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Developing essential health benefits: opportunity to provide input

Beginning in 2014, many health insurance plans, including those to be offered through the new state-based health insurance exchanges, must cover a minimum package of niagen preventive, diagnostic, and therapeutic services and products comparable to those offered in a typical employment-based plan, although some people that consume pain relieving drugs always struggle to be able to get hired, if you happen to be one of them there are sites where you’ll be finding the right solution for your employment issues. The specifics of the package are being developed right now by the U.S. Department of Health and Human Services (HHS), and HHS has encouraged consumer advocates to provide input. Here is how to weigh in:

 

Step 1: Learn more about essential health benefits and this process by reading issue summaries here and here or by participating in an upcoming webinar hosted by the National Academy for State Health Policy here.

 

 

Step 2: Prepare and e-mail your comments to ExternalAffairs@HHS.gov. HHS has requested that comments address some or all of the following 5 points below:

 

  • In keeping with the title of the Institute of Medicine report “Essential Health Benefits—Balancing Coverage and Cost,” how can the Department best meet the dual goals of balancing the comprehensiveness of coverage included in essential health benefits and affordability?

 

  • How might the Department ensure that essential health benefits reflect an appropriate balance among the categories so that they are not unduly weighted toward any category?

 

  • What policy principles and criteria should be taken into account to prevent discrimination against individuals because of their age, disability status, or expected length of life as the Affordable Care Act requires?

 

  • What models should HHS consider in developing essential health benefits?

 

  • What criteria should be used to update essential health benefits over time and what should the process be for their modification?

 


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GHF leads fight to protect new consumer-friendly health insurance standards

Last week, we sent an alert asking you to add your voice to our effort to ensure that exciting new health insurance standards that provide increased transparency and value for health care consumers, known as medical loss ratio rules, remain strong in Georgia. Your response was overwhelming!


Thanks to your strong support, Georgians for a Healthy Future and Georgia Watch are proud to announce that we jointly submitted public comments on behalf of 17 Georgia organizations to the U.S. Department of Health and Human Services (HHS) requesting that these new standards go through as planned. You can read our public comments here.


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Bills We’re Watching: HB 476

By Cindy Zeldin

 

On Friday, House Bill 476, which would establish the Georgia Health Exchange Authority, was introduced. The legislation sets up a governance structure for a state health insurance exchange and creates an advisory committee to advise the governing board on the design, implementation, and operation of the exchange and is tasked with providing a report containing specific recommendations based on a set of guiding principles delineated in the bill in December 2011. This legislation is a constructive first step towards creating a more competitive, consumer-friendly, and affordable health insurance marketplace in Georgia. The bill is on the agenda in the House Insurance Committee on Tuesday, March 8th at 4pm in Room 406 CLOB.

 


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Health Care and the Race for Insurance Commissioner

By Cindy Zeldin and Joann Yoon


On Election Day, Georgia voters will head to the polls to elect our state’s policymakers. Most voters are familiar with certain elected offices, like that of Governor, but many Georgians may be unaware of the importance, or perhaps even the existence, of the Office of State Insurance Commissioner.



The Insurance Commissioner runs the Georgia Department of Insurance and is elected every four years in a statewide vote. Among the core functions the Department of Insurance performs is the regulation of health insurance in Georgia. The Insurance Commissioner ensures that companies selling individual and small group policies in Georgia are financially solvent and enforces consumer protections and state laws regarding benefits that private insurers must include in policies sold in Georgia.



With the recent enactment of the Affordable Care Act, the new health care law, the role of the Insurance Commissioner has expanded. Our next Insurance Commissioner’s decisions will play an important role in shaping Georgia’s health insurance system for consumers in 2011 and well into the future.

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Struggling Georgians Deserve Better Health Care Options

By Cindy Zeldin


This piece originally appeared in the Macon Telegraph.


In these difficult economic times, the loss of a job is frequently compounded by the loss of the health insurance that had been tied to it. With unemployment rates hovering near 10 percent, more and more Georgians are facing this dual predicament.



For many recently unemployed Georgians, a popular program that subsidizes the continuation of employer-sponsored coverage has served as a lifeline since it was enacted into law in early 2009.  Under the program, known as the COBRA subsidy, most workers laid off between September 1, 2008 and December 31, 2009 were made eligible for a 9-month subsidy to ease the financial load of paying full freight to stay on their old plan.



In normal times, people losing their jobs can remain on their previous employment-based plan for 18 months by paying the entire premium, including the portion their former employer had previously contributed. For someone who has just lost his or her primary source of income, however, paying the entire premium can be cost prohibitive. To address this challenge, the subsidy puts COBRA coverage in reach for many Georgians:  according to a study recently released by Families USA, monthly premiums for subsidized COBRA coverage average $369 in Georgia, while the average monthly premium without the subsidy is $1,053.

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