On March 4th, the United States Supreme Court will hear oral arguments in King v. Burwell, a lawsuit challenging the tax credits that consumers utilizing the federal Health Insurance Marketplace receive to help make health insurance affordable. Consumers in thirty-four states, including Georgia, use the federal Marketplace to find and enroll in coverage. Nearly nine out of 10 people who enrolled in coverage through healthcare.gov received financial help and paid 75 percent less than the full monthly premium. This has helped bring the nation’s uninsured rate to an historic low.

A study by the Robert Wood Johnson Foundation and the Urban Institute found that the majority of health care consumers who would be impacted and who would likely become uninsured if the tax credits were struck down live in the South. Here in Georgia, hundreds of thousands of people are at risk for becoming uninsured.

We believe there is no legal basis for this challenge and that in June, when a decision comes down, we’ll all breathe a sigh of relief. If the court does, however, strike down the tax credits, such a decision would disproportionately impact the South and would put states like Georgia at a competitive disadvantage by exacerbating existing regional health disparities. If this comes to pass, Georgians for a Healthy Future will advocate for a contingency plan to ensure that Georgians have the same access to tax credits that their counterparts in states like New York, California, Colorado, and Kentucky (states that set up their own health insurance exchanges) have.

Our friends at Families USA have put together a resource page for advocates interested in learning more about King v. Burwell.

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!

Action Alert—Stop HB 707!

House Bill 707 would prohibit the state of Georgia from leveraging federal dollars to cover the uninsured and from providing consumer assistance to Georgians enrolling in health insurance. HB 707 was designed and promoted by the tea party to prevent hard-working Georgians from accessing health care, and it is in danger of becoming law in Georgia. We need your voice! Georgia citizens deserve better than to have the door slammed in their face when they seek out information about how to cover themselves and their family. Our state’s struggling hospitals and uninsured citizens deserve an honest policy discussion about Medicaid expansion, not a gag order on state and local employees. Call Lt. Governor Casey Cagle at 404-656-5030 and your state senator (locate your state senator here) and ask them to oppose HB 707.

House Bill 707 would:

1. Prohibit any state agency, department or political subdivision from using resources or spending funds to advocate for the expansion of Medicaid. This would stifle conversation and analysis about how to leverage federal dollars from covering the state’s uninsured.

2. Prohibit the state of Georgia from running an insurance exchange or accepting federal dollars related to an exchange. This broad language could stop quality local programs that provide assistance to vulnerable Georgians getting coverage through the exchange.

3. End the University of Georgia Health Navigator Program. Currently, the University of Georgia is providing enrollment assistance to consumers seeking out health insurance with federal grant money. HB 707 would prohibit UGA from sitting down with uninsured consumers and helping them enroll in a private health insurance plan.

4. Prohibit the Commissioner of Insurance from investigating or enforcing any alleged violation of federal health insurance requirements mandated by the Affordable Care Act. Under HB 707, if a consumer has been treated unfairly by their health insurance company, they may have no state recourse.

HB 707 has already passed the state House of Representatives and may be up for a vote in the State Senate early next week. We need your voice to prevent this harmful bill from becoming law!

Today, the U.S. Department of Health and Human Services (HHS) awarded health insurance navigator grants to 105 organizations in states with federally facilitated or partnership exchanges to conduct outreach and facilitate enrollment into qualified health plans when open enrollment begins in October. Georgians for a Healthy Future is excited to announce that we are part of a consortium of 15 partners, led by Seedco, a national non-profit organization that advances economic opportunity for people, businesses, and communities in need, that received one of two grants awarded for Georgia. We look forward to playing an active role in connecting Georgia consumers to the new health care coverage opportunities available to them.

