Based on feedback from consumer groups, the Centers for Medicare & Medicaid Services (CMS) announced today a shortened and simplified health coverage application that will help individuals easily apply for coverage when open enrollment begins on October 1, 2013.  Additionally, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options including those in the marketplace, Medicaid, PeachCare, and tax credits to help pay for premiums.  To view the new applications for individuals and families, click here and here, and 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.

Georgians for a Healthy Future is currently working with Enroll America to assess the interest and capacity of Georgia community-based organizations, health care-focused nonprofits, and other stakeholders in working collaboratively on education, outreach, and enrollment into the new health insurance options available to consumers in 2014 through the Affordable Care Act. As a first step, we held a webinar on April 10th and an in-person meeting on April 11th that many of you attended. For those who missed the meetings, the materials can be found here.

While a big part of those meetings focused on the navigator program, we are asking for your help today regardless of whether you plan to apply as a navigator. If your organization has a stake in covering the uninsured, we’re asking you to complete a brief survey about your current work and future plans to engage in connecting uninsured Georgians to coverage. Georgians for a Healthy Future plans to use the overall results of the survey to guide the formation of a new enrollment-focused coalition and to inform an upcoming policy brief on health insurance outreach and enrollment (all information will be reported in aggregate unless we seek and receive your permission to do otherwise).

Please take a few minutes to complete this survey. Georgians for a Healthy Future is committed to advancing the goal of covering Georgia’s uninsured by bringing stakeholders together who are interested in and able to collaborate towards this shared goal. The results of this survey will provide a baseline and starting point for this important work. Thank you!

Open enrollment into the new health insurance marketplace, or exchange, begins in just under six months (October 1, 2013) for coverage starting in January 2014.  Georgia has one of the highest numbers of uninsured in the nation (1.86 million), and many of these uninsured Georgians will be able to access health care coverage for the first time through the marketplace.

According to research from Enroll America, however, more than three-quarters of the uninsured don’t know about the new health insurance marketplace. Multiple surveys have also found that when uninsured individuals learn about the new health insurance options that will become available to them through the marketplace, they say they will need help navigating the process.

That’s why the new navigator program is so important. Last week, the U.S. Department of Health and Human Services (HHS) released a funding opportunity announcement inviting organizations and individuals to apply for the navigator program. Groups may apply individually or as a consortium, although HHS is encouraging the consortium approach. Navigator responsibilities include:

• Maintain expertise in eligibility, enrollment, and program specifications;

• Conduct public education activities to raise awareness about the Exchange;

• Provide information and services in a fair, accurate, and impartial manner. Such information must acknowledge other health programs (such as Medicaid and the Children’s Health Insurance Program (CHIP));

• Facilitate selection of a Qualified Health Plan;

• Provide referrals to any applicable office of health insurance consumer assistance or health insurance ombudsman established under Section 2793 of the Public Health Service Act, or any other appropriate state agency or agencies, for any enrollee with a grievance, complaint, or question regarding their health plan, coverage, or a determination under such plan or coverage; and

• Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Exchange, including individuals with limited English proficiency, and ensure accessibility and usability of Navigator tools, such as fact sheets, and functions for individuals with disabilities in accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act used in Holistic Drug and Alcohol Treatment centers and other similar types of organizations.

For entities interested in applying for the navigator funds, letters of intent (optional but recommended) are due on May 1, 2013 and applications are due to HHS on June 7, 2013.  To learn more about the navigator funding opportunity, click here.

Nearly 100 of you joined us last week for a meeting to begin discussing how consumer and community-focused nonprofit organizations can work collaboratively to maximize enrollment in Georgia. The meeting also was an opportunity for organizations considering applying to HHS for the navigator grants to network with each other and see if there were opportunities to submit joint applications. To those of you who were unable to join us, here are the resources and materials that were shared:

• HHS navigator funding opportunity announcement 
• Georgians for a Healthy Future’s navigator fact sheet
• Enroll America’s enrollment assisters fact sheet
• Enroll America’s navigator and in-person assistance programs
• Enroll America’s bridging the enrollment gap: the importance of providing in-person assistance
• Enroll America’s power point presentation
• Seedco’s power point presentation 
• Webinar power point presentation 

Join us for a webinar and in-person meeting about ACA Navigators April 10 and 11

If you or your organization are interested in applying for the upcoming funding opportunity provided through the Department of Health and Human Services (HHS) for navigator grants or you would like to connect with other organizations who will be applying, please join Georgians for a Healthy Future, Seedco, Families USA and Enroll America for an important webinar on April 10th, 2013 at 11am and an in-person meeting on April 11th, 2013 from 2:30 to 4:30pm at the Philip Rush Center (1530 DeKalb Ave).

 
In the next few days, HHS is planning to announce funding that will be available to organizations for outreach and assistance to help individuals and small employers enroll in health coverage. These grants are created as part of the navigator program that was established by the Affordable Care Act.  To learn more about navigators, click here.

To join us for the webinar, please click here to RSVP.  To join us for the in-person meeting to further discuss this funding opportunity and opportunities for collaboration on outreach and enrollment, click here.

The 2013 Legislative Session continues at a swift pace, with legislators in session today for day 17 of the 40-day session (the legislative calendar is available here). Here are some key health care updates:

• Yesterday, the Health Subcommittee of the House Appropriations Committee heard from the Commissioners of the state’s health-related agencies, including the Department of Community Health and the Department of Public Health, about their proposed FY 2014 budgets. Today, the subcommittee will meet again from 2 – 4pm in Room 506 CLOB to take public comment on the proposed budgets. If you would like to comment, you must sign up in advance in Room 245 of the State Capitol. The Georgia Budget & Policy Institute has released an analysis of the 2014 proposed budget for the Department of Community Health, available here.

