Georgians for a Healthy Future hosted another Georgia Voices for Medicaid training on Friday, August 10^th in partnership with the Athens Clarke County Library. The Georgia Voices for Medicaid trainings are designed to give participants the knowledge and skills they need to advocate for timely, important health care issues impacting Georgians.

At last week’s training, participants learned that Georgia’s Medicaid program provides health insurance for half of Georgia’s children, and that it also covers low-income people with disabilities, seniors, and pregnant women. In Clarke and Barrow counties, 15,830 and 10,845 residents respectively are covered through Medicaid. Alyssa Green, GHF’s Outreach & Education Manager, shared testimonials from several Georgians who are covered by Medicaid to demonstrate the real benefits of coverage to training participants. Alyssa also introduced ways that participants can advocate for the health care issues that matter most to them, like protecting and improving the Medicaid program or bringing down health care costs.

The training concluded with an invitation for attendees to continue their health care advocacy work with GHF’s new Georgia Health Action Network (GHAN) program. GHAN is a volunteer-led program that fosters and supports grassroots health advocates who work alongside GHF to reach a day when all Georgians have access to the quality, affordable health care they need to live healthy lives and contribute to the health of their communities.

If you were unable to attend this Georgia Voices for Medicaid event, check out our upcoming trainings or contact Alyssa at agreen@healthyfuturega.org or 404-567-5016, ext. 2 to schedule a training in your community. You can also contact Alyssa learn more about GHF’s new Georgia Health Action Network.

Georgians for a Healthy Future hosted its Georgia Voices for Medicaid training on Thursday, July 19^th in partnership with the Central Outreach & Advocacy Center.  The Georgia Voices for Medicaid trainings are designed to give participants the knowledge and skills they need to advocate for timely, important health care issues impacting Georgians.

At this week’s training, participants learned that Georgia’s Medicaid program provides health insurance for half of Georgia’s children, and that it also covers low-income people with disabilities, seniors, and pregnant women. In Fulton and DeKalb counties—Georgia’s two most populous counties–118,755 and 107,340 residents respectively are covered through Medicaid. Alyssa Green, GHF’s Outreach & Education Manager, shared testimonials from several Georgians who have Medicaid, including the story of a Georgia man who credits Medicaid as the reason he is able to financially support himself and work in his community.

GHF’s Executive Director Laura Colbert introduced ways that participants can advocate for the health care issues that matter most to them, like protecting and improving the Medicaid program or bringing down health care costs. Participants were given the opportunity to practice their advocacy skills by sending an introductory email to their state legislators that communicated what they learned at the training.

The training concluded with an invitation for attendees to continue their health care advocacy work with GHF’s new Georgia Health Action Network (GHAN) program. GHAN is a volunteer-led program that fosters and supports grassroots health advocates who work alongside GHF to reach a day when all Georgians have access to the quality, affordable health care they need to live healthy lives and contribute to the health of their communities.

If you were unable to attend this Georgia Voices for Medicaid training, join us for our next training event in Athens or contact Alyssa at agreen@healthyfuturega.org or 404-567-5016, ext. 2 to schedule a training in your community. You can also contact Alyssa learn more about GHF’s new Georgia Health Action Network.

Queenesther is a mother of five children living in Albany, GA. She and her children, all under the age of 10, receive health care coverage and care through Medicaid.

Queenesther recently underwent surgery to remove an ectopic pregnancy that was causing severe health issues and could have proved fatal. “Had it not been for Medicaid I wouldn’t have been able to get it removed and who knows what would have happened,” she said, reflecting on the importance of Medicaid for herself and her family. Because she was able to have the ectopic pregnancy removed quickly, Queenesther has been able to focus on caring for her young family and earning her degree.

Queenesther is fortunate compared to many low-income parents because Georgia makes it very difficult for parents to qualify for Medicaid coverage. Because Georgia’s Governor and the state legislature have so far refused to extend health coverage to most low-income parents (and other poor adults), parents must make less than 36% of the federal poverty line ($7656 annually for a family of three) to qualify for insurance through Medicaid. Parents who make between 36% and 100% of the federal poverty line ($9096-$25,100 annually for a family of four) are stuck in the coverage gap with no pathway to affordable coverage.

In Dougherty County, where Queenesther and her family live, 5,472 people, 22% of whom are parents, are stuck in the coverage gap but could be covered if Georgia’s policy makers extended insurance to this group. Like Queenesther, gaining coverage would enable them to better care for their children, pursue an education, and support their families.

For more on how parents and families would benefit from extending health insurance coverage, please revisit the Many Working Parents and Families in Georgia Would Benefit from Extending Medicaid Coverage report from GHF and the Georgetown Center on Children and Families.

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 its importance.

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!

