 74, sponsored by Senator Matt Brass, would eliminate certificate of need requirements for all health care facilities except certain long-term care facilities and services. This bill is the Senate companion piece to HB 198. Both bills aim to change the current certificate of need structure which regulates hospitals in Georgia.

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.

• 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.)

For the first time in Georgia, there is widespread and bipartisan agreement among Georgia’s Governor and legislative leaders about the pressing need to provide health insurance to more Georgians. To address the state’s rising uninsured rate, Governor Brian Kemp has put forth a bill, SB 106 (also called the Patients First Act), that would allow the state to submit two kinds of health care waivers:

• A Medicaid 1115 waiver that could be used to extend coverage to more low-income Georgians, among other reforms; and
• 1332 State Innovation waivers that would make changes to Georgia’s private health insurance marketplace.

(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.)

While the legislation’s goal to extend affordable, quality coverage to more Georgians is one with which GHF wholeheartedly agrees, the bill currently falls short by limiting the number of people who would benefit, increasing the likely costs to the state, and leaving to door open to an erosion of critical consumer protections.

SB 106 limits a future 1115 Medicaid waiver to cover only adults making up to 100% of the federal poverty line (FPL) ($12,490 for an individual and $21,330 for a family of three per year). While this would cover 240,000 more Georgians than are currently eligible for Medicaid, the cut-off leaves out an estimated 200,000 uninsured Georgia adults making just more than poverty-level wages (up to 138% FPL). These Georgians make up to $17,296 for an individual and $29,435 for a family of three.

The Affordable Care Act envisioned that all adults making up to 138% FPL would be covered by Medicaid and provides states with an incentive to do so. States that extend coverage to these newly-eligible adults pay only 10% of the costs and the federal government picks up the rest (90%) in perpetuity.

If Georgia’s leaders approve SB 106 in its current form and leave out the adults just above the poverty line, our state will miss out on the ACA’s “enhanced match rate”. Wisconsin is the only other state that has opted to take this route, and as a result, has paid $1.1 billion more to cover 80,000 fewer people.

A small change to the language in SB 106 would give the state the flexibility to increase coverage to people up to 138% FPL, allowing the state to cover an estimated 440,000 Georgians at a lower cost.

The second part of SB 106 allows Georgia to submit at least one 1332 State Innovation waiver. These innovation waivers were created by the ACA to allow states to test different approaches for providing primarily private health insurance to their residents. At the same time, the law established “guardrails” for 1332 waivers to ensure consumers were sufficiently protected. Unfortunately, these guardrails have been greatly weakened in recent months leaving consumers at risk.

So far, all eight states with approved 1332 waivers have carried out plans that benefit consumers—and Georgia could too. However, the broad language in SB 106 as currently written allows for proposals that could also create sizable and risky changes that harm consumers. For example, Georgia could allow the ACA’s financial help that is now available to consumers to buy coverage to be used instead for the purchase of junk insurance plans. This would likely draw healthy consumers out of the ACA Marketplace to cheaper, low-quality plans and send insurance premiums into an upward spiral for consumers with pre-existing conditions who need comprehensive coverage.

Georgia’s legislators could narrow the scope of allowable 1332 waivers by specifying that the waiver must be used for a specific beneficial reason, like establishing a reinsurance system to lower insurance premiums, or by laying out a set of principles that the waiver must meet to ensure Georgia consumers are fully protected. (GHF’s Executive Director proposed a set of consumer-friendly principles when she testified to the Senate Health & Human Services Committee in February.)

Georgia’s leaders have taken an encouraging step forward by proposing changes to state law that aim to increase access to care and address affordability concerns for Georgia families. A few small, meaningful changes to SB 106 would assure a path to affordable, quality health coverage exists for all Georgians.

Want to learn more? Here are a few resources that you may find helpful:

• Georgia Left Me Out fact sheet
• Understanding Medicaid in Georgia and the Opportunity to Improve It: A chart book
• What you need to know about waivers and Medicaid expansion by Georgia Watch
• What you need to know about 1332 waives and Georgia’s health insurance marketplace
• Getting Georgia Covered: What we can learn from consumer and assister experiences during the fifth open enrollment period

Follow changes and updates about SB 106 in GHF’s weekly legislative update emails.

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.

• 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.

Action Alert: Patients First Act falls short

Last week, state leaders introduced 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 legislation allows for an 1115 waiver to extend Medicaid coverage to some poor adults in Georgia but leaves out thousands who would be covered under a full Medicaid expansion. Additionally, the bill allows the Governor to make potentially seismic changes to private health insurance in Georgia through 1332 waivers with little accountability. While it is heartening that Georgia’s leaders see the need to create a pathway to coverage for more Georgians, this proposed legislation falls short for two reasons, both of which we’re asking you to take action on:

1. The proposed 1115 Medicaid waiver would cover fewer people at a higher cost than Medicaid expansion. It would leave out thousands of Georgians in need of coverage and leave the state accountable for a larger share of the medical costs for those who would be newly covered. Ask Governor Kemp and your state legislators to get the best deal for Georgia by covering all eligible Georgians. (Then plan to join us for Cover Georgia Day at the Capitol on February 28th!)

