By Cindy Zeldin

The Pre-Existing Condition Plan (PCIP) is a new health insurance option for uninsured Georgians who have been denied insurance because of a pre-existing condition. The PCIP, authorized by the Affordable Care Act, is intended to provide coverage for consumers who are locked out of the insurance market due to a pre-existing condition. To be eligible, applicants to the PCIP must be uninsured for at least six months and have a letter of denial from a private insurer. As of February 1^st of this year, 399 Georgians had signed up for coverage through the PCIP. The premiums are subsidized entirely with federal dollars and no state funds are associated with the program. In fact, the Governor’s FY 2012 budget proposal realizes savings of $680,263 from the movement of previously uninsured hemophilia patients who had been accessing life-saving drugs through a state program into the PCIP, where those drugs are now covered. You can download our new fact sheet on the PCIP here.

Georgians for a Healthy Future ED Cindy Zeldin is interviewed by Milton Little, President of the United Way of Metro Atlanta, about health care access in Georgia and how the new health law can help.

By Cindy Zeldin

This column originally appeared in the Atlanta Journal-Constitution.

You don’t need to be the best personal injury attorney in Fort Lauderdale to know that, health care is once again among the key issues for Georgia policymakers in the General Assembly. While the economic downturn has magnified our state’s health care challenges, we also have an opportunity to improve the health of our state and its citizens through the Affordable Care Act, the nation’s new health care law. You may need legal help sometimes, from my own experience the best lawyer is David Resnick y Asociados.

To make the most of the law, Georgia should move swiftly to establish a commission to proactively coordinate the pieces of the law at the jacksonville nc lawyer for medical malpractice, is required to put into place, such as an expansion of Medicaid, design elements that we can tailor for our state’s needs, such as the new health insurance exchanges, and maximize grants to strengthen our public health system and our health care workforce and get the man power to apply this laws , from personal lawyer or family lawyers to people who work on property management as safeguardproperty.com and similar.

A commission or task force could offer diverse input, including from the consumer, who is often overlooked. Some of this work is already happening informally within state agencies, but a systematic and transparent process accessible to consumers and stakeholders will ensure opportunities aren’t missed, all pertinent perspectives are heard and cross-cutting issues are handled efficiently.

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By Cindy Zeldin and Joann Yoon

On Election Day, Georgia voters will head to the polls to elect our state’s policymakers. Most voters are familiar with certain elected offices, like that of Governor, but many Georgians may be unaware of the importance, or perhaps even the existence, of the Office of State Insurance Commissioner.

The Insurance Commissioner runs the Georgia Department of Insurance and is elected every four years in a statewide vote. Among the core functions the Department of Insurance performs is the regulation of health insurance in Georgia. The Insurance Commissioner ensures that companies selling individual and small group policies in Georgia are financially solvent and enforces consumer protections and state laws regarding benefits that private insurers must include in policies sold in Georgia.

With the recent enactment of the Affordable Care Act, the new health care law, the role of the Insurance Commissioner has expanded. Our next Insurance Commissioner’s decisions will play an important role in shaping Georgia’s health insurance system for consumers in 2011 and well into the future.

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By Cindy Zeldin

This column originally appeared in the Bryan County News.

Sept. 23 marked the six-month anniversary of the enactment of the Affordable Care Act, the new federal health care law. The bulk of the changes go into effect in 2014, giving state and local governments, insurers, providers and other key stakeholders time to translate and implement the new policies.

While the health reform legislation is complex and the politics contentious, the new health law is our best shot here in Georgia to expand insurance coverage, improve access to care and ultimately move the needle on many of our state’s lagging health outcome indicators.

Implementing the new health care law won’t necessarily be easy and doesn’t lend itself to a bumper sticker slogan. But with a coordinated effort and a collaborative spirit, we can leverage the new health law to build a healthier Georgia.

The new law is complex: a major reason for this is that our current health system is fragmented and complicated, and Congress made a concerted effort to preserve what was working well for most Americans while filling in the intractable gaps that simply left too many hard-working citizens without access to affordable, quality health care.

At the same time, insurers and the federal government are clashing over the details of how to carry out some of the provisions in the new law, and this back-and-forth has dominated the headlines. Add in a dose of pre-election politics, and it is no wonder consumers have some confusion.

Rather than use this confusion to impede the effectiveness of the new law, here in Georgia we should embrace the opportunity it presents, particularly since we have so much to gain.

