GHF surveyed and interviewed enrollment assisters across the state to understand not only the “what,” but also the “why” behind the second open enrollment period.  The results of that research have led us to several policy recommendations to maximize health insurance enrollment and retention and to ensure that coverage translates to meaningful access to timely and appropriate medical services for Georgia health care consumers.

1. Close the coverage gap in Georgia. Approximately 300,000 Georgians fall into the coverage gap, meaning they do not qualify for Medicaid under existing income eligibility guidelines in Georgia but their income is still too low to qualify for financial assistance (tax credits) to purchase health insurance on the Marketplace. Eligibility for tax credits begins at 100 percent of the Federal Poverty Level, or $11,770 for an individual or $20,090 for a family of three in 2015, while Medicaid eligibility for most adults in Georgia cuts off at income much lower. Thirty states including DC have closed their coverage gaps thus far with promising results. We encourage Georgia policymakers to take this important step as well to ensure all Georgians have a pathway to coverage.
2. Set and enforce network adequacy and transparency standards. Many of the plans sold through the Health Insurance Marketplace are Health Maintenance Organization (HMO) plans that feature narrow provider networks. While these narrow networks can help keep premiums down, a trade-off many consumers may be willing to make, consumers do not currently have sufficient information to make this choice. There is no information available to consumers at the point of sale about whether a provider network is ultra narrow, narrow, or broad, and provider directories are routinely inaccurate. More transparency and oversight are needed to ensure that consumers have accurate and useful information to make these choices. It is also important that all provider networks allow for meaningful access to all covered benefits. To ensure this, we support putting in place and enforcing network adequacy standards.
3. Encourage public-private partnerships and remove unnecessary restrictions on consumer education and assistance. Many of the enrollment assisters we surveyed indicated that reducing barriers to partnering with state government organizations such as public colleges, universities, and health departments would lead to stronger and more effective partnerships. Specifically, many respondents indicated that improved coordination between enrollment assisters, the Marketplace, and the Georgia Department of Community Health (DCH) to better facilitate PeachCare for Kids and Medicaid enrollment would be helpful. The “Health Care Freedom Act,” passed in 2014 as part of HB 943, prohibits state and local governmental entities from operating a health insurance navigator program and places other limitations on governmental entities. This provision has been counterproductive, creating confusion around what educational and consumer assistance activities local entities can engage in as they work to serve their community members. We recommend lifting these restrictions.

More than 26,000 Americans die every year because they lack health insurance. Right here in Georgia, an estimated 1,000+ people died in 2010 because they didn’t have health insurance, among the most in the nation.  People who are uninsured are less likely to have a usual source of care, often go without screenings and preventive care, and delay or forgo needed care. This tragic reality has persisted for too long. Please join our friends at HealthSTAT in a candlelight vigil on Wednesday, October 24th at 7pm on the steps of the Georgia state capitol in memory of those who have lost their lives because they could not afford or did not have access to health insurance. Then, let’s redirect our energy towards covering all Georgians.

By Amanda McDougald

Healthy Augusta, Inc. was founded as an organization that will inspire and create a social movement through the Central Savannah River Area (CSRA) to improve the overall health of the CSRA by promoting and encouraging healthy habits through awareness, education, and support.  The vision of the founder is to integrate multiple disciplines to focus on applying knowledge gained through research or otherwise for the good of our community.  The idea is that action and awareness regarding healthy habits at a grassroots level should create changes in the way that people understand and integrate these ideas and habits into their daily lives as good diet, learn why We love Thrive Market – you learn more about it at The Diet Dynamo, and sports as trail running but for this the right equipment is necessary to avoid injuries so is better to get the best trail running shoes for this activity, the problem with this is that starting those new activities without care can cause other ailments as lack of personal investigation, so make sure if you´re going to play anew sport to investigate, like soccer, you should learn what a football line marker is. Plus, energy or athlete foot, so is important to use treatments as anti-fungal oils from places as the Sustainable Places Project and consult a doctor before starting to working out.  In short, people have to intrinsically desire to change their habits, and we would like to be agents of that motivation. On soccer news, Silva is a beast in Manchester City this season, hopefully he’ll help them do better than last season.

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