New Issue Brief: Building Georgia’s Health Insurance Exchange

Georgia is currently weighing options to determine whether it should establish a health insurance exchange.  Authorized by the Affordable Care Act, the goal behind these competitive health insurance marketplaces is to better facilitate competition and choice for health care consumers. Today, Georgians for a Healthy Future is releasing an issue brief entitled Building Georgia’s Health Insurance Exchange that outlines how a health insurance exchange can benefit Georgia consumers and makes recommendations for our policymakers as they weigh design options for an exchange.

 

Building Georgia’s Health Insurance Exchange addresses the following questions:

  • Who is eligible for the health insurance exchange?
  • What types of insurance plans will be available on the exchange?
  • How will consumers afford the products offered on the exchange?
  • What will Georgia’s exchange look like?
  • How will the exchange benefit Georgia consumers?
  • What should policymakers focus on to build a successful exchange?
  • What is the timeline for implementing an exchange?

 

Building Georgia’s Health Insurance Exchange recommends the following policy goals for an exchange:

  • Create a governance structure that can transparently and effectively oversee the exchange without any conflict of interests; insurance companies or other businesses that have a direct financial stake should not serve on the governing body

 

  • Provide structured choices that supply the information and tools consumers need to make optimal purchasing decisions, including quality and customer satisfaction ratings as well as information about price and benefits

 

  • Create incentives for insurance companies to compete based on value rather than by selecting the healthiest applicants:  consider leveraging volume within the exchange to drive better deals with insurance companies; consider crafting exchange participation rules to allow the highest quality and value plans to participate; and align regulations inside and outside the exchange to eliminate incentives to steer consumers outside the exchange

 

  • Serve as an easy-to-use, one-stop-shop and provide navigation assistance to programs like PeachCare for KidsTM and Medicaid where appropriate to ensure that all individuals and families eligible for these programs enroll

 

  • Develop a robust outreach and enrollment mechanism to ensure that low-income and minority communities that historically have had the highest rates of uninsurance are engaged and that consumers in rural areas, without internet access, or with limited English proficiency can still enroll in the plan that best meets their needs

 

The full issue brief is available here.

 


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Pathways to Coverage

Georgians for a Healthy Future has a new fact sheet out today about how to access health insurance in Georgia. Please share with patients, consumers, providers, community organizations, or anyone for whom it can serve as a resource. The fact sheet can be downloaded by clicking here.




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Building a Consumer Friendly Health Insurance Exchange

By Cindy Zeldin

 

This article originally appeared in the Atlanta Journal-Constitution.

 

Earlier this month, Gov. Nathan Deal signed an executive order creating the Georgia Health Insurance Exchange Advisory Committee, which is charged with determining whether Georgia should establish a state-based health exchange.

 

If well crafted, a Georgia insurance exchange has the potential to increase transparency, present clear and meaningful choices, and promote better value for consumers who don’t have access to a health plan at work.

 

The Affordable Care Act authorized state-level health insurance exchanges, providing a basic framework and initial funding. By 2014, each state’s exchange must be able to enroll individuals and small businesses into health insurance plans and certify that plans meet certain requirements, such as an adequate provider network and an essential benefits package. Within this framework, Georgia has considerable flexibility to fashion a structure that best meets our state’s individual needs like luxury. Luxurious cars, great clothes, Tahitian Necklace, and houses. When you want to have the most comfortable beds and mattress, avail the black friday casper mattress for maximum comfort.

 

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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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PCIP Update

By Cindy Zeldin


The Pre-Existing Condition Plan (PCIP) is a new health insurance option for uninsured Georgians who have been denied insurance because of a pre-existing condition. The PCIP, authorized by the Affordable Care Act, is intended to provide coverage for consumers who are locked out of the insurance market due to a pre-existing condition. To be eligible, applicants to the PCIP must be uninsured for at least six months and have a letter of denial from a private insurer. As of February 1st of this year, 399 Georgians had signed up for coverage through the PCIP. The premiums are subsidized entirely with federal dollars and no state funds are associated with the program. In fact, the Governor’s FY 2012 budget proposal realizes savings of $680,263 from the movement of previously uninsured hemophilia patients who had been accessing life-saving drugs through a state program into the PCIP, where those drugs are now covered. You can download our new fact sheet on the PCIP here.




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Live United Interview: Accessing Health Care in Georgia

Georgians for a Healthy Future ED Cindy Zeldin is interviewed by Milton Little, President of the United Way of Metro Atlanta, about health care access in Georgia and how the new health law can help.



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Potential Health Care Cutbacks Cause for Concern

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.”

 

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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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Tobacco Tax Is a Win for Georgia

Guest Blog By Michelle Putnam, MPH

For those inclined to live under a rock, the state of Georgia is in a deep recession, with revenues steadily declining over the past year and showing no sign of recovery.  In Georgia, 20% of adults and 18% of high school students smoke, costing our $2 billion a year in smoking-related health problems.  Is there a magic pill that would solve both of these problems at once?  You bet there is.  I give you, the tobacco tax.

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Health Care Reform Will Help Georgia Residents Find Coverage

This post originally appeared in the Atlanta Journal-Constitution on December 8, 2009.


By Cindy Zeldin


Our nation is on the cusp of historic public policy change. In the next several weeks, the most sweeping health reform legislation in 40 years will likely become law. Despite the heated town halls of August and the steady stream of information coming from the legislative debates in Washington, many Georgians are still wondering: What does this mean for me?


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