Georgians for a Healthy Future has a new resource available to help low-and middle-income consumers navigate the often confusing and opaque health care, health insurance, and social services systems. The My Health Resource Guide provides consumers with an understandable, easy-to-use tool to help them better understand the health and social services systems that impact their health and connect with needed resources.

Included in the guide are sections about health insurance, finding a health care provider, and accessing mental health and substance use treatment services. The guide also points consumers to social services that fulfill other basic needs like transportation to and from health appointments, housing and food assistance, and legal support. All of the resources referenced in the guide are provided for free or at low-cost by community-based organizations or public agencies.

GHF developed the My Health Resource Guide to be distributed to and used by consumers, but we also anticipate it will be useful to professionals who know and work with low- and middle-income Georgians. We invite enrollment assisters, community health workers, social workers, clinicians, and others to use it as a reference or to distribute it directly to clients, patients and family members.

A printable, pdf version of the My Health Resource Guide is available here or contact Alyssa Green at 404-567-5016 x 2 or agreen@healthyfuturega.org to request printed copies.

Teresa began working as a teacher for the Headstart preschool program in 1994 but retired in 2010 because multiple health conditions made it difficult for her to work. Now her family’s only source of income is her husband’s monthly disability check, which is too high to allow him to qualify for Medicaid and too low to allow them to qualify for financial help to purchase private insurance through the Affordable Care Act. (Teresa cannot qualify for Medicaid no matter how low her income is because she does not have a disability or a child under the age of 18.) Both of them fall in Georgia’s coverage gap.

Teresa and her husband are just two of 197 of the Georgians in Clay County that are uninsured because Georgia’s decision makers have not extended health insurance coverage to low-income adults in Georgia (those making less than $16,000 annually for an individual or $20,780 for a family of three.)

Teresa struggles to manage multiple health conditions, the worst of which is a jaw condition that has caused her teeth to rot. Because Teresa has not had health coverage since 2009, she has had to find alternative, insufficient treatments for her jaw condition. She would have to pay $5000—almost four months of income—to receive the necessary medical remedies to alleviate her pain and stop the dental deterioration. If Georgia were to close the coverage gap, Teresa would be able to see her doctor on a regular basis without having to forgo appointments and services that would otherwise be too costly.

Georgia’s Governor and legislature have so far rejected the option to close the state’s coverage gap, leaving people like Teresa and her husband uninsured. Until Georgia’s policymakers extend health insurance to all low-income Georgians, Teresa, her husband, and 240,000 other Georgians will likely continue to skip health care appointments and forgo needed care because they have no pathway to coverage.

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 its importance.

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!

Travis suffered from a series of strokes when he was 11 years old that left him with several physical disabilities. He is one of the approximately 250,000 Georgians with disabilities to be covered by Medicaid.

Several years ago, Travis started volunteering with DisabilityLINK because he believes in the power of community and he likes being able to help others. Since then, he was hired as a Independent Living Specialist at the organization, where he connects people with disabilities to community-based resources and assists in coordinating various events at the DisabilityLINK office. He also works alongside other activists on issues such as housing, accessibility and self advocacy.

Travis recognizes that Medicaid is the reason he is able to financially support himself and work for an advocacy organization. Without the support Medicaid provides, Travis explains, he would not be able to help others the way he has been able to through his work at DisabilityLINK. When asked what he wanted others to know about him being able to receive affordable health insurance he replied, “With me working I am able to be a tax paying citizen.”

Medicaid is essential to ensuring that people with disabilities, like Travis, are able to lead fulfilling, independent lives as active participants in their communities. Georgia’s Medicaid program provides almost 2 million low-income children, people with disabilities, seniors, pregnant women, and very low-income parents with access to the health care services that they wouldn’t have otherwise.

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 its importance.

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!

Surprise billing legislation passed by committee 

SB 8 was heard by the House Insurance committee this morning and passed unanimously. Among other transparency and notification requirements, this version of the surprise billing legislation requires that providers and hospitals must provide consumers with information about the plans in which they participate, and that upon the request of consumers, providers give an estimated cost of non-emergency services before they are provided. Insurers must inform consumers whether a provider scheduled to deliver a service is in-network, and if not, an estimation of how much the insurer will pay for the services, among other notification requirements. SB 8 will now go to the House Rules committee.

WHAT HAPPENED LAST WEEK

Senate passed the FY2018 budget

Last week, the Senate approved the FY 2018 budget. The budgets approved by the Senate and House differ slightly, so a conference committee will be appointed to meet and work out the differences. You can check the Differences Report for specifics on the variance between the House and Senate budgets, and we will provide a brief overview of the final version once the conference committee finishes its work.

Insurance coverage for children’s hearing aids passed

SB 206 was approved by the House of Representatives today, and will require private health insurance plans to cover hearing aids for children under 19 years old. The legislation stipulates that the costs cannot exceed $3000 per hearing aid and that the plans cover replacement hearing aids every four years or when the hearing aid fails before that time. Medicaid already covers hearing aids for children who qualify for coverage.