2. More than 480,000 Georgians rely on Georgia’s health insurance marketplace for health coverage, and many more are eligible. Changes made to private coverage through a 1332 waiver could benefit or harm these consumers, but the legislation, as written is too broad to determine its impact. Ask Governor Kemp and your state leaders to specify in the bill that any waiver will preserve critical consumer protections (like those that protect consumers with pre-existing conditions), maintain comprehensive, quality health coverage, support a stable marketplace through increased enrollment, and will not leave consumers on the hook for higher costs.

House passes step therapy bill

Step therapy legislation moves quickly through House

HB 63, a bill sponsored by Chairman of the House HHS Committee Representative Sharon Cooper, was passed by the House this week. HB 63 addresses step therapy, which 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. This bill would require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. HB 63 will now go to the Senate for consideration.

GHF releases annual consumer health advocate’s guide

A Consumer Health Advocate’s Guide to the 2019 Legislative Session

GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. This annual booklet provides information on the legislative process, legislators, and committees, key agency officials, advocate contacts, and more. Experienced advocates and new volunteers will find their way around Georgia’s Capitol more easily with the information provided in this year’s guide. Download or pick up your copy today.

(Interested in a hard copy? Contact Michelle Conde.)

RSVP for Cover Georgia Day

Join Cover Georgia at the state capitol on February 28th!

Join us on Thursday, February 28th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of all Georgians. For the first time in Georgia, there is wide-spread agreement among Georgia’s legislators that something must be done to extend coverage to low-income Georgians across the state. Take advantage of this opportunity to ask your elected officials to close Georgia’s coverage gap now! RSVP today!

Can’t make it? Call or send an email to your state legislators asking them to put an insurance card in the pockets of all Georgians.

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.

• 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

Georgians for a Healthy Future’s ninth annual Health Care Unscrambled breakfast built on previous years’ successes with another standing room-only crowd.

This year’s program began with a personal story from consumer Lori Murdock, who bravely shared her experience struggling to manage a chronic disease without health insurance because she was caught in Georgia’s coverage gap. Lori’s experience illustrates the pressing need to provide health insurance to all Georgians regardless of income.

Following Lori was our bipartisan legislative panel. This year’s legislative panelists were:

• Senator Kay Kirkpatrick
• Representative Debbie Buckner
• Representative Lee Hawkins

Each panelist provided updates on emerging health care trends impacting Georgia and took questions from the audience about what health issues are likely to be taken up in the 2019 legislative session. Topics included Medicaid expansion, surprise out of network medical billing, access to mental health,  network adequacy, Certificate of Need reform, social determinants of health, rural health care access, federal health care reform, and affordability of health care. All three panelists shared an optimistic vision for health care in this years legislative session.

This year’s key note speaker was Dr. David Blumenthal, President of the Commonwealth Fund. Dr. Blumenthal brought a wealth of knowledge and insight to our conversation about how innovations in health care and coverage can help us achieve better health outcomes for all Georgians. He led the discussion by comparing Georgia’s health outcomes to those of our neighboring states, and then provided an agenda for improvement. He emphasized that Georgia is unlikely to overcome poor health outcomes unless state leadership improves insurance coverage, as demonstrated by the Commonwealth Fund’s own research on Medicaid expansion’s impacts on population health. Dr. Blumenthal also shared the importance of investments in the social determinants of health for improving health outcomes and ultimately saving money. Dr. Blumenthal’s presentation can be accessed here and the Georgia scorecard from the Commonwealth Fund can be found here.

To see photos, review materials, and get more information about this year’s Health Care Unscrambled event, please visit the event page.

For more event pictures visit our Facebook photo album. 

Medicaid provides health care coverage to almost two million Georgians, including 1.3 million children across the state and 500,000 seniors and people with disabilities. It’s comprehensive coverage provides needed health care services that would otherwise be unaffordable to low-income Georgia families and individuals in communities across the state. Because Medicaid is so fundamental to Georgians and Georgia’s health care system, GHF is highlighting it in two new resources!

The Medicaid Matters to Georgia storybook shares the real health care stories of Georgia children and families. Georgians from across the state share the important role that Medicaid plays in their lives. Hear directly from Sherry, Travis, Oliver, and others about their experiences. Oppositely, Mary, Susie, and other uninsured Georgians share how Medicaid coverage could improve their lives if state policy makers closed Georgia’s coverage gap.

Our new Medicaid Matters for Georgia fact sheet is updated with what you need know about Medicaid. This one-page fact sheet outlines who is eligible for Medicaid in Georgia, what health services and supports are covered, and why Medicaid is a good investment for Georgia.

GHF’s new resources bring attention to the difference Medicaid makes in the lives of Georgians every day and the potential it has to serve those who are currently uninsured. We hope these new resources help policymakers, advocates, and consumers from across the state better understand the importance of ensuring all Georgians have access to quality, affordable healthcare. We invite you to read and share both with your friends, colleagues, and partners.

Georgians for a Healthy Future is partnering with community groups across the state to host Georgia Voices for Medicaid events. If you are interested in learning more about Georgia’s Medicaid program, who it covers, how it benefits the state, and how you can be a strong health care advocate, you should attend! Check out our events page to see if we have any Georgia Voices for Medicaid events happening near you or contact Alyssa Green at agreen@healthyfuturega.org if you would like to schedule one in your community.