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GHF’s Executive Director Laura Colbert provided testimony to the House Special Committee on Access to Quality Health Care on SB 106 and the risks this legislation poses for consumers as it is currently written.
Testimony of Laura Colbert, GHF’s Executive Director
March 20, 2019
“Thank you Chairman Smith and members of the committee. My name is Laura Colbert and I am the ED of GHF. We represent health care consumers across Georgia and work to build a future in which all Georgians have the quality, affordable health coverage and care they need to live healthy lives and contribute to the health of their communities.
First, we want to thank Governor Kemp, Senator Tillery and Representative Lott for your work on this bill. We are excited that this very important conversation is moving forward. We appreciate your open door and on-going dialogue with us on this issue.
Like my colleagues before me, GHF agrees with the goals of this bill and we are pleased by the prospect of meaningful coverage for 240,000 Georgians who live below the poverty line. We are to balance that with our consternation that 200,000 uninsured Georgians who make just more than the poverty line may remain uncovered by this bill as it’s written.
Georgians with insurance coverage are healthier, better able to work and go to school, have less medical debt and better credit scores, and have healthier families, among other benefits. While Georgians below the poverty line are sure to reap these benefits after gaining coverage, those just above it likely will not if SB 106 is not amended to specifically include them.
Based on other states’ coverage expansions and the affordability information provided to you by Ms. Haynes at Georgia Watch, it is clear that many near-poor constituents are likely to face significant cost-related barriers to health care, even with the ACA’s financial assistance. While Georgians in this income range can afford more than those below the poverty line, it is unrealistic to expect them to pay as much as 20% of a person’s $14,000 yearly wage or a family of four’s $30,000 salary for health care. An investment that large for families barely making ends meet effectively keeps them locked out of the health care system, only experiencing the benefits of coverage in emergency situations. The financial protection and access to care provided by Medicaid can better serve as the stepping stones for these families to climb into Georgia’s middle class.
Georgia is at the table now, and we have the opportunity to get this right for all Georgians on the first try.
That is why we recommend that this committee amend the bill to expand eligibility to 133% FPL and cover more Georgians for fewer state dollars. Georgia is at the table now, and we have the opportunity to get this right for all Georgians on the first try. Or consider removing the percentage provision altogether so that the bill is silent on the exact income limit, providing flexibility to the state to negotiate the waiver specifics that work best for Georgians and Georgia’s budget, particularly in the likely event that CMS is unable to provide an enhanced match rate for a partial expansion.
I also want to briefly turn to the second part of the bill concerning Section 1332 State Innovation waivers. A 1332 waiver to establish a reinsurance program would help thousands of Georgians by reducing insurance premiums and attracting more insurers to the marketplace. GHF stands in support of such efforts. However, the legislation as currently written is so broad that it leaves the door open to many more changes, some of which could destabilize Georgia’s marketplace and jeopardize access to care for Georgians covered by individual or small-group health insurance.
We recommend that this committee consider narrowing the scope of an allowable 1332 waiver by specifying that the state is authorized to establish a reinsurance program or, if other proposals may be considered, lay out criteria that any innovation waiver must meet. Georgians for a Healthy Future has laid out four criteria that we believe are critical to ensuring that any 1332 waiver benefits consumers without putting vulnerable groups at risk.
We appreciate your consideration of our suggestions and hope that we can act as a resource for the state as it drafts these waivers. Thank you very much for your time and your efforts on behalf of all of the health care consumers in your districts.”
Legislative Update: Week 8
Crossover Day brings legislative action late into the night
Last Thursday was the 28th day of the Georgia legislative session, which is also referred to as Crossover Day. Crossover Day is the final day for a bill to cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. This week’s legislative update provides a rundown of consumer health legislation: which bills made it through and which did not. You can see a list of all the bills we’re tracking here. (Note: After a flurry of activity last week, we are still working to update our legislative tracker with the current status of each bill. So while many of the bills are updated, it is best to find the bill you are interested in and click through to find the full information on the bill’s statis on legis.ga.gov.
Our priorities
Surprise billing legislation moves forward
SB 56, sponsored by Senator Chuck Hufstetler, received approval by the full Senate on Wednesday and may be considered by the House Insurance Committee in the coming weeks. The legislation aims to improve transparency for consumers who may be subject to a surprise out-of-network bill. This bill would disallow surprise billing in emergency situations but does not prohibit surprise billing in non-emergency situations like when a physician uses an out-of-network laboratory for diagnostic tests. This bill now sits in the House Insurance committee. (For more details on the legislation, see our February 11th legislative update.)