Georgians for a Healthy Future will support the consortium’s success by drawing upon our strengths as a consumer health care advocacy leader, experience building and managing coalitions, and knowledge of the Affordable Care Act. In particular, we will work to ensure that the consortium’s activities are coordinated with a wide array of organizations in Georgia that share the goal of maximizing health insurance enrollment in our state. Through our Connecting Georgians to Coverage initiative, we have already held several webinars and meetings for organizations planning to participate in outreach and enrollment in Georgia. To learn more about our work to date in this area, click here. If your organization is planning to engage in outreach and enrollment, either as a navigator, certified application counselor organization, or champion for coverage and if you would like to coordinate your efforts with ours, please email Amanda Ptashkin at aptashkin@healthyfuturega.org.

Here is a full list of our navigator consortium members who will work collaboratively with Seedco and with other organizations and stakeholders to connect Georgia’s uninsured to health care coverage:

• Boat People SOS
• Center for Black Women’s Wellness
• Emory-Grady Urban Health Initiative
• Georgia Equality & The Health Initiative
• Georgia Refugee Health and Mental Health
• Georgia Watch
• Georgians for a Healthy Future
• Healthy Mothers Healthy Babies Coalition of Georgia
• Jewish Family & Career Services
• Latin American Association
• Mental Health America of Georgia
• Parent to Parent
• Quality Med-Care Inc.
• Spring Creek Health Cooperative

We look forward to working with Seedco and this strong and diverse coalition over the next year!

CARE-M is a coalition of organizations who advocate on behalf of vulnerable populations, patients, and health care consumers in Georgia (Georgians for a Healthy Future is a member of the coalition). The coalition was formed shortly after the Georgia Department of Community Health (DCH) announced plans to explore redesigning Georgia’s Medicaid and PeachCare for Kids (CHIP) programs to ensure that the voices of these patients and consumers were heard in the process. Many CARE-M partners have been appointed to and serve on task forces and work groups convened by DCH to gain stakeholder input.

In May 2013, CARE-M released an updated version of its principles and concerns around Medicaid redesign, described below (you may also download this document in pdf format here).

CARE-M Principles and Concerns: Updated May 2013

CARE-M Principle: Improved healthcare outcomes for members should be the primary goal that drives changes to Medicaid. Improvement in the Medicaid system of services and supports will result in improved healthcare outcomes for the members.

Background — DCH’s Expressed Goals
o Enhance appropriate use of services by members
o Achieve long term sustainable savings in services
o Improve health care outcomes for members

CARE-M – Cross-cutting Concerns:

Concern 1: State Oversight and Accountability: Regardless of the details of any change or redesign, DCH must build and maintain adequate staff capacity and expertise at the state level to implement the plan, oversee operations, and diligently enforce contract requirements.

Concern 2: Medicaid Vehicle: As of Spring 2013 plans include using an 1115 waiver for foster children but a decision has not been made about whether or not an 1115 or a 1932(a) will be used for the Aged, Blind and Disabled populations. It is important that this decision be made soon and be communicated to stakeholders immediately. Regardless of the vehicle chosen it is critical to maintain the elements of care management that are working now and to consistently implement best practices.

Concern 3: Stakeholder Participation: Each population included in managed care must be fully engaged in designing, implementing, and monitoring the outcomes and effectiveness of the managed care program and be empowered to bring issues occurring in care delivery forward to the attention of the managed care entities and the Department of Community Health. This involvement should not end with the awarding of contracts, but should continue with providing feedback on system performance and recommendations for plan improvement. In order to perform this role effectively, stakeholders need access to performance data and progress on established benchmarks. After integration has been implemented, consumer involvement should extend into ongoing monitoring through representation in standing advisory groups at both a state and local plan level.

Concern 4: Definition of Medical Necessity: The definition of medical necessity for persons under age 21 is statutory and requires that determinations be based on the needs of the individual child. Medical necessity standards for persons age 21 and over should be modified to include those home and community-based services that are necessary to support individuals in a stable way in their homes, whether in the community or in a long-term care facility, despite having been excluded under a prior narrowly construed definition of medical necessity.

Concern 5: Appeals and Independent Problem Resolution: Stakeholders must be certain that any managed care system implemented in Georgia includes an easily navigable appeal system that ensures full Medicaid rights. The managed care system must include an independent ombudsman who has expertise in the delivery of Medicare and Medicaid benefits to seniors and persons with disabilities, including Long-Term Services and Supports and Behavioral Health services. This ombudsman will assist beneficiaries with appeals and will identify systemic problems in the CMO and be able to bring those concerns to the agency authority.

