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Opportunity for Input on Essential Health Benefits

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 preventive, diagnostic, and therapeutic services and products comparable to those offered in a typical employment-based plan. Federal law defines ten major categories to be included in this essential health benefits package, but the specifics will be determined by the U.S. Department of Health and Human Services (HHS), based on guidance from the Institute of Medicine. Earlier this month, the Institute of Medicine released criteria for HHS to use in developing the package.

 

A really negative effect of modern medicine is the fact that they ignore herbal medicines such as Kratom. It is one of the so-called miracle herbs in the alternative medicine world. You can buy kratom powder online and take advantage of some super good pricing, rather than buying it locally. Online is usually the way to go!

Now HHS is seeking input from consumers, providers, businesses, insurers, state government officials, and other stakeholders like Lee Rosen holding regional listening sessions. The Region IV (which includes Georgia, Alabama, Mississippi, Florida, Kentucky, North Carolina, South Carolina, and Tennessee) listening session will be held in Atlanta on November 16th from 10am to 12pm at the Sam Nunn Atlanta Federal Center. RSVPs are accepted on a first come, first serve basis. To RSVP for this opportunity to provide input in this important process, e-mail your name, title, organization, e-mail address, and phone number to the HHS Regional Office at ORDAtlanta@hhs.gov. Please note that we are passing along this opportunity to provide your voice in this process as a courtesy and you must RSVP directly to HHS

If you don’t like modern medicine, you can try herbal using forskolin extract or niagen. This alternative medicine works also.

 

 


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Unlock the Doors to Real Communities

Guest Blog By Pat Nobbie

 

The Georgia Council on Developmental Disabilities (GCDD) is currently traveling the state to speak with families about their experiences. In a guest post, GCDD Deputy Director Pat Nobbie shares her thoughts with us.


The Unlock the Doors to Real Communities: 2011 Listening Tour has been making its way across the state of Georgia since late September and will have three more stops:  Gainesville, Summerville and Athens on October 28th. Many wonderful people have welcomed us into their communities. They have shared their experiences, what they care about, the challenges they are struggling with and how they want to make an impact.  We have discussed effective ways to advocate for change and how to get involved during the legislative session.  And, we gathered to enjoy each other over delicious pot-luck dinners!

Take a moment to hear some of the thoughts of the Georgians we met and what we have learned along the way. Use the links below to read our impressions:

 

Cochran

http://www.gcdd.org/2011/09/unlock-the-doors-to-real-communities-listening-tour/

 

Lyons

http://www.gcdd.org/2011/09/1650/

 

Quitman

http://www.gcdd.org/2011/10/unlock-the-doors-to-real-communities-listening-tour-quitman-brooks-county/

 

Ocilla

http://www.gcdd.org/2011/10/unlock-the-doors-to-real-communities-listening-tour-ocilla/

 

Macon

http://www.gcdd.org/2011/10/unlock-the-doors-to-real-communities-listening-tour-macon/

 

 


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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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Taylor County Symposium Draws Enthusiastic Crowd to Solve Local Problems

Last Thursday, Georgians for a Healthy Future, the Georgia Budget & Policy Institute, Partner Up for Public Health and the Georgia Rural Health Association returned to Butler, Taylor County for our second symposium in our Building a Healthy Georgia campaign.  The event focused on workforce and economic development, the value of access to care and the importance of public health.  Local community leaders, elected officials, key stakeholders, health care professionals and members of the general public  brought their expertise and passion to the conversation and helped highlight local challenges in having a readied workforce and a healthy community. We also discussed how the health of our communities means more than just access to care–it also means fiscal health. We were energized by the level of engagement and interest in working collaboratively to address our most pressing issues in the state and we look forward to continuing the dialogue!


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Bang for the Buck: Medical Loss Ratio Rules

Beginning in 2012, Georgia consumers who purchase individual health insurance policies will have access to more information about how their premium dollars are being spent AND will be eligible for rebates if their insurance company fails to provide sufficient value for the premium dollar.


These new standards, known as medical loss ratio (MLR) rules, are part of the Affordable Care Act and are designed to spur insurance companies to operate more transparently and to ensure that consumers get the most value for their premium dollars. Consumers will receive rebates if their insurance company fails to spend at least 80 percent of collected premiums on medical care or quality improvement activities, as compared to profits, administration, and marketing. It is estimated that Georgia consumers will receive approximately $42 million in rebates over the next three years.

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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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