Legislation to fully expand coverage stalls; Patients First Act advances
HB 37, the Expand Medicaid Now Act, and SB 36 sponsored by Representative Bob Trammell and Senator Steve Henson respectively, did not receive hearings and did not cross over last week. Each bill was written to expand Medicaid in Georgia as envisioned by the Affordable Care Act.
Meanwhile SB 106, the Patients First Act, has moved quickly through the Senate in the weeks before Crossover Day. The legislation, as written, would allow the Department of Community Health to request an 1115 waiver to extend Medicaid coverage to adults making up to 100% of the federal poverty level (FPL) ($12,490 annually for an individual). This “partial expansion” would leave out thousands of new-poor Georgians who are meant to be similarly covered according to federal health law and will likely cost the state more to cover fewer people. Additionally, the bill allows the Governor to make potentially tremendous changes to private health insurance in Georgia through 1332 waivers with little accountability. The bill will now awaits a hearing from the House’s Special Committee on Access to Quality Healthcare.
Healthy housing legislation moves to Senate committee
Georgians for a Healthy Future is a member of the Healthy Housing Georgia coalition because evidence shows the strong and firect influence housing has on a person’s health. The coalition supports HB 346, which would prohibit retaliation by a landlord against a tenant for complaining to Code Enforcement about unsafe or unhealthy housing conditions like the presence of mold, radon, rodents, insect infestations, or lead. Georgia is the only state in the country that does not protect tenants against unsafe and uninhabitable housing conditions with a “warranty of habitability.” This bill now sits in the Senate Judiciary committee. (For more details on the legislation, see our March 5th legislative update.)
Crossover day recap
HB 30: Amended FY 2019 Budget | CROSSED OVER
HB 30 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2019. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on Saturday, March 9th.
HB 31: FY 2020 Budget | CROSSED OVER
HB 31 is the budget document for the coming state fiscal year which will run from July 1, 2019 to June 30, 2020. The budget includes several new investments in behavioral health and mostly maintains funding for other health care programs and priorities. The Senate will continue to hold hearings on the “big budget” this week. For more information on the health care highlights in the proposed FY 2020 budget, read the Community Health and Behavioral Health budget overviews from the Georgia Budget & Policy Institute.
HB 37: Expand Medicaid Now Act | DID NOT CROSS OVER
HB 37, sponsored by Rep. Bob Trammell, expands Medicaid in Georgia as envisioned by the Affordable Care Act by increasing Medicaid eligibility for adults up to 138% of the federal poverty guidelines (FPL). This is equivalent to $17,236 annually for an individual and $29,435 for a family of three.
HB 63: Step therapy legislation: CROSSED OVER
HB 63, sponsored by Rep. Sharon Cooper, would require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. Step therapy is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the higher-cost treatment prescribed by a patient’s physician.
HB 84: Provider network transparency | DID NOT CROSS OVER
HB 84, sponsored by Rep. Richard Smith, increases transparency related to possible surprise medical bills. The legislation requires that information on billing and the providers that a consumer may encounter during a course of care must be provided to the consumer at their request. In circumstances where a consumer receives a surprise bill, HB 84 also allows for arbitration between the consumer and the health care provider, the specifics of which would be determined by Georgia’s Department of Insurance.
HB 158: Improve Medicaid patient access to effective HIV treatment | CROSSED OVER
HB 158, sponsored by Rep. Deborah Silcox, requires that Medicaid recipients have the same access to antiretroviral drugs used to treat HIV and AIDS as to those included in the formulary established for the Georgia AIDS Drug Assistance Program. This change would allow for increased continuity of care for people living with HIV/AIDS in Georgia.
HB 198: Eliminate certificate of need requirements | DID NOT CROSS OVER
HB 198, sponsored by Rep. Matt Hatchett, would change the certificate of need process that is used to regulate health care facilities. The bill also included requirements for increasing transparency of hospital financial information and an increase in the rural hospital tax credit from $60 million to $100 million.
HB 217: Needle exchange program | CROSSED OVER
HB 217, sponsored by Rep. Houston Gaines, decriminalizes the act of working or volunteering for a syringe services program, a step towards legalizing the programs. Distributing clean hypodermic syringes and needles to people who use injection drugs (e.g. heroin) helps to prevent the spread of HIV and Hepatitis C, and does not increase the likelihood that people will newly take up injections drug use.