For more information about CARE-M, click here.

It’s time for our state policymakers to catch up to their constituents. A new public opinion survey out today from the Joint Center for Political and Economic Studies finds strong support within Georgia  and across the Deep South for covering the uninsured through an expansion of Medicaid. Sixty-one percent of Georgians support expanding Medicaid, including forty-seven percent of self-identified conservatives. In addition, fifty-five percent of Georgia respondents said that the Medicaid program is important because they like knowing that it exists as a safety net to protect low-income people who can’t afford needed care. Four in ten said it was important because they or someone they know may need to rely on Medicaid benefits in the future. Georgians care about the health of their families and communities and want our policymakers to do the right thing. Please sign the Cover Georgia petition or distribute postcards throughout your network to ensure this majority support for Medicaid is heard.

The Georgians for a Healthy Future board of directors invites you to join us for an evening of camaraderie, conversation, and celebration as we gear up for the next big phase of health reform implementation: connecting hundreds of thousands of uninsured Georgians to coverage. Since our founding in 2008, Georgians for a Healthy Future has worked with all of you to provide a strong voice for Georgia’s health care consumers in the policy decisions that impact their lives. Please save the date for a reception and fundraiser on the evening of June 27th to celebrate our successes and prepare for the challenges ahead. Thanks to national health reform, consumers have more options than they have ever had before. But covering Georgia’s uninsured will take all of us, working in concert, to move our state forward. We need all hands on deck!  Please join us for an entertaining evening of celebration and conversation about our collective strength and how Georgians for a Healthy Future will continue to work on behalf of all Georgians to help navigate the rough waters ahead.

Thursday, June 27th from 6:00 to 8:00pm
Nelson Mullins Riley & Scarborough

Atlantic Station
201 17^th Street NW, Atlanta, GA 30363
Tickets are $60.

Host Committee Levels:
Cadet ~ $250
First Mate ~ $500
Captain ~ $1000+
To join the host committee, email Cindy Zeldin

To register, click here.

Many of the Affordable Care Act’s major health insurance reforms take effect in 2014. One of the most important changes impacting consumers will be the availability of substantial new tax credits to help individuals and families afford health care coverage. Individuals with annual incomes between about $15,860 and $45,960 (or between about $32,500 and $94,200 for a family of four) will be eligible for the health insurance tax credits. According to a new study by Families USA, about 800,000 Georgians will be eligible for these credits to help make coverage more affordable for them or they could use credit cards for this also by getting amazing credit card advice from reasonable sources online. Georgians for a Healthy Future joined with Families USA in a co-release of the report to highlight the Georgia-specific findings. You can find media coverage of the report’s findings here, here, and here. You can download the report here.

An analysis conducted by Dr. Bill Custer of Georgia State University and released today by the Healthcare Georgia Foundation finds that, if Georgia policymakers choose to accept the $40.5 billion in federal funds available to the state between 2014 and 2023 to expand Medicaid, this infusion of resources would create more jobs in Pensacola FL and 70,000 jobs countrywide, adding an annual $8.2 billion to statewide economic output and generating $276 million in state and local tax revenue annually.

As part of the Affordable Care Act, states can create a new eligibility category for Medicaid for people with incomes up to 138 percent of the federal poverty level, or approximately $15,850 for an individual or $26,950 for a family of three. In Georgia, according to the report, about 694,000 people would gain health coverage under this expansion, mostly childless adults and some parents.

To date, Governor Deal has rejected the offer to expand coverage citing concerns about the cost to the state.  As this new report details, however, expanding Medicaid would be an economic engine for Georgia. Of the more than 70,000 jobs that would be created, just over half would be in the health care sector; however, other industries such as real estate, food services, and wholesale trade businesses would also gain jobs. The report also shows the geographic distribution of jobs created throughout Georgia by state service delivery region. To read the full report, click here.