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

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:

• Senator Kay Kirkpatrick
• Representative Debbie Buckner
• Representative Lee Hawkins

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.

This week GHF’s Outreach and Education Manager, Alyssa Green, takes some time to share her experiences and reflections from traveling across Georgia to collect consumer stories.

As the Outreach and Education Manager, I am tasked with the responsibility of traveling around the state to collect consumer stories. My travel and conversations with consumers provides a wonderful opportunity to better understand the health care issues many Georgians face. This past year, I’ve been to many Georgia communities and one place that has had a particularly significant impact on me has been Clay county.

Located in the Southwest region of the state, Clay county has one practicing physician, Dr. Karen Kinsell. Dr. Kinsell is a volunteer physician who provides medical care to approximately 3,000 patients in a small office building in that once served as a Tastee Freeze stand. There is a liquor store next door where patients have been known to buy alcohol while waiting to be seen.

Rural areas of the state have struggled economically for years, and Fort Gaines, the county seat, is no exception. Since 2013, two nearby hospitals have closed, the county has seen an exodus of physicians and other providers, and this year, the county’s only pharmacy closed. As a result, Clay county residents have increasingly had to seek treatment outside of their community, forcing them to travel more than an hour in one direction for doctor’s appointments and prescriptions. Limited access to transportation, job security, and limited opportunity for quality education has made recruiting and retaining health care providers and facilities nearly impossible. 

These circumstances lead to community members forgoing care and relying on home remedies for serious health conditions. I’ve met a few of Dr. Kinsell’s patients and they all had distressing stories about their health and health care. They’ve told me stories about being turned away from hospitals after experiencing a stroke, self-medicating with alcohol for severe dental problems, and hoping a suspected blood clot isn’t “that serious.” If it were not for Dr. Kinsell’s compassion and generosity, many Clay county residents would likely have to go without any medical care at all.

Seeing the statistics that come out of rural Georgia is concerning, but meeting the people behind the numbers can be heartbreaking. Each of these stories matters individually, and here at GHF, we think there is great value in lifting up the voices and experiences of individual consumers. But collectively these stories are even more powerful. They speak to the great need that exists across Georgia for an equitable, accessible, affordable health care system that provides quality care to every Georgian regardless of geography, income, or demographic.

Medicaid provides health care coverage to almost two million Georgians, including 1.3 million children across the state and 500,000 seniors and people with disabilities. It’s comprehensive coverage provides needed health care services that would otherwise be unaffordable to low-income Georgia families and individuals in communities across the state. Because Medicaid is so fundamental to Georgians and Georgia’s health care system, GHF is highlighting it in two new resources!

The Medicaid Matters to Georgia storybook shares the real health care stories of Georgia children and families. Georgians from across the state share the important role that Medicaid plays in their lives. Hear directly from Sherry, Travis, Oliver, and others about their experiences. Oppositely, Mary, Susie, and other uninsured Georgians share how Medicaid coverage could improve their lives if state policy makers closed Georgia’s coverage gap.

Our new Medicaid Matters for Georgia fact sheet is updated with what you need know about Medicaid. This one-page fact sheet outlines who is eligible for Medicaid in Georgia, what health services and supports are covered, and why Medicaid is a good investment for Georgia.

GHF’s new resources bring attention to the difference Medicaid makes in the lives of Georgians every day and the potential it has to serve those who are currently uninsured. We hope these new resources help policymakers, advocates, and consumers from across the state better understand the importance of ensuring all Georgians have access to quality, affordable healthcare. We invite you to read and share both with your friends, colleagues, and partners.

Georgians for a Healthy Future is partnering with community groups across the state to host Georgia Voices for Medicaid events. If you are interested in learning more about Georgia’s Medicaid program, who it covers, how it benefits the state, and how you can be a strong health care advocate, you should attend! Check out our events page to see if we have any Georgia Voices for Medicaid events happening near you or contact Alyssa Green at agreen@healthyfuturega.org if you would like to schedule one in your community.

The race to be Georgia’s Insurance Commissioner is one of the most overlooked statewide races on the ballot this November, despite the position’s impact on the health and finances of almost all Georgians.

