“Separating Georgia from healthcare.gov puts people with pre-existing conditions, rural Georgians, and people of color at unnecessary risk of enrolling in substandard health insurance or becoming uninsured altogether,” said Laura Colbert of…
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Today Governor Kemp and the Centers for Medicare & Medicaid Services announced the approval of Georgia’s 1115 Medicaid waiver & pending approval of 1332 private insurance waiver. Laura Colbert, Executive Director of Georgians for a Healthy Future has issued the following statement:
“In the midst of a once-in-a-century health crisis, Georgians need & deserve bold action from their leaders. Unfortunately, the Governor’s health proposals miss that mark. The plans approved today are insufficient and ill-advised. Georgians deserve better.
“When both of these proposals are rolled out, it is likely that more Georgians will lose health coverage than gain it in the first year. When health insurance is more valuable than ever for the access to care and financial protections that it provides to families, state leaders would leave more Georgians uninsured.
“Under the proposals agreed to by Governor Kemp and federal officials today, individuals and families will have a more difficult time getting covered and staying covered. The Georgia Access plan would eliminate the option for people to easily compare health plans and enroll at HealthCare.gov, as tens of thousands do each year. It would also increase opportunities for insurers to take advantage of consumers. The Governor is touting lower premiums, but lower premiums are only beneficial if Georgians actually have health insurance.
“At the same time, the Medicaid proposal fails to extend coverage to all of the low-income Georgians who need coverage while leaving Georgia’s tax dollars on the table.
“Unfortunately, those who live in rural areas and people of color are the biggest losers under these proposals, further exacerbating the disproportionate burden they have carried during the COVID-19 pandemic.
“With a similar investment of state dollars and some political bravery from state leaders, more than half a million Georgians could gain health coverage under a full Medicaid expansion. That number would continue to grow with a modest outreach & enrollment program that helps middle-income families find affordable, private insurance through the ACA marketplace.
“What’s clear is that state and federal officials did not take seriously their responsibility to the 1.4 million uninsured Georgians and their families as they considered these waiver proposals. Georgians who commented on Governor Kemp’s Medicaid plan opposed it by a 9-to-1 margin. Nearly 1000 Georgians weighed in during the state comment period late last year and yet Georgia leaders submitted their plan with few changes to federal officials only three weeks later. Just as concerning, Gov. Kemp chose not to reevaluate this plan, even as COVID-19 emerged and changed everything.
“Similarly, the final public comment period for the Georgia Access proposal closed just three weeks ago on September 23rd. More than 1800 comments were recorded—the most ever on this type of health proposal. The overwhelming majority of those comments were in opposition and came not only from Georgians but from a wide array of respected organizations, like the American Medical Association and the Black Mamas Matter Alliance, as well as the American Academy of Pediatrics and the United Way. Despite this, Georgia has just earned one of the fastest approvals for the proposal.
“Everyone in our state should be concerned about the speed at which state leaders pursued these proposals, even in the face of steep opposition and compelling evidence that they will harm more Georgians than they will help. At every turn in this process, the most cost-effective, evidence-based, equitable, and practical solutions have been ignored. If Georgia leaders fully expand Medicaid to cover low-income adults and invest (even modestly) in local outreach & enrollment help, Georgians would be better off than they will be under these proposals.”
Coverage gains expected in the first year of 1115 Medicaid waiver: 25,028 (Georgia “Pathways to Coverage” Section 1115 Demonstration Waiver application, Pg. 10)
Coverage losses expected in the first year of 1332 private insurance waiver: 25,000-35,078 (Estimates from Tens of Thousands Could Lose Coverage Under Georgia’s 1332 Waiver Proposal, endnote #24, Center on Budget & Policy Priorities, and Georgia’s latest 1332 proposal continues to violate the ACA, Figure 1., Brookings Institute)
 Georgia Department of Community Health, Dec. 23, 2020. Georgia “Pathways to Coverage” Section 1115 Demonstration Waiver application, Pg. 10
Legislative Update: Week 4
Legislative session paused amid budget disagreements
The Georgia legislature voted to pause the official legislative calendar last week due to the difficult and sometimes contentious discussions over the state budget. Governor Kemp’s proposed budget cuts for the current and subsequent state budgets have left the legislature to the difficult tasks of finding savings where possible, making cuts to some services and programs, and debating how to bring in sufficient revenue. Speaker of the House David Ralston has instructed the House to hold only budget-related hearings this week.
