New health insurance opportunities created through the Affordable Care Act (ACA ) have led to historic reductions in the nation’s uninsured rate. Here in Georgia, more than half a million consumers signed up for health insurance during the open enrollment period that ended this past February, known as OE 2.

These strong enrollment numbers mean that more Georgia consumers can access the health care services they need and enjoy enhanced financial security for themselves and their families. The reduction in our state’s uninsured rate, although smaller than that of the nation as a whole, also has positive implications for the vitality of local health care systems and communities throughout Georgia.

Too many Georgians, however, remain uninsured, either because

• they are unaware that there are coverage options that can meet their needs and budget
• face cultural, linguistic, financial, or other barriers to coverage; or
• fall into the “coverage gap” that was created when Georgia declined to expand Medicaid as authorized under the ACA

The goals of this report are

• to explain the role of in-person assistance on enrollment outcomes and consumers’ experiences
• to explore best practices that helped achieve robust enrollment in Georgia
• to identify any common challenges or barriers to enrollment that Georgia consumers faced during OE2
• to highlight promising strategies and approaches to reach the remaining uninsured who qualify for affordable health insurance
• to put forth policy recommendations that can help facilitate a positive experience for health care consumers, both for those who are newly enrolled and for those who remain uninsured.

You can download and read the report below.

[embeddoc url=”https://healthyfutprod.wpengine.com/wp-content/uploads/2015/12/Getting-Georgia-Covered-Cover.pdf”]

While Georgia has made little progress on closing its coverage gap, the subject is a hot topic elsewhere.

• Montana has closed its coverage gap! As the 29^th state to close the gap, Montana will provide 70,000 Montanans with quality, affordable health care coverage.  The state is currently working with CMS to gain approval for its expansion proposal.
• Face Off in Florida–The debate over closing the coverage gap is as hot as sunburnt skin after spring break! Floridians have seen a sudden and unexpected adjournment of the legislative session, a stand-off with HHS over the low-income pool (LIP), and their governor file suit against the federal government.  The debate is far from over as the legislature plans to reconvene in June to complete their legislative responsibilities.
• Policy makers in both Alaska and Louisiana are discussing if and how to close their coverage gaps.  While their legislators debate whether or not to close the coverage gap during a special session, polls show that Alaskans are hugely in favor of the policy.  In Louisiana, Gov. Jindal remains opposed to the idea of closing his state’s coverage gap, but legislators are discussing their options.

While Montana closes its gap and other states think through their options, more and more studies are revealing that closing the coverage gap is good for states! It saves money in state budgets and facilitates job growth, especially in the health care sector.  Families USA summarized the new data in a recent blog post.

Please join us on Wednesday, March 25, from 8:45 am to mid-day for a morning of advocacy!  GHF will provide individuals and organizations with the opportunity to advocate for the important health issues that matter to you in the closing days of this legislative session.  You may want to advocate for closing the coverage gap, Medicaid payment parity, raising the tobacco tax, the Family Care Act, rural health care access, or another health policy issue.  You’re all invited to participate!  We’ll provide breakfast, an advocacy training, and an opportunity to share and network with other health advocates.

To sign up, click here.  If you have any questions, please contact Laura Colbert.

Yesterday marked the 27th day of the 2015 Legislative Session. Crossover Day, the 30th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015, is set for next Friday, March 13th. Sine Die, the 40th and final legislative day for the year, will be April 2nd.

It has been a big week for health care issues at the State Capitol. GHF brought the consumer perspective to Senate Insurance on Wednesday and shared with the committee through testimony from our Executive Director the challenges that consumers face in obtaining accurate information about provider networks at the time they sign up for health insurance and why setting network adequacy standards is important for consumers. Her testimony was provided as part of the discussion around SB 158. Also this week, legislation was introduced in the Senate that would establish a study committee onpreventing youth substance use disorders, the Senate began its work on the FY 2016 budget, and a range of other health care bills were discussed.

The State Budget:  The FY 2016 Budget passed the House of Representatives and is now in the Senate. The Senate expects to finish their revisions to the budget this week and send it back to the House and then to a conference committee.

Medicaid Parity:  Last week, the House of Representatives added $2.96 million in the budget to increase reimbursement for certain OB/GYN services and $1.5 million for reimbursement rate increases for certain primary care services. Because Medicaid parity has been shown to be an effective strategy for improving access to care, GHF supports raising Medicaid reimbursement rates to parity with Medicare rates. We are advocating for a higher appropriation amount for Medicaid reimbursement rate increases as the budget moves through the process.