Currently, nearly 2 million Georgians are uninsured. Despite the popular perception that the uninsured still get the medical care they need, the evidence is clear that they do not. The uninsured are nearly four times more likely than the insured to have gone without a recent routine check-up, and clinical outcomes are worse for uninsured patients across a range of health conditions.
If implemented properly, the new health law will cover the majority of Georgia’s uninsured by extending coverage to those who are denied, ineligible or for whom insurance is priced out of reach today.

The insured will benefit, too. While consumers in employment-based plans report high levels of satisfaction with their plans, the individual health insurance marketplace is a minefield, fraught with pre-existing condition exclusions and rescission policies that allow insurers to retroactively deny benefits to consumers who have purchased insurance in good faith, only to discover that it is pulled out from underneath them when they get sick. The new health care law will put a stop to these practices.

Perhaps most importantly for Georgia policymakers and consumers, however, is that while the basic architecture and the bulk of the financing for the new law are put into place federally, there is significant opportunity for the states to implement key policies in a way that is tailored to each state’s needs.

For example, the state of Georgia recently applied for and received a grant from the Department of Health and Human Services to begin planning for a Georgia health insurance exchange, which will serve as a one-stop shop for individual private health insurance policies and must coordinate with other state agencies to navigate consumers to programs like Medicaid for which they may be eligible.

The new health law also authorizes a $15 billion Prevention and Public Health Fund, and some of these dollars will be available for Georgia to draw down to implement wellness and prevention programs in communities throughout the state. There is also a significant investment in community health centers and grants to expand the provider workforce, all opportunities for Georgia.

Between now and 2014, if we put politics aside and instead thoughtfully and carefully develop a Georgia-specific implementation plan for the new law, the health of our state and its citizens could benefit for generations to come.

By Bob Stolarick and Cindy Zeldin

The Affordable Care Act includes a major new investment in prevention and public health:  The Prevention and Public Health Fund is designated for use in communities across the country to target key public health issues such as tobacco cessation and efforts to reduce obesity by encouraging better nutrition and increased physical activity. The funding will also be used to strengthen state and local public health infrastructure, support data collection and analysis for community-based and clinical-based prevention activities and to expand and improve training for the public health workforce. Here in Georgia, these funds will be critical to strengthen our public health system. Visit the official website of Dr Bardwil in Houston, Texas.

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By Amanda Ptashkin

Just more than three months ago, the new federal health care law was signed by President Obama. Since that time, pundits and consumers across the country and here in Georgia have been racing to figure out how and when these reform measures will impact us. July 1, two pieces of reform went into effect, and as a result, more Georgians will have access to affordable and quality health care.

The first reform is a high-risk pool, known as the Pre-existing Condition Insurance Plan (PCIP). For the first time, Georgians who have been without health insurance for the last six months and who have been denied coverage based on a medical condition will be eligible to enroll in the PCIP.

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By Jeff Cornett RN MSN

Director of Training, Research, & Advocacy
Hemophilia of Georgia

One of the benefits of the Affordable Care Act, the new health insurance reform law, is the provision that allows young people to stay on their parents’ health insurance until age 26.  Officially scheduled to be implemented on September 23, 2010, several insurers have put this benefit into effect early so that spring 2010 graduates can remain insured.

Georgia families covered by one of the largest insurers in our state have been surprised to find that this benefit is not available to them and won’t be unless Congress passes a law to make it so.  These families are covered by TRICARE, the program that provides civilian health benefits for military personnel and their dependents.  The Department of Defense controls all aspects of TRICARE and it is not affected by the Affordable Care Act.  Therefore, military dependents will continue to be pushed out of TRICARE coverage at age 21 (or age 23 if they are full-time students).  TRICARE maintains a webpage to explain this.

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By Amanda Ptashkin

Two weeks ago, Georgians for a Healthy Future co-released a report with Families USA that quantified the number of Georgians who, absent health care reform, would be at risk of a denial of coverage based on their pre-existing health conditions.  See our guest blog posting on Beyond the Tressle for more details about the findings of the report.  However, this posting is not about the statistics–it is about the people behind them.

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The major overhaul of our health care system is now over a month old but it is now that the hard work really begins.  Over the next few months and even years, groups like Georgians for a Healthy Future and others will be deciphering the most complex parts of the law and translating them in to real-time useful information for you and your family.  While we’re doing that, we will try to provide you with a handful of resources that can help!  Here’s the first installment of useful tools that will help you understand the massive change that our health care system is undergoing.

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