The legislature plans to officially reconvene next Tuesday, February 18th for day 13 of this year’s legislative session. According to the legislature’s new calendar, Crossover Day (the day by which a bill has to be approved by at least one chamber in order to remain “alive” for this year) is scheduled for March 12th.
Strong surprise billing legislation introduced
Surprise billing legislation would protect consumers in emergency & non-emergency situations
Last week companion legislation were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. SB 359 and HB 888, sponsored by Senator Hufstetler and Representative Hawkins respectively, both contain strong consumer protections and set a fair payment resolution process that takes consumers out of fights between insurers and health care providers. If passed, these bills would protect 2.6 million Georgians from surprise medical bills.
SB 359 has been read and reffered to the Senate Health and Human Services committee. HB 888 is in House first readers and in the House Special Committee on Access to Quality Health Care.
Call one or more of these committee leaders to ask for their support of SB 359 and HB 888:
- Sen. Ben Watson, Chairman of Senate HHS committee,
- Sen. Dean Burke, Vice Chairman of Senate HHS committee, 404-656-0040
- Rep. Mark Newton, Chairman of the House Special Committee, 404-656-0254
- Rep. Sharon Cooper, Vice Chairman of the House Special Committee, 404-656-5069
If your state Senator or Representative is on either committee, please call them as well!
House examines mental health and organ transplant issues
Involuntary commitment emerges as theme in mental health legisation
Two pieces of mental health legislation garnered attention from mental health advocates and legislators last week.
HB 544, sponsored by Rep. Chuck Efstration, would make changes to how people in mental health or SUD crises can be committed to emergency involuntary treatment. This legislation could have negative consequences for people with substance use disorders who could be involuntarily committed to treatment under certain circumstances. This bill sits in the House Judiciary committee but the discussions of this issue may instead be moved to a subcommittee of the Behavioral Health Innovation and Reform Commission.
HB 760, sponsored by Rep. Sharon Cooper, would give peace officers the authority to take a person to a physician or emergency department for emergency examination under certain circumstances. This legislation is not supported by mental health advocacy groups because it could lead to involuntary committal for people with mental health issues. The bill now sits in the House Public Safety and Homeland Security committee.
Gracie’s Law would protect organ transplant discrimination for Georgians with disabilities
Rep. Rick Williams has introduced HB 842, titled “Gracie’s Law.” According to the Georgia Council on Developmental Disabilities (GCDD), Gracie’s Law would protect patients with disabilities from being removed from the organ donor waiting list because of their disability. According to an article in GCDD’s Making a Difference magazine, “While the Americans with Disabilities Act (ADA) denies discrimination based on any disability, there is still a lack of federal enforcement,” prompting the need for state action on this issue. This bill has been referred to the House Insurance committee. You can read more about Gracie’s Law here (pg. 12-13).
Health care heroes like you submitted 1,710 comments!
Before the legislative session began, Governor Kemp filed paperwork with health officials in the federal government to move forward with plans to change Medicaid and private insurance in Georgia. When health officials needed your input on the Medicaid plan, more than 1700 Georgians like you stepped up!
We are incredibly grateful for your advocacy on behalf of Georgians and communities who would benefit from Medicaid expansion in Georgia. Thank you for speaking up for your friends, neighbors, and all Georgians! Now your comments become part of a powerful legal record that health officials must take into acocunt as they decide whether or not to approve Governor Kemp’s Medicaid plan.
Stay tuned! Health officials are still reviewing Governor Kemp’s planned changes for private insurance. When the time comes, we will ask you to speak up again by submitting a comment again! Here and at coverga.org, we will let you know what those changes mean for you and your loved ones and when you can comment.
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.
In March 2019, Georgia lawmakers approved SB 106, the Patients First Act. The new law allows Georgia to use two kinds of health care waivers to make changes to health coverage in the state. These waiver plans could affect you, your friends, family, neighbors, and Georgians all across the state and the way you access and pay for health care.
(Waivers allow a state to set aside or “waive” certain requirements imposed by the federal government and try new models of providing health coverage and care.)
The state has hired Deloitte as a consultant to work with state leaders to develop the waiver plans. Georgia’s decision-makers have proposed an aggressive timeline and aim to finalize the waiver plans by the end of 2019.