• SB 24, which would authorize the Department of Community Health to levy a fee on hospitals to continue drawing down federal funds to support Medicaid and PeachCare for Kids, was passed by both the House and Senate and is expected to be signed into law by the Governor this morning. The current hospital fee is set to expire on June 30, 2013. The renewal of the fee is essential to ensuring Medicaid and PeachCare’s solvency and preserving access to hospital care in Georgia.

• HB 198 would require navigators to be licensed, place certain restrictions on their functions, and would give the Georgia Insurance Commissioner regulatory authority over them. Navigators are organizations or entities that apply for and receive federal grants authorized by the Affordable Care Act to provide individuals and small businesses with impartial information and assistance with enrollment in health coverage in the new health insurance marketplaces, or exchanges. While it is important that navigators are qualified to perform these functions and that there is adequate oversight to protect consumers, consumer advocates are also concerned that overly restricting navigators could have a chilling effect on the community-focused organizations whose participation in the navigator program will be critical in connecting hard-to-reach and vulnerable populations to coverage. Advocates worked with legislators to improve the bill, which passed the House Insurance Committee last week and was passed by the Rules Committee yesterday.

This afternoon, Governor Deal announced that Georgia would not move forward with a state-based health insurance exchange. Instead, Georgia will have, by default, a federally facilitated exchange. While a state-based exchange would have been more easily tailored for Georgia and could have been more responsive to the needs of Georgia’s health care consumers, a federally facilitated exchange will still provide information, decision tools, and access to tax credits to help consumers find and purchase meaningful and affordable health insurance.

As the federal exchange gets built out, it will be important that federal officials consider the needs of consumers in states like Georgia. To that end, earlier this week Georgians for a Healthy Future joined with consumer advocates in states across the country to submit a letter to the U.S. Department of Health and Human Services recommending that federal officials create a robust stakeholder planning process, ensure in-person consumer assistance programs meet consumers’ needs, and ensure that qualified health plans available on the exchange protect consumers and meet their needs. You can learn more about health insurance exchanges in Georgia by visiting Georgians for a Healthy Future’s health insurance exchange resource page here. We look forward to working with policymakers to ensure that the federally facilitated exchange is successful in Georgia and that consumers have better access to meaningful and comprehensive health coverage for themselves and their families.

This week’s election results removed any uncertainty about the Affordable Care Act’s future: the health reform law is here to stay. Now it is time to do the hard work of ensuring that health reform meets its promise in Georgia and that health care consumers have access to meaningful and affordable coverage.

Over the past three days, several news stories have outlined the key next steps and decision points for Georgia policymakers on Medicaid and the private health insurance marketplace, and many of them turned to Georgians for a Healthy Future to explain the implications for Georgia health care consumers. All articles are linked below.

Georgia expected to spar over Medicaid expansion in election aftermath

The Augusta Chronicle  | November 8, 2012

Big healthcare decisions loom for state in election’s wake

Atlanta Journal-Constitution  | November 7, 2012

Deal: No state exchange likely under Obamacare

11 Alive News  | November 8, 2012

Deal suggests Ga. unlikely to run health exchange

Columbus Ledger-Enquirer  | November 7, 2012

Health care law lives — and Ga. faces big choices

Georgia Health News  | November 7, 2012

Perhaps the biggest issue for Georgia’s policymakers to consider in the coming months is the Medicaid expansion. Leveraging the resources on the table to expand Medicaid will improve access to care, strengthen our state’s health care delivery system, and bolster Georgia’s economy. If your organization would like to join the Cover Georgia coalition in support of expanding Medicaid, email Georgians for a Healthy Future’s Outreach and Advocacy Director Amanda Ptashkin.

Health exchanges are a central feature of the Affordable Care Act and are intended to provide meaningful and affordable health insurance options for individuals and families who don’t have access to health insurance at work. The exchange, or marketplace, will be a place where consumers can shop for private health insurance plans utilizing decision tools and accessing tax credits to make the plans affordable. By 2014, these marketplaces will be up and running in every state, with some states operating their own exchange marketplaces, some states partnering with the U.S. Department of Health and Human Services on a “state partnership exchange,” and some states deferring to a federally facilitated exchange.

States planning to move forward with their own state-based exchanges must submit a blueprint by November 16^th of this year.  Georgia is not expected to be ready for a state-based exchange, as reported in the Atlanta Journal Constitution last week, and thus a default to a federally facilitated exchange is likely in Georgia.

Ensuring that a health insurance exchange works for Georgia consumers is a key priority for Georgians for a Healthy Future, whether it is a state-based exchange, partnership exchange, or federally facilitated exchange. Regardless of who is administering the exchange on the back end, we must make sure it works for consumers on the front end. To that end, Georgians for a Healthy Future remains engaged in this important issue on behalf of health care consumers. Our Executive Director served on the Governor’s Health Insurance Advisory Committee in 2011, which studied options for Georgia, and submitted a minority report advocating for Georgia to move forward with planning for a state-based exchange despite the full committee’s recommendations against doing so; Georgians for a Healthy Future released a well-received policy brief in August 2011 making policy recommendations for a Georgia exchange; and our staff and coalition partners have been active in discussions with federal officials, along with consumer health advocates from around the country, about how to make sure federally facilitated exchanges are responsive to the needs of consumers within the states.

More information about the exchange blueprint submission process is available here; a summary of Georgia’s status on exchange planning is available here; and all archived materials from Governor Deal’s health insurance exchange advisory committee are available here.

On June 28th, the United States Supreme Court upheld the constitutionality of the Affordable Care Act, a major victory for health care consumers in Georgia and across the country. Now, all eyes turn to the states for implementation of two of the most critical pieces of the law: the expansion of the Medicaid program and the establishment of health insurance exchanges. (more…)