Georgia’s Office of Insurance and Safety Fire Commissioner (commonly referred to as the Department of Insurance or DOI) is headed by Georgia’s Insurance Commissioner. The Department oversees health, auto, long-term care, and other insurance products that can be regulated by the state. For Georgians who have individual or small-group insurance (about 2.6 million Georgians), the Insurance Commissioner has a direct impact on their insurance rates, their ability to access needed health services, and the extent to which their coverage is transparent and fair.

Georgia’s Insurance Commissioner is a constitutional officer in Georgia and is elected by Georgia voters for a four-year term. The Commissioner and the Department are tasked with regulating insurance companies and licensing insurance agents operating in Georgia and overseeing state fire safety initiatives, in addition to other non-health-related duties.

Because the Insurance Commissioner is primarily responsible for overseeing private health insurance in Georgia, they are key to how the Affordable Care Act and its consumer protections are implemented in the state. For example, the ACA requires that insurance companies justify any premium rate increases of more than 10% through a process called “rate review”. The Commissioner and Department staff determine how strong and transparent to make Georgia’s rate review process, and in doing so, determine how accountable insurers must be as they ask consumers for more dollars out of their household budgets.

The Commissioner and DOI are also responsible for ensuring that health plans do not design their benefits so that they discriminate against certain types of consumers. For example, if a health plan only covers one type of HIV medication and only at the highest cost-sharing level of the plan, the Commissioner could instruct his department to examine whether the plan’s design constitutes discrimination against people living with HIV. Similarly, health plans are required to cover mental health and substance use treatment services at the same level as they cover physical health services. If the Commissioner is lax in overseeing the enforcement of these laws, consumers could be financially blocked from receiving the health services that they need.

The Commissioner and his office also license insurance agents selling health insurance plans and other consumer products, as well as Georgia’s health insurance navigators. The position of “navigator” was created and funded through the Affordable Care Act in order to provide free, local, unbiased assistance for consumer enrolling into health coverage through the Marketplace. Currently, Georgia’s navigators have to meet unnecessarily burdensome licensing requirements and pay a large fee in order to be licensed by the state, something that Georgia’s next Insurance Commissioner has the power to address.

The Department of Insurance is further charged with protecting Georgia citizens from insurance fraud, mediating disputes between consumers and insurance companies, and assisting consumers with questions. The Georgia Department of Insurance has historically been under-resourced and, as a result, has struggled to carry out these tasks in a robust way. Georgia’s next Commissioner will be integral in advocating for the budget and resources needed to assist and support Georgia consumers across all insurance products.

Georgia’s next Insurance Commissioner will have a significant role in shaping the state’s health care landscape over the next four years or more. Whether and how the state addresses issues like access to care, health care affordability, the opioid crisis, and the sustainability of the rural health care system may be decided by voters at the ballot box this November.

This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2018 election on timely consumer health issues. Please check out our previous blogs in the series:

• Eight questions for health care voters to ask Georgia candidates
• Governor blog
• General Assembly Blog

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.

Pricilla Epps is a 54-year-old former security guard who lives in Blakely, GA, a rural community in the southwest region of the state.

Two days after having a sudden stroke, Priscilla lost her job because she was unable to work her scheduled shifts as she recovered that week. Priscilla’s health insurance was provided by her employer, so she lost her health insurance coverage when she lost her job, leaving her on the hook for all of the hospital costs that accumulated as she received care for her stroke. After a two-day stay, Priscilla was told she would have to leave the hospital due to her inability to pay for the costs of in-patient care.

Experiencing dizziness, difficult walking, discomfort in her limbs, and frequent forgetfulness, Priscilla went to see Dr. Kinsell, the only available physician in Clay County, where she still receives the limited follow-up care she can afford. She is still unable to go back to work or live on her own, so Priscilla has been living with her daughter for the time being.

Like Priscilla, 360,000 low-income Georgians, many of whom are uninsured, live in small towns and rural areas across the state. These areas have the most at stake in the debate over whether or not to close the health care coverage gap. According to a new report from Georgetown University’s Center for Children and Families and the University of North Carolina’s Rural Health Project, Medicaid expansions in other states have cut the uninsured rate in rural areas by half, while Georgia has seen a much smaller decline from 43 percent to 38 percent among the same population.

For rural Georgia residents like Priscilla, health coverage would open doors to the physicians and services that they need to stay employed or get back to work. For rural communities like Blakely, more residents with health coverage could make the difference between keeping or losing the few remaining primary care physicians in the area.

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!