HB 290: PrEP pilot program | CROSSED OVER
HB 290, sponsored by Rep. Sharon Cooper, would establish a pilot program to provide preexposure prophylaxis (PrEP) drug assistance or services to persons at risk of being infected with HIV. PrEP is a medication taken by people who are HIV-negative to reduce their risk for infection. The pilot program would provide PrEP to people in counties identified by the Centers for Disease Control & Prevention as at risk of HIV outbreaks due to a high rate of opioid use and participants would receive regular HIV testing and related support services.
HB 321: Medicaid financing program | CROSSED OVER
HB 321, sponsored by Rep. Jodi Lott, would extend the sunset provision of the hospital provider fee for five years. The hospital payment program, which draws down additional federal funding, provides almost $1 billion annually to the state’s Medicaid budget. More information about HB 321 is available here.
HB 514: Georgia Mental Health Reform and Innovation Commission | CROSSED OVER
HB 514, sponsored by Rep. Kevin Tanner, would create the Georgia Mental Health Reform and Innovation Commission through at least June 30, 2020. Within the Commission, several subcommittees would be established to include Children and Adolescent Mental Health; Involuntary Commitment; Hospital and Short-Term Care Facilities; Mental Health Courts and Corrections; and Workforce and System Development.
SB 16: Interstate Medical Licensure Compact Act | CROSSED OVER
SB 16, sponsored by Sen. Kay Kirkpatrick, would allow Georgia to enter the “Interstate Medical Licensure Compact Act” which allows health care providers to more easily obtain licenses to practice in multiple states. It also provides Georgia’s Medical Board with easier access to investigative and disciplinary information about providers from other states, an important protective measure for Georgia patients.
SB 74: Eliminate certificate of need requirements | DID NOT CROSS OVER
SB 74, sponsored by Senator Matt Brass, would eliminate certificate of need requirements for all health care facilities except certain long-term care facilities and services. This bill is the Senate companion piece to HB 198. Both bills aim to change the current certificate of need structure which regulates hospitals in Georgia.
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.
- Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide. (Contact Michelle Conde at mconde@healthyfuturega.org for a printed copy.)
Legislative Update: Week 6
Patients First Act moves quickly through Senate committee
Last week, the Senate Health and Human Services (HHS) committee met to discuss and hear testimony on SB 106. Titled the Patients First Act, the legislation permits Georgia’s Governor to pursue two health care waivers that could make significant changes to health coverage for Georgia consumers. The bill passed out of committee with no changes and now sits in the Senate Rules Committee awaiting a vote to move to the Senate floor.
The legislation, as written, would allow the Department of Community Health to request an 1115 waiver to extend Medicaid coverage up to 100% of the federal poverty level (FPL). This would leave out thousands who would be covered under a full Medicaid expansion and will likely cost the state more to cover fewer people. Additionally, the bill allows the Governor to make potentially tremendous changes to private health insurance in Georgia through 1332 waivers with little accountability. This proposed legislation falls short of the promise to put a health insurance card in the pockets of all Georgians.
There is still time to ensure that this bill covers all Georgians in need of an insurance card in a fiscally responsible way. Join us this Thursday, February 28th, for Cover Georgia Day at the Capitol to talk with your elected officials about this important piece of legislation.
(Can’t make it? Call or send an email to your state legislators today!)
General Assembly moves forward on budget bills
Budget progresses through General Assembly
The House and Senate are inches away from completing work on HB 30, the FY2019 supplementary budget which only needs a House “agree” to move to the Governor’s desk. The supplemental budget (also called the “little budget”) makes necessary, mid-year adjustments to the current state budget. The Governor’s proposed amended FY2019 budget provides $1 million for the Department of Community Health to hire an external consultant to draft the waiver options authorized in SB 106, if passed. The House Appropriations Committee has begun working on the FY 2020 budget, (also called the “big budget”). The FY2020 budget contains significant additions for health, including $8.4 million to fund a school-based mental health initiative called Project Apex, which aims to increase access to mental health services for children and youth.
