GHF surveyed and interviewed enrollment assisters across the state to understand not only the “what,” but also the “why” behind the second open enrollment period.  The results of that research have led us to several policy recommendations to maximize health insurance enrollment and retention and to ensure that coverage translates to meaningful access to timely and appropriate medical services for Georgia health care consumers.

1. Close the coverage gap in Georgia. Approximately 300,000 Georgians fall into the coverage gap, meaning they do not qualify for Medicaid under existing income eligibility guidelines in Georgia but their income is still too low to qualify for financial assistance (tax credits) to purchase health insurance on the Marketplace. Eligibility for tax credits begins at 100 percent of the Federal Poverty Level, or $11,770 for an individual or $20,090 for a family of three in 2015, while Medicaid eligibility for most adults in Georgia cuts off at income much lower. Thirty states including DC have closed their coverage gaps thus far with promising results. We encourage Georgia policymakers to take this important step as well to ensure all Georgians have a pathway to coverage.
2. Set and enforce network adequacy and transparency standards. Many of the plans sold through the Health Insurance Marketplace are Health Maintenance Organization (HMO) plans that feature narrow provider networks. While these narrow networks can help keep premiums down, a trade-off many consumers may be willing to make, consumers do not currently have sufficient information to make this choice. There is no information available to consumers at the point of sale about whether a provider network is ultra narrow, narrow, or broad, and provider directories are routinely inaccurate. More transparency and oversight are needed to ensure that consumers have accurate and useful information to make these choices. It is also important that all provider networks allow for meaningful access to all covered benefits. To ensure this, we support putting in place and enforcing network adequacy standards.
3. Encourage public-private partnerships and remove unnecessary restrictions on consumer education and assistance. Many of the enrollment assisters we surveyed indicated that reducing barriers to partnering with state government organizations such as public colleges, universities, and health departments would lead to stronger and more effective partnerships. Specifically, many respondents indicated that improved coordination between enrollment assisters, the Marketplace, and the Georgia Department of Community Health (DCH) to better facilitate PeachCare for Kids and Medicaid enrollment would be helpful. The “Health Care Freedom Act,” passed in 2014 as part of HB 943, prohibits state and local governmental entities from operating a health insurance navigator program and places other limitations on governmental entities. This provision has been counterproductive, creating confusion around what educational and consumer assistance activities local entities can engage in as they work to serve their community members. We recommend lifting these restrictions.

From choosing a plan to using your plan, health insurance can be complicated and many Georgians lack the information they need to make informed decisions.  In GHF’s recent report Getting Georgia Covered: Best Practices Lessons Learned and Policy Recommendations from the Second Enrollment Period, we interviewed enrollment assisters across the state and found that more than two-thirds of our survey respondents identified low health insurance literacy as a barrier to enrollment. Many of the consumers that assisters worked with had never been insured before, so they did not know how to choose a primary care physician or pay their monthly premium. One of the assisters interviewed acknowledged they needed to educate consumers on how to use their health insurance, but that it was a challenge when scheduled with a large number of enrollment appointments, although there are lawyers and Massachusetts firms that are specialized in insurances policies so they can help you understand better how it works. Additionally, some assisters reported that consumers chose the lowest premium plan because they did not understand the concept of a high deductible. Sometimes consumers would return to the assister wanting to change plans once they had tried to use their coverage. As we move forward, Georgians for a Healthy Future will be focusing efforts on improving the health literacy of Georgians and ensuring they have the knowledge, information, and confidence they need to make informed decisions.

New health insurance opportunities created through the Affordable Care Act (ACA) have let to historic reductions in the nation’s uninsured rate.  The strong enrollment numbers in Georgia mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families.

You’re Invited!

May 13, 2015 from 11:30 to 2:00

Georgia Railroad Freight Depot; Blue Room

Sign up here!

More than half a million Georgians signed up for health insurance during the open enrollment period that ended this past February (OE2). These strong enrollment numbers mean that more Georgians have access to the health care services they need and the peace of mind that comes from knowing that they are covered. What drove this success story for health care consumers in Georgia? Please join us for a conversation with representatives of the organizations most active in OE2 to learn lessons about their strategies, successes, and challenges that you can apply to your work. After their presentations, you will have the opportunity to ask your most pressing questions about health coverage in Georgia.  Lunch will be provided.

Panelists

Enroll America: Danté McKay, Georgia State Director

GHF: Whitney Griggs, Consumer Education Specialist

InsureGA: Sarah Sessoms, Executive Director

SEEDCO:  Lisa Stein, Vice President Work and Family Supports

US Dept. of Health & Human Services: Dr. Pamela Roshell, Region 4 Director

While this is a free event, please RSVP so we can order enough food.