SBIRT Resolution:  Senate HHS Chairwoman Renee Unterman officially introduced a resolution (SR 407) to form a joint House and Senate Study Committee on preventing youth substance use disorders. Through GHF’s work with the Georgia Council on Substance Abuse, we are advocating for a public health approach to substance use disorders that focuses on prevention. This resolution gets the conversation started about how to do that in Georgia. Please take the time to thank Senator Unterman for her support of this effort and to let your elected officials know you support SR 407.

SB 158 (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee where it received a hearing on Wednesday, March 3.  GHF Executive Director Cindy Zeldin testified in committee, focusing specifically on the network adequacy component of the bill. GHF also met with committee members individually about the bill after the committee hearing.  While the bill is not expected to move in its current form this legislative session, there will likely be a study committee on the network adequacy component. GHF has identified network adequacy as an important consumer issue and plans to remain engaged on this topic as discussions move forward.

Closing the Coverage Gap: No hearings have been scheduled or are pending to address the possibility of expanding Medicaid in Georgia. Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians, an approach which GHF supports.  Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills, Rep. Rahn Mayo and Senator Vincent Fort, for their support and show your support by filling out a postcard that we’ll mail to your legislators!

Tobacco Tax:  No additional standalone proposals have been made to increase Georgia’s tobacco tax (other than HB 445 as previously reported).  The Senate however, may respond to the House proposal on transportation funding by including a tobacco tax increase to the regional average of around 68 cents. Importantly, Alabama’s Governor is proposing an increase in their state tobacco tax to $1.25 per pack, which would increase the regional average.  GHF continues to advocate for an increase to the national average by raising our tobacco tax by $1.23.  Such an increase would generate $585 million per year according to the fiscal note generated by the non-partisan fiscal office at GSU.

Other Bills of Interest

Below is a summary of bills that may impact health care consumers in Georgia, with information about where they are in the legislative process.

SB 1 (Sen. Bethel) provides certain insurance coverage for autism spectrum disorders. SB 1 has passed the Senate and is in the House Insurance Committee.

HB 1 (Rep. Peake) would allow for the limited use of medical marijuana as long as long as the provider is the best weed dispensary for conditions including cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, crohn’s disease, mitochondrial disease, fibromyalgia, parkinson’s disease, and sickle cell disease, but it is still important for people to know the the difference between CBD and THC.  HB 1 passed the House of Representatives and is now in the Senate Health and Human Services Committee. Go to Dank City – Cannabis News, Culture, Entertainment and Information to find out more.

HB 195  (Rep. Cooper) and SB 51 (Burke) provide parameters for substitutions of interchangeable biological products. HB 195 passed the House Health and Human Services Committee and is expected to come out of the Rules Committee next week, and Senate Bill 51 has passed the Senate and has been assigned to the House HHS committee, but is not expected to get a hearing until after crossover day.

HB 482 (Rep. Willard) seeks to eliminate two of the requirements that the Cancer Treatment Centers of America was subject to when they were allowed into Georgia as a destination hospital.

HB 416 (Rep.Rogers), routinely referred to as the badge bill, seeks to provide clarity and transparency for the patient as to the qualifications of the provider that they are seeing.  The bill calls for providers to identify the health care practitioner’s name and the type of license or educational degree the health care practitioner holds. The bill passed out of committee on Tuesday March 3.

HB 34 (Rep. Dudgeon) is known as the “Right to Try” bill and calls for patients with advanced illnesses and in consultation with their doctor to use potentially life-saving investigational drugs, biological products, and devices. The bill passed out of the House HHS committee.

HB 429 (Rep. Stephens) seeks to ban coverage denials for medically necessary treatment based solely on life expectancy or the diagnosis of a terminal condition.  The bill is in the House Insurance Committee.

HB 76 The House appropriations bill, provides $200,000 to continue the Prescription Drug Monitoring Program in the state, which would otherwise run out of funds and expire on June 30, 2015.  The appropriations bill is currently in the Senate.

HB 504 (Rep. Cooper) would extend the flu vaccine protocol that is in place between physicians and pharmacists and nurses for adults to pneumococcal, shingles, and meningitis.

HB 436 (Rep. V. Clark) would require physicians and health care providers to offer to test pregnant women who are in their third trimester for HIV and syphilis.

HB 463 (Rep. Harbin) would permanently extend a $1,000 tax credit for “medical core clerkship” preceptors for “community based” nurse practitioners and physician assistants.

Yesterday marked the 23rd day of the 2015 Legislative Session. We are getting closer to Crossover Day, the 30^th legislative day and the deadline for a bill to pass its chamber of origin to remain viable for 2015. Crossover Day is set for March 13th. Sine Die, the 40^th and final legislative day for the year, will be April 2nd.

As part of this week’s legislative update, we sat down with Representative Debbie Buckner and spoke with her about access to care in rural communities, Georgia’s coverage gap, and other health care issues on her mind this Legislative Session.