Legislature prioritizes HIV prevention & treatment
Bills to increase prevention & treatment of HIV move forward in the House
Georgia now leads the U.S. in the number of new HIV cases diagnosed each year. State legislators have turned their attention to this problem with the introduction and passage of several bills aimed at preventing the further spread of HIV/AIDS and increased access to treatment for those living with the disease:
- HB 158, sponsored by Rep. Deborah Silcox, requires that Medicaid recipients have the same access to antiretroviral regimens used to treat HIV and AIDS as to those included in the formulary established for the Georgia AIDS Drug Assistance Program. This change would allow for increased continuity of care for people living with HIV/AIDS in Georgia. The bill has passed the House and has been referred to the Senate HHS committee.
- HB 217, sponsored by Rep. Houston Gaines, decriminalizes the act of working or volunteering for a syringe services program, a step towards legalizing the programs. Distributing clean hypodermic syringes and needles to people who use injection drugs (e.g. heroin) helps to prevent the spread of HIV and Hepatitis C, and does not increase the likelihood that people will newly take up injections drug use. This bill was passed by the House yesterday and now moves to the Senate.
- HB 290, sponsored by Rep. Sharon Cooper, would establish a pilot program to provide preexposure prophylaxis (PrEP) drug assistance or services to persons at risk of being infected with HIV. PrEP is a medication taken by people who are HIV-negative to reduce their risk for infection. The pilot program would provide PrEP to people in counties identified by the Centers for Disease Control & Prevention as at risk of HIV outbreaks due to a high rate of opioid use and participants would receive regular HIV testing and related support services. The House HHS committee passed HB 290 last week and now awaits a full vote by the House.
Surprise billing legislation advances
Surprise billing legislation approved by Senate committee
SB 56, sponsored by Senator Chuck Hufstetler, was approved by the Senate Insurance and Labor Committee last week. The legislation addresses surprise out-of-network billing and aims to improve transparency. A surprise medical bill can occur when a consumer unknowingly encounters an out-of-network (OON) provider at an in-network facility and can have serious financial impacts on individuals and families. This bill would disallow surprise billing in emergency situations but does not prohibit surprise billing in non-emergency situations like when a physician uses an out-of-network laboratory for diagnostic tests. (For more details on the legislation, see our February 11th legislative update.) The bill was approved and now sits the Senate Rules Committee awaiting a vote.
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.
- Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide. Contact Michelle Conde at mconde@healthyfuturega.org for a printed copy.
Action Alert: Patients First Act falls short
Last week, state leaders introduced SB 106. Titled the Patients First Act, the legislation permits Georgia’s Governor to pursue two health care waivers that could make significant changes to health coverage for Georgia consumers. The legislation allows for an 1115 waiver to extend Medicaid coverage to some poor adults in Georgia but leaves out thousands who would be covered under a full Medicaid expansion. Additionally, the bill allows the Governor to make potentially seismic changes to private health insurance in Georgia through 1332 waivers with little accountability. While it is heartening that Georgia’s leaders see the need to create a pathway to coverage for more Georgians, this proposed legislation falls short for two reasons, both of which we’re asking you to take action on:
1. The proposed 1115 Medicaid waiver would cover fewer people at a higher cost than Medicaid expansion. It would leave out thousands of Georgians in need of coverage and leave the state accountable for a larger share of the medical costs for those who would be newly covered. Ask Governor Kemp and your state legislators to get the best deal for Georgia by covering all eligible Georgians. (Then plan to join us for Cover Georgia Day at the Capitol on February 28th!)
2. More than 480,000 Georgians rely on Georgia’s health insurance marketplace for health coverage, and many more are eligible. Changes made to private coverage through a 1332 waiver could benefit or harm these consumers, but the legislation, as written is too broad to determine its impact. Ask Governor Kemp and your state leaders to specify in the bill that any waiver will preserve critical consumer protections (like those that protect consumers with pre-existing conditions), maintain comprehensive, quality health coverage, support a stable marketplace through increased enrollment, and will not leave consumers on the hook for higher costs.
House passes step therapy bill
Step therapy legislation moves quickly through House
HB 63, a bill sponsored by Chairman of the House HHS Committee Representative Sharon Cooper, was passed by the House this week. HB 63 addresses step therapy, which is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the higher-cost treatment prescribed by a patient’s physician. This bill would require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. HB 63 will now go to the Senate for consideration.
GHF releases annual consumer health advocate’s guide
A Consumer Health Advocate’s Guide to the 2019 Legislative Session
GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. This annual booklet provides information on the legislative process, legislators, and committees, key agency officials, advocate contacts, and more. Experienced advocates and new volunteers will find their way around Georgia’s Capitol more easily with the information provided in this year’s guide. Download or pick up your copy today.
