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.

Georgia consumers purchasing health insurance deserve the peace of mind that comes from knowing that they are purchasing a quality plan that meets basic standards and that will provide adequate protection in the event they get sick. That is why Georgians for a Healthy Future is monitoring the essential health benefits selection process. As part of the Affordable Care Act (ACA), beginning in 2014 all health insurance plans sold in the private individual and small group markets must include a minimum package of benefits to ensure that all consumers purchasing health insurance have access to comprehensive health care services.

In a process outlined late last year by the U.S. Department of Health and Human Services, states were instructed to choose a benchmark plan and supplement it to fill any gaps (the essential health benefits package must, under federal law, include items and services within ten broad categories, described here). Georgia chose the default option, the largest small group plan sold within the state, as our state’s benchmark plan. According to the Georgia Department of Insurance, the U.S. Department of Health and Human Services (HHS) will review and supplement the plan. You can read more about this issue and Georgia’s decision to default to federal officials on the decision in Georgia Health News here.

Later this fall, HHS is expected to issue a notice of proposed rule-making listing each state’s minimum essential health benefits package. The National Academy for State Health Policy is also tracking all states’ progress on essential health benefits. You can view their latest chart here.

More than 240,000 Georgia health care consumers are set to receive nearly $20 million in total rebates by August 1st from insurance companies who couldn’t meet the 80/20 rule (also known as “medical loss ratio”), which requires insurers to spend at least 80 percent of premiums on medical care, as compared to overhead and profits. This exciting new rule, part of the Affordable Care Act, holds insurance companies accountable for providing value and requires them to issue rebates to consumers if they don’t. Learn more from the U.S. Department of Health and Human Services here and visit an interactive map to see how Georgia stacks up against other states here.

The Hispanic Health Coalition of Georgia released the “Status of Latino Health in Georgia” at the 2012 Latino Health Summit held at Emory University’s Rollins School of Public Health on June 7^th and 8^th.  According to the report, 47 percent of Hispanics in Georgia are uninsured, as compared to about 20 percent uninsured in the overall Georgia population. Georgians for a Healthy Future ED Cindy Zeldin presented information about coverage disparities and the expected impact of the Affordable Care Act (ACA) during the Summit’s health policy and advocacy panel (presentation available for download here). The full “Status of Latin Health in Georgia” is available for download here, and you can learn more about Latino health in Georgia by visiting the Hispanic Health Coalition of Georgia’s website here.

Governor Deal signed HB 1166 (sponsored by Representative Atwood) into law on May 1^st. The legislation requires insurance companies who sell policies in the individual health insurance market to also sell child-only plans during an open enrollment period. These plans had previously been available in Georgia, but insurance companies stopped writing new policies in response to a change in federal law that prohibited discrimination against children due to pre-existing conditions. HB 1166 drew widespread support and Georgians for a Healthy Future was proud to be a part of the coalition effort that ensured its passage.

The 2012 Legislative Session continues today as legislators meet for Day 27 of the 40-day Session. Crossover Day (Day 30), when a bill must pass at least one chamber to remain viable for the Session, will be March 7th. Here is what health care advocates are watching:

• The House and Senate have both passed versions of the Amended FY 2012 Budget (HB 741); since there are minor differences, HB 741 now heads to conference committee. Notably, the Senate version added $1.2 million in the Department of Public Health budget for the Children 1^st program to replace the loss of Supplemental TANF funds. This program provides screenings for newborns. Also in the Senate version, funds were added to the Department of Community Health budget to reflect projected need in Medicaid but there were also cuts to reflect the rounding down of co-payments to the nearest dollar. Meanwhile, work continues on the FY 2013 budget. Click here for the Georgia Budget & Policy Institute’s analyses of the implications for the state’s health care agencies on the governor’s proposed 2013 budget recommendations.

• HB 1166, sponsored by Representative Atwood, would restore child-only health insurance policies to Georgia’s individual market. Georgians for a Healthy Future, along with a range of child health advocacy groups, is in strong support of this measure to provide this option for families who need coverage for their kids. The bill is expected to be before the House Insurance Committee on Wednesday. You can learn more about this issue by downloading our fact sheet.

• HB 801 and SB 418 were introduced by Representative Gardner and Senator Orrock, respectively, as companion bills to establish a health insurance exchange in Georgia. While leadership in the House and Senate have indicated that there will not be movement on an exchange this year, please thank Representative Gardner and Senator Orrock for their leadership on this important issue. You can learn more about how a Georgia exchange could work by downloading our issue brief here. All information from the Governor’s Health Insurance Exchange Advisory Committee, which met throughout the second half of 2011 to develop recommendations on this issue, is available here.

• HB 1159, sponsored by Representative Pruett, is known as the New Parent Information Bill and would create a Joint Study Commission on Education for Parents with Newborn Children to determine how best to gather information, raise funds and create a comprehensive informational video.  The video would include but not be limited to information on the prevention of childhood obesity; how to prevent SIDS, shaken baby syndrome, and other forms of child abuse; how to prevent death and injury and additional information which would assist parents to raise safe and healthy children. The bill is expected to be before the House Health and Human Services Committee this week.

Don’t forget to download our Consumer Health Advocate’s Guide to the 2012 Georgia Legislative Session to help you navigate the Capitol! A limited number of hard copy guides are available. Please contact us if you’d like a copy.

