WEEK 5

As the session has progressed, additional pieces of legislation that could impact health care consumers have been introduced. For a list of all the bills we’re watching, click here. SB 302, the Provider Directory Improvement Act was heard in committee and goes to a vote this week.

WHAT HAPPENED THIS WEEK

Improving Provider Directories

SB 302 was heard in committee last Thursday. We are happy to report that the conversation was widely favorable. There were a few points of contention around the usability provisions in the bill but the committee chair and bill sponsor were optimistic that consensus could be reached ahead of this coming Thursday’s committee meeting, where a vote is expected.

Please call or email the committee members and ask that they vote for SB 302, the Improving Provider Directories Act!

Sen. Charlie Bethel (Chairman)  404-651-7738

Sen. David Shafer (Vice Chairman) 404-656-0048

Sen. P.K. Martin (bill sponsor) 404-656-0048

Sen. Gail Davenport 404-463-5260

Sen. Marty Harbin 404-656-0078

Sen. Ed Harbinson 404-656-0074

Sen. Burt Jones 404-656-0074

Sen. Josh McKoon 404-463-33931

Sen. Renee Unterman (bill co-sponsor) 404-463-1368

Sen. Larry Walker 404-656-0081

Surprise Out-of-Network Billing

In both the House and Senate we are still hearing strong interest in addressing surprise out-of-network billing. We expect legislation to be introduced this week from Sen. Renee Unterman that would address this issue. Join the Georgia Health Action Network (GHAN) to receive updates on health-related legislation the General Assembly is considering and information about steps you can take to show your support (or raise your concerns)!

Network Adequacy 

GHF supports updating Georgia’s network adequacy standards. We don’t expect to see legislation this year, but there are conversations happening in both chambers and in both parties. GHF will be advocating for a study committee to meet during the 2016 off-session so that the legislature will have enough information during the 2017 Legislative Session to debate the best standards for Georgia. To read more about network adequacy and why is matters to Georgia check out our new policy brief. You can also watch this interview with Julie Silas of Consumers Union on the topic.

Closing Georgia’s Coverage Gap

Rep. Stacey Abrams has sponsored HB 823, the Expand Medicaid Now Act. While we don’t expect this legislation to receive a hearing this year, it is sparking important conversations about the coverage gap in Georgia. Read more here.

If you want to get involved in the movement to close Georgia’s coverage gap you can share this video with your social network or sign this petition. You can also follow the conversation on Twitter using #CoverGA

LET’S CHAT

This week we’re highlighting a conversation with Consumer’s Union policy expert, Lynn Quincy. Lynn talks about why Georgia should be talking about health value, and the cost to taxpayers when we don’t.

As consumers navigate the new landscape of increasingly narrow networks and high deductibles, they need the right tools and information to choose a health insurance plan that best fits their medical needs and their household budgets. Provider directories are the primary tool available to consumers to determine whether the plan they are selecting has a narrow or broad network and to identify which providers are in their plan. As such, these directories should be accurate, up-to-date, and should truly function as a tool. Despite the important role directories play, they are notorious for being rife with errors and for lacking the functionality to help consumers make optimal choices in the market. By drawing upon model legislation from the National Association of Insurance Commissioners (NAIC) and best practices from other states, Georgia can take steps to improve directories. This policy brief:

– explains the role provider directories play as a tool for consumer decision-making

– describes current provider directory provision in Georgia

– describes common problems with provider directories

– outlines recent policy activity around provider directories

– highlights other state examples of provider directory improvements

Download the brief here.

When consumers enroll in a health insurance plan, they gain access to a network of medical providers. This network must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. While network adequacy is not a new concept, it has a new urgency in light of the sheer number of newly insured Georgians enrolled in individual plans; the move on the part of insurance companies toward narrow networks and tiered networks, which limit the number of providers plan enrollees can access; new federal standards; and a new model act from the National Association of Insurance Commissioners (NAIC) that provides updated guidance for states. Georgia health care consumers need and deserve clear standards and protections that ensure their coverage translates to access to care without financial hardship. Georgians for a Healthy Future released today at a public policy form held in Atlanta a new policy brief on network adequacy. This policy brief:

– explains the importance of network adequacy for access to care

– outlines current network adequacy standards in Georgia

– summarizes recent policy activity around network adequacy

– sets forth consumer-oriented principles for network adequacy standards in Georgia

– provides policy recommendations to achieve network adequacy in Georgia.

Download the brief here. 

GHF helped over 100 people get covered

Open enrollment formally concluded on January 31, 2016 and 587,845 Georgians enrolled in the Marketplace (healthcare.gov).

Throughout open enrollment, GHF worked to get Georgians enrolled through direct service and the creation of GEAR (or the Georgia Enrollment Assister Resource Network). GEAR is the new central hub of resources for Georgia’s enrollment assisters and community partners who work with consumers to educate them on their health and health care coverage options. If you are interested in learning more about GEAR or want to sign up for the newsletter, email Whitney. Additionally, during this open enrollment period we have provided enrollment assistance to 78 applicants and their families, totaling 141 Georgians. Of those, 91%  received financial assistance.

In December, the ACA Implementation Research Network released its Georgia state report at a policy forum held at the Community Foundation for Greater Atlanta. The report provides a detailed look at the key decisions made by Georgia policymakers around the implementation of the Affordable Care Act over the past five years. Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated in a discussion with advocates, policymakers, and stakeholders to reflect on the report’s findings. The conversation ranged from health insurance enrollment best practices to health system reform to what it will take to close the coverage gap in Georgia. The ACA Implementation Research Network is jointly operated by the Nelson A. Rockefeller Institute of Government, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania. The Georgia state report was written by Michael Rich, Professor of Political Science and Environmental Sciences at Emory University.  Download the Report.

The National Association of Insurance Commissioners approved an updated network adequacy model act at its Fall meeting in November. The model act is a framework that states can adopt to help ensure that consumers have meaningful and timely access to the health services in their benefit package. With more insurance companies offering narrow network plans, these basic standards are an important consumer protection, and GHF encourages state policymakers to consider tailoring and adopting the model act in Georgia. We’ll be announcing our legislative priorities for 2016 soon, and this issue will be on the list!

This workbook is a take-home, interactive resource for the newly enrolled. It covers topics that enrollment assisters may not have time to cover during the enrollment appointment, such as how to find a primary care provider, how to make your first appointment, and even how to make a budget. People can fill in the workbook with their own information so they have all of their important health coverage information in one place. Download the workbook here.

How much of the state budget went to health, and where was that money allocated?

Which health care-related bills passed, and what do they mean for my family and my community?

For the bills that didn’t pass, are they dead?

What study committees should I be paying attention to throughout the summer and fall?

For a complete understanding of what happened this legislative session, don’t miss our webinar.  Lobbyist Andy Lord and Community Outreach Manager Laura Colbert will walk you through what you need to know and answer any questions you may have.

Don’t worry – you can still sign up!

Date:Thursday, April 9

Time:12:00 – 1:00 EDT