(Interested in a hard copy? Contact Michelle Conde.)
RSVP for Cover Georgia Day
Join Cover Georgia at the state capitol on February 28th!
Join us on Thursday, February 28th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of all Georgians. For the first time in Georgia, there is wide-spread agreement among Georgia’s legislators that something must be done to extend coverage to low-income Georgians across the state. Take advantage of this opportunity to ask your elected officials to close Georgia’s coverage gap now! RSVP today!
Can’t make it? Call or send an email to your state legislators asking them to put an insurance card in the pockets of all Georgians.
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.
- Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide
Momentum builds to close Georgia’s coverage gap
The 2019 legislative session is now in full swing and the past few weeks have brought the introduction of two bills that would close Georgia’s coverage gap by expanding Medicaid.
HB 37: Expand Medicaid Now Act; enact and SB 36 are sponsored by Representative Bob Trammell and Senator Steve Henson respectively. Each bill expands Medicaid in Georgia as envisioned by the Affordable Care Act by increasing Medicaid eligibility for adults up to 138% of the federal poverty guidelines (FPL). This is equivalent to $17,236 annually for an individual and $29,435 for a family of three.
In addition, Governor Kemp has announced that his office will seek an 1115 Medicaid waiver. An 1115 waiver provides states with the ability to experiment with or tailor their Medicaid programs. Governor Kemp has not released details of the waiver, so its impact on consumers is uncertain. The waiver could close Georgia’s coverage gap, among other changes to Medicaid coverage. Legislation to allow Georgia’s Medicaid agency to seek an 1115 waiver is expected to be introduced soon by Senate Republicans.
Tell Governor Kemp and your legislators that you support putting a health insurance cards in the pockets of Georgians regardless of their income.
Consumer protection bills introduced
Surprise medical billing emerges as a prominent issue
Surprise out‑of‑network medical billing is once again emerging as a prominent issue within the Georgia General Assembly. A surprise medical bill can occur when a consumer encounters an out-of-network (OON) provider at an in-network facility or in other circumstances. Two pieces of legislation have been introduced to address surprise billing and each attempts to resolve the issue in its own way.
HB 84: Insurance; provide for consumer protections regarding health insurance
Rep. Richard Smith, Chair of the House Insurance Committee, introduced HB 84 to increase transparency related to possible surprise medical bills. This bill sets disclosure requirements for health care providers, insurers, and hospitals. The legislation requires that information on billing, reimbursement, and arbitration of services must be provided to the consumer at their request. The bill also allows for an arbitration process between the consumer and the health care provider, the specifics of which would be determined by Georgia’s Department of Insurance. This bill currently sits in the House Insurance Committee and is in House second readers.
SB 56: Consumer Coverage and Protection for Out-of-Network Medical Care Act
Senator Chuck Hufstetler, Chair of the Senate Finance Committee, introduced SB 56 to address surprise out-of-network billing. This legislation disallows surprise billing in emergency situations under insurance plans issued after July 1, 2019. The bill contains similar transparency provisions to HB 84. For consumers who receive elective medical care after which they receive a surprise bill greater than $1000, the legislation makes available a mediation process through the Department of Insurance. This bill was referred to the Senate Insurance and Labor Committee.
Legislative calendar set
Legislature plans to finish work by April 2nd
The schedule for the remainder of the legislative session has been set in HR 152. Crossover Day, the day that legislation must move from one chamber to the other in order to be considered in 2019, will fall on March 7th. The remaining sixteen legislative days will be broken up throughout March, culminating on Sine Die, the last day of the session, on April 2nd. The full calendar can be viewed here.
RSVP for Cover Georgia Day
Join us at the state Capitol on February 28th!
Join us on Thursday, February 28th for Cover Georgia Day at the Capitol when we will ask our state legislators to close Georgia’s coverage gap by putting insurance cards in the pockets of low-income Georgians. This is the most important step that our elected officials can take to slow the growing opioid crisis, strengthen our state’s struggling rural health care system, and improve the health & finances of hardworking Georgia families. Take advantage of this opportunity to talk with your elected officials about closing Georgia’s coverage gap! RSVP today!
Can’t make it? Call or send an email to your state legislators asking them to put an insurance card in the pockets of all Georgians.
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.
- Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
Charlie Ellison is 87 years old and a long time resident of Dalton, Georgia. Charlie is one of over half a million seniors and people with disabilities in Georgia who depend on Medicaid and Medicare to live and function in their communities.
After suffering a fall while living alone in 2016, Charlie’s nervous system was damaged and he was no longer able to live independently. He attended physical therapy for ten months and lived at a nursing home in Dalton during this time which he paid for out of pocket.
Now that Charlie has Medicaid coverage, he is able to visit RossWoods Adult Day Services every day and enjoys engaging in activities with others his age. He is also able to live at home with his daughter and son-in-law who help take care of him, rather than in a nursing home where he had less independence and fewer activities to keep him healthy and active.
Before Charlie’s fall, he was already managing diabetes and high blood pressure, and had a pacemaker in his chest. Charlie’s Medicaid coverage picks up the costs of some of his medications that are not covered by Medicare, which ensures Charlie remains as healthy and independent as possible.
For 168,000 seniors like Charlie who typically rely on low, fixed incomes, Medicaid makes the difference and helps to pay the costs of their Medicare coverage, and for some, it provides additional health benefits not covered through Medicare. For others, Medicaid allows them to age with dignity in their communities by covering needed home and living adaptations like chair lifts, wheelchair ramps, or engaging day programs with trained staff.
Your story is powerful! Stories help to put a human face to health care issues in Georgia. When you share your story, you help others understand the issue, its impact on Georgia, and why it’s important.
Your health care story is valuable because the reader may be your neighbor, friend, someone in your congregation, or your legislator. It may inspire others to share their stories or to become advocates. It is an opportunity for individuals who receive Medicaid or fall into the coverage gap, their family members, their physicians and concerned Georgia citizens to show that there are real people with real needs who will be impacted by the health policy decisions made by Congress and Georgia’s state leaders.
Share your story here! Read and share our latest storybook here!
General Assembly meets for joint budget hearings
Last week the Georgia General Assembly met for the joint budget hearings during which Senate and House legislators heard from agency leaders and Governor Brian Kemp about the proposed current and upcoming state budgets. This year’s budgetary considerations consist of requested changes to the current FY 2019 state budget which will run through June 30th and proposals for the FY 2020 general state budget, which will begin on July 1st.
The House will now craft the budget requests into legislation and continue its funding considerations. Both chambers reconvened yesterday, January 28th, for the fifth day of legislative session.
2019 joint session budget hearings
Budget requests presented to the General Assembly
Last week, the General Assembly heard from department commissioners and other leaders regarding their budget requests for the amended FY 2019 budget (sometimes called the “little budget”) and the upcoming FY 2020 budget (called the “big budget”). Here we highlight some of the primary asks made by the state agencies that most impact consumer health. For more detailed budget analysis, please see the Georgia Budget and Policy Institute’s Overview of Georgia’s 2020 Fiscal Year Budget document.
Department of Community Health
The Department of Community Health (DCH) oversees Medicaid, PeachCare, and other state health care programs. Commissioner Berry requested an increase of $71 million in the amended FY 2019 budget to include $33.7 million for growth in Medicaid expense and $18.7 million for the Indigent Care Trust Fund, which draws down additional federal money for Disproportionate Share Hospital payments.
Commissioner Berry’s most significant request in the FY 2020 budget was an increase of $92 million to offset a reduction in the federal cost-sharing payments for Medicaid and PeachCare for Kids. Georgia’s Federal Medical Assistance Percentage (FMAP) rate will drop from 67.62% to 67.30% for Medicaid and from 100% to 88.61% for PeachCare for Kids, prompting the funding request.
Department of Behavioral Health and Developmental Disabilities
The Department of Behavioral Health and Developmental Disabilities (DBHDD) provides treatment, support services, and assistance to Georgians with disabilities, behavioral health challenges, and substance use disorders. Commissioner Fitzgerald’s request for the little budget mirrored the Governor’s recommendations to add $8.4 million for the Georgia Apex Program to provide support counselors for mental health services in high schools.
Commissioner Fitzgerald requested that the big budget include an increase of $78.6 million for the Department. The additional funds would be partially compromised of an additional $10.2 million for behavioral health crisis beds, $2.5 million for supported housing, and 125 new slots for NOW and COMP waivers to reduce the current waiting list.
Department of Human Services
The Department of Human Services (DHS) delivers a wide range of human services designed to promote self-sufficiency, safety and well-being for all Georgians. Commissioner Crittenden requested that the big budget include $849,951 to increase funds for 50 additional Medicaid eligibility caseworkers.