Pranaya Rana joined Georgians for a Healthy Future this week as our new Navigator! In this role, Pranaya will work with consumers to help them enroll in health insurance through the Marketplace.  Pranaya is a former Lieutenant from the Nepalese Army Elite Forces. He has served as a U.N. Peacekeeper in post-earthquake Haiti and as a Refugee Resettlement Program Officer in Connecticut before he came to Kennesaw State University, Georgia to pursue his Ph.D. in International Conflict Management in 2012.   He has been working as a certified Healthcare Navigator in Metro Atlanta since the first open enrollment began in 2013. He recently completed his 6 months long Navigator’s term at Georgia Watch before joining Georgians For a Healthy Future.  He specializes in refugees and international communities and has served a wide variety of international communities enroll into affordable healthcare using a community specific service model developed through continued outreach, education and  needs assessment. He is Fluent in Nepali and Hindi besides English, and, speaks Urdu and intermediate French. If you’d like to contact Pranaya, he can be reached by email or by phone at 404-567-5016.

Open Enrollment for the Health Insurance Marketplace ended Sunday and more than half a million Georgians enrolled in plans through the Marketplace! Georgia’s enrollment was the fourth highest of states using the Federally Facilitated Marketplace, trailing only behind Texas, Florida, and North Carolina. The state’s enrollment numbers passed the 500,000 mark in large part due to a last minute surge in sign-ups. This year’s enrollment numbers greatly exceed last year’s enrollments of 316, 543. Nationally, 11.4 million Americans selected plans or were automatically re-enrolled through the Marketplace. Click here to learn more about Georgia’s enrollment numbers. For Georgians who begun the enrollment process prior to the deadline but, due to issues with either healthcare.gov or call centers, were unable to complete their enrollment, CMS has extended a Special Enrollment Period (SEP).  These people are “in line” and still eligible to enroll this year.  This SEP will end February 22nd.  If you or someone you know thinks they qualify for this extended enrollment period visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596

The 2014 Georgia Legislative Session has ended. Thank you to so many of you for reaching out to your legislators during this past session to let them know that covering Georgia’s uninsured and improving access to health care for all Georgians are important priorities for you. Thank you to the dozens of committed advocates who joined us for Cover Georgia day at the Capitol, and thank you to the more than 8,000 of you who signed the Cover Georgia petition to express your support for the Medicaid expansion.

This was a disappointing legislative session for health care consumers. HB 990, which prohibits Medicaid expansion without prior legislative approval, and the portions of HB 707 (amended onto HB 943) that would prevent state entities from serving as health insurance navigators, prohibit the state from setting up a health insurance exchange, and limit the ability of state and local employees to advocate for the Medicaid expansion passed through the General Assembly. While some of the most harmful elements of HB 707 were removed before its final passage, this bill sends a horrible message to Georgia health care consumers who seek information about how to enroll in and utilize the new health insurance options available to them through the Affordable Care Act.

On the upside, hundreds of Georgians are enrolling each day in health insurance. At last count, more than 139,000 Georgians have enrolled in health care coverage through the Health Insurance Marketplace, and Georgians for a Healthy Future is actively working alongside our coalition partners to maximize enrollment leading up to the March 31^st deadline. And despite the setbacks of the 2014 Legislative Session, the Cover Georgia coalition will continue to advocate for covering our state’s uninsured, strengthening our state’s health care delivery system, and growing the economy by implementing the Medicaid expansion.

Thank you again for your continued support and advocacy!

With the changing healthcare landscape, there are new words and phrases that the average consumer is unfamiliar with. Navigators….Certified application counselors (CACs)….and even Marketplace.  As consumers try to gather as much information as they can to make informed health care decisions, Georgians for a Healthy Future will continue to demystify the changes and provide you the information you need to make the right decision for you and your family. (more…)

Join us for a webinar and in-person meeting about ACA Navigators April 10 and 11

If you or your organization are interested in applying for the upcoming funding opportunity provided through the Department of Health and Human Services (HHS) for navigator grants or you would like to connect with other organizations who will be applying, please join Georgians for a Healthy Future, Seedco, Families USA and Enroll America for an important webinar on April 10th, 2013 at 11am and an in-person meeting on April 11th, 2013 from 2:30 to 4:30pm at the Philip Rush Center (1530 DeKalb Ave).

 
In the next few days, HHS is planning to announce funding that will be available to organizations for outreach and assistance to help individuals and small employers enroll in health coverage. These grants are created as part of the navigator program that was established by the Affordable Care Act.  To learn more about navigators, click here.

To join us for the webinar, please click here to RSVP.  To join us for the in-person meeting to further discuss this funding opportunity and opportunities for collaboration on outreach and enrollment, click here.