A new survey shows that consumers aren’t satisfied with the level of customer service they receive from their health insurance plans. In fact, the industry ranked the lowest of any industry measured in this survey. Additionally, other studies have found that consumers often find health insurance jargon confusing, which makes it challenging for consumers to select a policy that best meets their needs, to know what is covered and what isn’t, and to understand their rights as consumers if disputes arise. While overshadowed by some of the other major reforms included in the law, the Affordable Care Act contains some exciting reforms for consumers in this area, including making available access to clear, plain language information about their insurance plans. The U.S. Department of Health and Human Services issued final regulations on February 9^th requiring an easy-to-understand Summary of Benefits and Coverage and a uniform glossary of terms. These new tools will be available to consumers on September 23, 2012. More information is available here and here.

Georgia lags other states in progress towards establishing a health insurance exchange as authorized by the Affordable Care Act (ACA), despite the fact that Georgia stands to experience one of the largest drops in the uninsured as a result of the ACA reforms, according to an analysis by the Urban Institute. At our Health Care Unscrambled breakfast in January, a panel of Georgia policymakers discussed prospects for a health insurance exchange and indicated that exchange legislation would not move through the General Assembly in 2012. Nevertheless, Representative Pat Gardner has introduced HB 801 to establish a Georgia health insurance marketplace, or exchange. Please thank Representative Gardner for taking a stand on this important issue! For recent news articles on health insurance exchanges and Georgia, click here and here.

Georgians for a Healthy Future is monitoring developments at the federal level that will impact benefits and consumer protections for new individual and small group health plans in Georgia beginning in 2014. In December, the Center for Consumer Information and Insurance Oversight (CCIIO), the division of the U.S. Department of Health and Human Services charged with implementing the provisions of the Affordable Care Act (ACA) related to private health insurance, released a bulletin on the essential health benefits (EHB) that all new plans will need to include.

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Georgians for a Healthy Future is a non-profit, non-partisan health policy and advocacy organization that addresses health care issues through a consumer lens. Our 2012 policy priorities were developed with broad input from community stakeholders. We will work collaboratively with our community partners to advance these priorities.

Maximize opportunities and benefits presented by the Affordable Care Act for Georgia health care consumers. Georgians for a Healthy Future will continue to monitor legislation and agency-level activity to implement the ACA and support Georgia laws and regulations that establish structures and systems that maximize benefits for consumers in this process.

Preserve consumer protections for Georgians in private health insurance plans. State laws and regulations provide a basic level of protections and benefits to consumers who buy private health insurance plans. These protections ensure that consumers who purchase these plans obtain meaningful health insurance that covers essential medical services in the event they get sick. Georgians for a Healthy Future will continue to support efforts to preserve and strengthen consumer protections and oppose legislation that would place consumer protections at risk.

Modernize Medicaid and PeachCare by utilizing best practices to improve coverage rates, access to care, and health outcomes. The Medicaid and PeachCare for Kids programs provide health insurance for our state’s most vulnerable citizens. The Georgia Department of Community Health is currently weighing options to redesign these programs. Georgians for a Healthy Future will monitor this process as well as legislative activity and will support policy changes that facilitate continuous coverage and enrollment, preserve and expand access to care, and improve health outcomes. Georgians for a Healthy Future will oppose policy changes that restrict access to vital health care services for Medicaid and PeachCare beneficiaries.

Establish a consumer-friendly health insurance exchange. A well-designed health insurance exchange can add transparency to the health insurance marketplace, spur competition and choice, help make insurance more affordable and available, and give consumers the information they need to make optimal purchasing decisions. Georgians for a Healthy Future will support a health insurance exchange compatible with the American Health Benefit Exchanges (AHBE) authorized by the Affordable Care Act that provides consumers with the appropriate information, tools, and navigation assistance to make optimal purchasing decisions and a governance structure that can effectively and transparently oversee the exchange without conflicts of interest.

Restore child-only health insurance plans to the private health insurance market. Due to a recent change in federal law, insurance carriers in the individual market can no longer deny coverage to a child with a pre-existing condition. Even though insurers may still medically underwrite these policies, insurance carriers in Georgia stopped issuing these policies altogether. Georgians for a Healthy Future will support legislation to restore these plans to Georgia’s health insurance marketplace.

Strengthen Georgia’s public health system. Our public health system plays a critical role by vaccinating children, monitoring and preventing epidemics, ensuring safe food and water, and providing both clinical and community-based preventive services. Despite an increasing need for services, Georgia’s per capita public health spending is among the lowest in the nation. The establishment in 2011 of the new Department of Public Health presents an opportunity to rebuild our public health infrastructure and to place renewed focus on the critical role of public health. Georgians for a Healthy Future supports a robust, adequately funded public health system to meet the critical needs of our state.

Increase the tobacco tax. The current funding environment demands evidence-based policy solutions that both advance the health of our state and generate needed revenue. In recent years, even the most basic, vital, and cost-effective programs have been subject to deep budget cuts. Georgians for a Healthy Future opposes further cuts to these vital programs and supports budget solutions such as a substantial increase in the state’s tobacco tax. Tobacco taxes are a proven strategy with the dual benefit of bringing in additional state revenue and increasing the health of Georgians by reducing adult and youth smoking.