The Department of Public Health did not present during the joint budget hearings last week and the Department of Insurance did not have any budgetary requests that were specifically health related. We will include summaries from both departments as we learn more.
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.
- Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
- Track health-related legislation
- Look out for the 2019 Consumer Health Advocates Guide coming soon!
Georgians for a Healthy Future’s ninth annual Health Care Unscrambled breakfast built on previous years’ successes with another standing room-only crowd.
This year’s program began with a personal story from consumer Lori Murdock, who bravely shared her experience struggling to manage a chronic disease without health insurance because she was caught in Georgia’s coverage gap. Lori’s experience illustrates the pressing need to provide health insurance to all Georgians regardless of income.
Following Lori was our bipartisan legislative panel. This year’s legislative panelists were:
Each panelist provided updates on emerging health care trends impacting Georgia and took questions from the audience about what health issues are likely to be taken up in the 2019 legislative session. Topics included Medicaid expansion, surprise out of network medical billing, access to mental health, network adequacy, Certificate of Need reform, social determinants of health, rural health care access, federal health care reform, and affordability of health care. All three panelists shared an optimistic vision for health care in this years legislative session.
This year’s key note speaker was Dr. David Blumenthal, President of the Commonwealth Fund. Dr. Blumenthal brought a wealth of knowledge and insight to our conversation about how innovations in health care and coverage can help us achieve better health outcomes for all Georgians. He led the discussion by comparing Georgia’s health outcomes to those of our neighboring states, and then provided an agenda for improvement. He emphasized that Georgia is unlikely to overcome poor health outcomes unless state leadership improves insurance coverage, as demonstrated by the Commonwealth Fund’s own research on Medicaid expansion’s impacts on population health. Dr. Blumenthal also shared the importance of investments in the social determinants of health for improving health outcomes and ultimately saving money. Dr. Blumenthal’s presentation can be accessed here and the Georgia scorecard from the Commonwealth Fund can be found here.
To see photos, review materials, and get more information about this year’s Health Care Unscrambled event, please visit the event page.
For more event pictures visit our Facebook photo album.
Georgians for a Healthy Future released its 2019 policy priorities at this morning’s ninth annual Health Care Unscrambled legislative breakfast. These annual priorities outline the issues that GHF believes are most pressing for Georgia consumers and are best addressed by the state legislature. GHF will work to move all of these issues forward by engaging state policy makers, consumers, and coalition partners throughout the legislative session and the remainder of the year.
1. Increase the number of Georgians with health insurance.
Georgia’s uninsured rate hit a historic low of 12.9% in 2016, but remains one of the highest uninsured rates in the country because Georgia has not accepted federal funds to cover low-income Georgians. Approximately 240,000 Georgians remain stuck in the resulting coverage gap. These Georgians do not qualify for Medicaid under current rules and do not earn enough money to qualify for financial help through the Marketplace. Georgians for a Healthy Future supports closing this gap by extending health insurance to all Georgians with incomes up to 138 percent of the federal poverty level.
2. Stabilize Georgia’s health insurance Marketplace
Almost half a million Georgians are enrolled in health care coverage through the health insurance Marketplace. While Georgia’s Marketplace has proven robust, the last two years have brought declines in enrollments, as federal policy changes have undercut its stability. Other states have taken steps to shore up their markets by implementing state reinsurance programs, instituting state-level consumer protections and enforcement mechanisms, limiting the sale of short-term junk plans, and investing in outreach & enrollment. Georgians for a Healthy Future supports policies that promote affordable, comprehensive coverage and a competitive, stable Marketplace.
3. Ensure access to care and financial protections for consumers purchasing private health insurance.
When consumers enroll in a health insurance plan, they should have reasonable access to all covered services in the plan. As narrow provider networks become more common, health care consumers are at increased risk of not being able to access the medical services and providers they need without going out-of-network and receiving surprise out-of-network medical bills. In 2015, the National Association of Insurance Commissioners adopted a network adequacy model act for states. Georgians for a Healthy Future supports using this act as a foundation to develop quantitative standards for Georgia. Georgians for a Healthy Future further supports legislation that will hold consumers harmless when consumers end up with out-of-network bills despite making appropriate efforts to stay in network or because inadequate provider networks require them to go out of network to receive the services that they need.
4. Set and enforce standards that provide for equitable coverage of mental health and substance use treatment services by health plans.