To watch the video, click on the image below.

The State Budget

The FY 2016 Budget passed the House of Representatives this week and now heads to the Senate for hearings. Of note, the House of Representatives added $2.96 million in the budget to increase reimbursement for certain OB/GYN services, $1.5 million for reimbursement rate increases for certain primary care services, $1.3 million to increase the hourly rate for personal support services under the Independent Care Waiver Program, and $500,000 to increase reimbursement for air-ambulance services for adult patients. The House also added in $3 million to implement the recommendations of the Rural Hospital Stabilization Committee. The House removed $22.8 million for new treatment medications for patients with Hepatitis C and $12.1 million for costs to launch a new case management program for enrollees eligible under the Aged, Blind, & Disabled program. Also of note, the House reinstated health coverage for non-certificated part-time school employees; however, local school districts and not the state would be responsible for those costs. Click here for an analysis of the health care provisions in the budget that passed the House from our friends at the Georgia Budget & Policy Institute.

Closing the Coverage Gap

Closing Georgia’s coverage gap by expanding Medicaid would open a pathway to health insurance for approximately 300,000 uninsured Georgians. Two bills have been introduced to address Georgia’s coverage gap (HR 226 and SB 38), although neither is expected to receive a hearing. Please thank the cosponsors of these bills, Rep. Rahn Mayo and Sen. Vincent Fort, and show your support for closing the coverage gap by filling out a postcard that we’ll mail to your legislators!

Tobacco Tax

HB 445 (Carson) represents the first additional or alternative funding proposal to the transportation funding bill (HB 170). While the overall bill includes regressive provisions including an increased sales and grocery tax combined with a reduction in the income tax that GHF does not support, it is notable that a tobacco tax is in the mix in the bill. This keeps the tobacco tax on the radar and provides an opportunity for health advocates to continue to push for an increase to the national average in the tobacco tax to curb smoking rates and bring in much-needed revenue.

Other Bills of Interest

Below is a summary of bills that may impact health care consumers in Georgia, with information about where they are in the legislative process.

SB 1 (Sen. Bethel) provides certain insurance coverage for autism spectrum disorders. SB 1 has passed the Senate and is the House Insurance Committee.

SB 158 (Sen. Burke) provides certain consumer and provider protections regarding health insurance, including network adequacy language. SB 158 has been referred to the Senate Insurance Committee.

HB 1 (Rep. Peake) would allow for the limited use of medical marijuana for conditions including: cancer, amyotrophic lateral sclerosis, seizure disorders, multiple sclerosis, crohn’s disease, mitochondrial disease, fibromyalgia, parkinson’s disease, and sickle cell disease.  HB 1 passed the House of Representatives and is now in the Senate Health and Human Services Committee.

HB 195 (Rep. Cooper) and SB 51 (Burke) provides parameters for substitutions of interchangeable biological products. HB 195 passed the House Health and Human Services Committee and is expected to come out of the Rules Committee next week, and Senate Bill 51 has passed the Senate and has been assigned to the House HHS committee, but is not expected to get a hearing until after crossover day.

HB 482 (Rep. Willard) seeks to eliminate two of the requirements that the Cancer Treatment Centers of America are currently subject to when they were allowed into Georgia as a destination hospital.

HB 416 (Rep. Rogers): Routinely referred to as the badge bill, HB 416 seeks to provide clarity and transparency for the patient as to the qualifications of the provider that they are seeing.  The bill calls for providers to identify the health care practitioner’s name and the type of license or educational degree the health care practitioner holds. The bill will be heard in the House HHS committee on Monday March 2, 2015 at 3 PM.

HB 34 (Rep. Dudgeon) is known as the “Right to Try” bill and calls for patients with advanced illnesses and in consultation with their doctor to use potentially life-saving investigational drugs, biological products, and devices.

With this week’s legislative update, we bring the Gold Dome to you! Our biggest update this week is that Senator Renee Unterman is making a $60 million appropriations ask in the state budget to maintain Medicaid payment parity. Medicaid payment parity is an effective strategy to increase access to health care services for low-income children and families enrolled in Medicaid (click here to learn more about what payment parity is and why it matters for health care access). Your GHF team was at the Capitol this week to talk with Senator Unterman about her proposal.

Also this week, the Senate Appropriations Subcommittee on Health held a hearing that included discussion about Medicaid payment parity. No decisions were made at the hearing but we expect the topic will come up again. What can advocates do?  Contact one or more of these legislators!

1. Call or email Senator Unterman and thank her for leading the charge on this important initiative!
2. Call or send an email to Senator Burke, who chairs the Senate Appropriations Subcommittee on Health, and Representative Butch Parrish, who chairs the House Appropriations Subcommittee on Health, and thank them for their support on Medicaid payment parity.
3. