According to numbers provided Monday by Georgia Department of Human Services Sec. Candice Broce, about 1.7 million people still need their cases processed...While the state has yet to break down…
Tag: health insurance exchange
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
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.
If you’ve been following the Peach Pulse you know that network adequacy is a hot topic in health care right now. (And if you missed it, check here and here to get caught up!) Decision-makers are weighing policy choices that will have implications for health care consumers in Georgia and across the nation. We know that they are hearing from health industry stakeholders; now they need to hear from you!
1) The US Department of Health and Human Services (HHS) Proposed Rule on the 2016 Notice of Benefit and Payment Parameters is open for comment until December 22, 2014. To submit a comment, click here.
2) The National Association of Insurance Commissioners (NAIC) is currently updating its model act on network adequacy. This model provides an example that states can use to enact their own legal protections to guarantee private insurance consumers an adequate provider network once they are enrolled in coverage. Advocates can email email@example.com until January 12, 2015 with input.
Consumer advocates are asking these two entities to put in place 1) specific network adequacy standards such as time and distance standards and appointment wait time standards and 2) rules that provide consumers the right to go out-of-network at no extra cost if their plan cannot provide them timely, geographically accessible, and appropriate in-network care. Please take a few moments to submit your comments to HHS and to the NAIC with this important request. If your organization is interested in engaging more deeply on this issue, please contact Laura Colbert at firstname.lastname@example.org to let us know you’re interested in collaborating.
Georgians for a Healthy Future is excited to welcome Nykita Howell, our new Health Insurance Navigator, who joined us this week! In this role, Nykita provides Marketplace enrollment assistance to Georgia health care consumers. Prior to joining Georgians for a Healthy Future, Nykita worked in the fields of clinical and community based research and as a navigator for the first open enrollment period of the Health Insurance Marketplace. Her research efforts have been on studies focused on retention strategies for an NIH-funded cohort based at Umass Medical School, and a church-based diabetes project housed at Mercer University. Her work as a navigator prior to joining Georgians for a Healthy Future included building community partnerships and educating consumers over a seven county area. She holds an MPH from Mercer University School of Medicine and is a Certified Health Education Specialist. Prior to her graduate studies, Nykita received her B.S. in Biology from Clark Atlanta University, in Atlanta, GA. If you or anyone you know needs assistance navigating the health care system, please contact Nykita at email@example.com or 404-567-5016. Remember, open enrollment begins Nov. 15th—just one month away!
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:
- 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.
- 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.
- 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.
- 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!
The following opinion piece by Georgians for a Healthy Future’s Executive Director Cindy Zeldin originally appeared in today’s Atlanta Journal-Constitution.
Large majorities of young adults say they need and value health insurance, yet people in this age group are far more likely to be uninsured than children, seniors or older adults. Thirty-five percent of Georgians between 18 and 34 are uninsured. How can something so important be so elusive?
Until now, the health insurance of millenials had largely been neglected by public policy, leaving them with few options that provided adequate benefits at an affordable cost.
Most Americans get health insurance as a workplace benefit. They get a substantial employer contribution and receive these benefits on a pre-tax basis. Today’s young adults, however, are entering the job market in a tough economy. They are less likely to land jobs with health insurance. They often cobble together internships and part-time work to gain experience and make ends meet. For too many young adults, there simply has been no viable pathway to coverage.
The tide is turning. An estimated 3.1 million young adults nationwide — and 123,000 here in Georgia — have gained coverage as a direct result of an Affordable Care Act provision that allows parents to keep their children on policies up to age 26. This popular and effective public policy change was just a first step. The new health insurance exchanges will provide options for young adults who previously had nowhere to go.
These plans provide decent benefits and, in many cases, access to tax credits to make them affordable. The tax credits, available to individuals with annual incomes between $11,490 and $45,960, can be taken either at the time health insurance is purchased or at tax time. Some moderate-income individuals also can get help with out-of-pocket expenses.
For millenials who had been underwhelmed with the health insurance options available to them in the past, this is a breath of fresh air. For example, maternity coverage had been nearly impossible to secure in the Georgia non-group market for young couples ready to start a family. Now, this important benefit will be available.
While it is true some young adults enrolled in old plans may see higher premiums, many of those old plans didn’t provide adequate protection. Further, young adults who had a pre-existing chronic helath condition were locked out of the market entirely, a practice insurance companies must discontinue.
The private insurance plans available through the exchanges won’t meet the needs of all young adults in Georgia. Those who have incomes that place them below the poverty line will likely remain uninsured unless Georgia expands its Medicaid program.
Most young adults want what Americans of all ages want: the peace of mind that comes with knowing that an unexpected cancer diagnosis or accident doesn’t equal financial ruin, and that they have access to basic medical services. The new coverage options are finally leveling the playing field for this generation. It’s about time.
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 firstname.lastname@example.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!
During the 2013 Georgia Legislative Session, our state’s policymakers enacted HB 198 into law, which requires state training, licensure, background checks, and continuing education for navigators. Georgians for a Healthy Future has some concerns about this law and the potential hurdles it sets up for community-focused nonprofits already facing an uphill battle to reach, educate, and facilitate enrollment for consumers who haven’t historically had insurance. As such, we reached out to the Georgia Department of Insurance with suggestions to make the implementation of the law less burdensome for navigators, and some of our input was incorporated.
The proposed rule was presented at a hearing held by the Department of Insurance on July 30th. The regulation implementing HB 198 is available here. Georgians for a Healthy Future was also featured in two recent news articles in the Atlanta Journal-Constitution about the navigator program, available here and here. Additionally, the Center for Public Integrity just released an article focusing on various state licensure laws as they affect navigators. That article can be found here. We will continue to monitor this process with an eye towards ensuring navigators and assisters aren’t impeded from carrying out their important work.
Last week, health insurance premiums for the Marketplace were a hot topic, as Georgia’s Insurance Commissioner released some information about the rates that insurance companies proposed for the Marketplace. Georgians for a Healthy Future was frequently cited in media coverage of this issue, drawing attention to the fact that many consumers who were shut out of the market in the past would now be able to purchase insurance for the first time, with hefty tax credits that will make these plans affordable.
This issue was covered by the Atlanta Journal- Constitution, Georgia Health News, The Augusta Chronicle, and WSAV-Savannah. Articles featuring comments by Georgians for a Healthy Future’s Executive Director are available below.
Some Warn Exchanges Will Raise Insurance Rates
WSAV | August 5, 2013
State grudgingly OKs insurance rates for exchange
Georgia Health News | August 1, 2013
State OKs new rates for insurance exchange
Atlanta Journal-Constitution | August 1, 2013
Georgia seeks delay on high health care premium approvals
Augusta Chronicle | July 30, 2013
State seeks delay on rate approval for exchanges
Georgia Health News | July 30, 2013
Thank you to the dozens of community groups, nonprofit organizations, and health care stakeholders who responded to our survey about your plans to conduct consumer outreach and facilitate enrollment into the new health insurance options that will become available to many uninsured and underinsured Georgians later this year through the new health insurance exchange, or marketplace. Georgians for a Healthy Future will compile the results and share them as part of a resource document later this summer. In the meantime, here are two new resources that may be useful for you.
- Families USA, a national consumer health advocacy organization, has developed an online resource center for navigators and others working on outreach and enrollment. You can visit the resource center here.
- Consumers Union, the policy and action division of Consumer Reports, has developed a consumer-tested brochure to help consumers understand the new health insurance tax credits. The brochure is available here.
You can also find links and resources regarding health insurance navigators on the Georgians for a Healthy Future website here.