Pharmacy Patients Fair Practices Act passed by both chambers

Both HB 276 and SB 103 were approved by the Senate and House respectively last week and will get sent to the Governor for his signature. This legislation (which we previously covered here) will regulate practices of pharmacy benefit managers so as to allow consumers access to their pharmacy of choice, provide the opportunity for home delivery of medications, and prevent consumers from over-paying for prescriptions. It is really important to find a pharmacy that you can trust, I suggest to check Canadian pharmacies which have been very reliable for me.

Legislation to synchronize multiple medications passed

SB 200 will make it easier for people to synchronize their prescriptions so that they can pick up multiple prescriptions at the same time. The bill requires that insurance plans pro-rate medication co-pays for partial prescription fills so that the schedules for medications can be synced if requested by a patient. Under current law, a person may have to pay a full co-pay even if a pharmacist is providing only a part of their 30-day medication in order to synchronize multiple prescriptions. SB 200 passed the House Insurance committee last week and was approved unanimously by the House this morning.

A win for Georgia health care consumers! 

Today the Department of Justice (DOJ) announced they will file suit to block both the Aetna-Humana and Anthem-Cigna health insurance mergers. Georgia’s attorney general is listed as one of the plaintiffs in the Aetna-Humana case.

Earlier this week we released a policy report, Proceed with Caution: Proposed Health Insurance Mergers Could Harm Georgia Consumers, which details Georgia’s current health insurance market and how these mergers could decrease competition like what happened in California’s Health Insurance Quote, and access to care while increasing prices from many insurance companies, but it may not affect private online companies as InsurancePartnership.org and others.

In light of the DOJ’s announcement, the Georgia Department of Insurance is indefinitely postponing its review of the Aetna-Humana merger and has canceled next week’s hearing. This marks an important milestone victory for Georgia health care consumers and we will keep you posted on any future developments.

The Georgia Department of Insurance will be holding hearings this summer on two key mergers that could impact the cost, quality, and coverage of health insurance that Georgia consumers are able to obtain.

Three of the nation’s biggest insurance companies (Aetna, Anthem, and Centene) are seeking mergers that would drastically change the health insurance market in Georgia and other states. What’s at stake for consumers is competition. Consumers benefit from competition, it encourages companies to offer lower prices, increase quality, and spur innovation. Currently in Georgia, the top four insurers control at least 75 percent of the market for individual, small group, and Medicare plans sold in the state. If the proposed Aetna-Human and Anthem-Cigna mergers go through then millions of Georgians can expect to see affordability, choice, and access greatly impacted.  But Georgia has the opportunity this summer to assess the merits of these mergers and, if approved, to guarantee that negative outcomes for our state’s consumers are mitigated.

State regulators have  power to approve mergers

Before the proposed Aetna-Humana and Anthem-Cigna mergers can go into effect in Georgia, both must be approved by the Georgia Office of Insurance and Safety Fire Commissioner (DOI). The DOI began reviewing the two proposed mergers in the summer of 2015. See initial findings for Aetna and Anthem here. After the review process is completed, a public commenting period, which includes a public hearing, will begin. During the public comment period this summer, consumer advocates have the opportunity to provide input and testimony in the public hearings where insurers will be questioned.  Following the public hearing, the Commissioner will issue a final decision to approve the mergers as is, approve with conditions, or disapprove.

How consumer advocates can get involved and have their voices heard

• Submit public comments and/or questions on how you believe mergers would affect consumers. Email mergercomments@oci.ga.gov or send by U.S. mail to Administrative Procedure Division, 2 Martin Luther King Jr., Drive, West Tower, Suite 1016, Atlanta, GA 30334
• Attend the hearing on the pending Aetna-Humana and Anthem-Cigna mergers. To receive meeting notifications, subscribe here
• Georgians for a Healthy Future plans to submit public comments and provide testimony. If you would like to learn more about our comments and sign onto them as a partner organization, contact Meredith Gonsahn at mgonsahn@healthyfuturega.org.

How to ensure that bigger means better for consumers

Georgians for a Healthy Future looks forward to participating in the public commenting process. Over the next month, we will release a policy brief on insurance mergers to help inform our partner organizations and submit public comments to Georgia’s DOI. We will put forth recommendations of merger approval conditions for premium stability, network adequacy, value-based coverage, consumer protections, and regulatory oversight. We recommend that Georgia’s DOI carefully consider whether or not to approve each merger and which remedies best address the expected concerns of and effects on consumers.

Once the mergers are approved they cannot be reversed. Therefore, we urge extreme caution in reviewing whether the mergers should be approved at all. If, at the end of the comment and review period, the DOI has a high degree of certainty that the mergers can benefit consumers, the DOI should set conditions for approval by which insurers should be held accountable to ensure consumers realize these benefits.