Two types of waiver plans
Two types of plans are being developed by state leaders: an 1115 waiver and a 1332 waiver. An 1115 waiver allows Georgia to make changes to the state’s Medicaid program. Medicaid is the state’s health insurance program that covers kids, some low-income parents, seniors, and people with disabilities, and pregnant women. SB 106 limits the 1115 waiver to cover people making up to the poverty line (about $12,000 a year for an individual or $26,000 for a family of four). Medicaid expansion, which GHF has advocated for, would extend public coverage to people with incomes just above the poverty line (138% of the federal poverty line.) A successful way to use an 1115 waiver would be to cover everyone under the poverty line and exclude barriers to coverage such as burdensome paperwork requirements, confusing cost-sharing, or counterproductive lock-out periods.
A 1332 waiver allows the state to make changes to private insurance and the health insurance marketplace. About 450,000 Georgians buy their health coverage through the marketplace. Most of these Georgians receive federal tax credits to cover some or all of their premium costs. (Another 827,600 of Georgians are eligible for private coverage and financial help to buy it but have not yet enrolled.) A successful way to use a 1332 waiver is to establish a “reinsurance program” to reduce premium costs. This waiver should also ensure all plans continue to cover the essential health benefits (like prescription drugs) and maintain protections for people with preexisting conditions.
You can weigh in!
Now is the time to ensure that Georgia gets a plan that will provide comprehensive coverage to as many people as possible. Thousands of Georgians across the state could gain health care coverage through the Patients First proposals. While positive intentions have been expressed by Georgia’s elected officials about the forthcoming waivers, none has yet committed to ensuring all Georgians have a pathway to comprehensive, affordable coverage.
For every 1115 and 1332 waiver that the state wants to pursue, Georgia’s policymakers must seek input from the public. Because there are required state and federal public comment periods for each waiver proposal, there will be at least four public comment periods (a state and federal period for an 1115 waiver and a state and federal period for a 1332 waiver). These are your chances to help shape and influence health care in Georgia!
GHF and our Cover Georgia partners will let you know when the public comment periods begin and end and we will provide an easy way for you to have your say. Make a plan to submit comments during every public comment period so that state leaders know how their ideas will impact you and your family! Your story can help make a difference for thousands of Georgians and can support positive changes in health care coverage.
On Tuesday, February 19th, 2013, over 100 advocates, health care consumers, providers and others gathered at the State Capitol to deliver an important message to our elected officials: coverage matters. Georgia has an unprecedented opportunity to drastically reduce the number of uninsured in our state by accepting the federal dollars and expanding coverage through Medicaid. With nearly 2 million uninsured Georgians (that’s 1 in 5), it is likely you already know those people who would benefit from expanded coverage–they are your neighbors, your co-workers, and sometimes they are you.
There is still time to do your part: join the Cover Georgia coalition by helping us make the case for expanding coverage. Pick up the phone and call your legislator and tell them why the decision to expand coverage through Medicaid is so important to Georgians like you.
Here are some key talking points:
- Expanding Medicaid in Georgia would create 70,343 new jobs and would infuse an additional $8.2 billion per year in economic activity into our state’s economy each year.
- This economic activity will result in an additional $276 million a year in state and local tax revenue.
- Money has already been set aside at the federal level to cover 100% of the costs of Georgia’s expansion for the first three years and at least 90% in future years. Should the federal reimbursement levels drop below this level, Georgia can pull out of the expansion at any time.
- Expanding Medicaid will bring an estimated $40.5 billion in federal funds into Georgia over a decade.
- Medicaid expansion will free up state dollars that are currently covering programs such as mental health, the Georgia AIDS Drug Assistance Program, the State Hemophilia Program, and indigent care.
- Hospitals lost $1.5 billion in uncompensated care in 2010. Increasing the number of insured patients by expanding Medicaid will help prevent struggling hospitals from closing and save Georgia taxpayers dollars that currently go toward covering uncompensated care.
- Medicaid improves access to care, health status, and financial security of enrollees who would likely otherwise be without coverage.
- Medicaid expansion in other states have reduced mortality, and based on an estimated 650,000 new enrollees, an approximate 3,693 lives could be saved each year in Georgia by expanding coverage through Medicaid.
- More than 38,000 new health care sector jobs will be created. Other industries such as real estate who can benefit from the hoa management greenville sc, restaurants, transportation, and other businesses will also benefit from more than 30,000 new jobs.
- Under the current Medicaid program, low-income childless adults and most low-income parents do not qualify for coverage, leaving many working Georgians without access to adequate health care.
- Georgia has one of the nation’s highest uninsured rates; expanding Medicaid will help cover more than 650,000 people.
To find your legislator’s contact information, click here. Help us multiply our voice and our presence at the Capitol. Call your legislators now!