The 2008 passage of the Mental Health Parity and Addiction Equity Act (Parity Act) required that health plans cover behavioral health services as they would physical health services. The Parity Act is only meaningful if health plans are implementing it well, consumers and providers understand how it works, and there is appropriate oversight. GHF supports legislation that sets standards and oversight procedures to ensure that Georgia consumers receive the coverage for mental health and substance use disorder benefits to which they are entitled by law and for which they have paid.
5. Prevent nicotine use and addiction by young Georgians
Georgia has one of the lowest tobacco taxes in the country at just 37 cents per pack, which makes tobacco much more accessible to youth in Georgia than in many other states. Moreover, Georgia does not apply an excise tax on the nicotine-delivery devices (e.g. e-cigarettes, vaping pens) that are preferred by young people today. For price-sensitive young people, increasing the price of tobacco and nicotine products decreases use and addiction, and the burden of chronic disease in Georgia. Georgians for a Healthy Future supports legislation to increase Georgia’s tobacco tax by at least $1 and to add an equitable excise tax on all nicotine delivery devices.
6. Support partners in integrating health and equity in the policies across every sector to address social determinants of health that prevent equitable access to care and equitable health status.
Factors outside the health system such as adequate housing, education, and economic opportunity impact the health of individuals, families, and communities. Left unaddressed, these and other complicating factors can inhibit the effectiveness of approaches that are strictly within the health system. Georgians for a Healthy Future supports policies that aim to advance health and health equity by addressing the social determinants of health.
To download GHF’s 2019 policy priorities, click here.
Georgia consistently ranks poorly among states in children’s mental health services, this year ranking 51st in a report from the Commonwealth Fund. However, state leadership has been adamant about improving Georgia’s system of care through the infusion of additional dollars for children’s mental health services in the state budget and through innovative programs like Project Advancing Wellness and Resilience Education (AWARE).
Georgia Project AWARE is a youth mental health initiative focused on improving the experiences of school-aged youth in Georgia, and is funded by a grant from the Substance Abuse and Mental Health Services Agency (SAMHSA) to the Georgia Department of Education (GaDOE).
The purpose of Georgia’s Project AWARE is “to increase awareness of mental health issues among school-aged youth; provide training in Youth Mental Health First Aid; and connect children, youth, and families who may have behavioral health issues with appropriate services.”
The four main goals of Georgia Project AWARE are:
- Increase participation of families, youth, and communities and mental health providers in efforts to identify the mental health resources available to meet the needs of students and families;
- Increase awareness and identification of mental health and behavior concerns, and student and family access to mental health providers through the PBIS framework in Georgia Project AWARE (GPA) schools;
- Increase the percentage of Georgia youth and families receiving needed mental health services through collaboration between school systems and community mental health providers; and
- Train educators, first responders, parents and youth group leaders to respond to mental health needs of youth by providing free training in Youth Mental Health First Aid (YMHFA).
Georgia’s Project AWARE grant supports the participation of three Georgia school systems: Griffin-Spalding County School System, Muscogee County School District, and Newton County Schools. The GaDOE has partnered with these school districts to provide training in Youth Mental Health First Aid and to develop innovative ways to connect youth and families to community-based mental health services.
Through Project AWARE, elementary and middle school teachers conduct universal screenings of their students and the screening results are used in two ways. School-, grade-, and classroom-level data is used to guide decisions about what universal supports or programs may be needed to better support the social and emotional needs of students. For example, if the results of the screening show high rates of anxiety for an entire grade of students, school leaders and teachers may make changes to school practices that may contribute to student anxiety or implement a program to help reduce or address the anxiety students are feeling.
Individual level screening results are used to identify those students who could benefit from extra social and emotional supports. These students are then connected to the appropriate behavioral services through partnerships the schools have developed with community-based providers.
Georgia Project AWARE has already screened a total of 18,713 students in 29 schools. Georgia State University’s Center for Leadership in Disability and the Center for Research on School Safety, School Climate and Classroom Management provide support for the program through analysis of the screening results and trainings for school leadership and staff.
In Getting to know Project AWARE: Part II, we’ll learn more about Youth Mental Health First Aid and how it helps educators meet the social and emotional needs of their students.
To learn more about Georgia Project AWARE:
- Visit the Georgia Department of Education (GaDOE)
- Read more from the Substance Abuse and Mental Health Services Agency (SAMHSA)
- Read the latest issue of the Georgia Project AWARE Digest
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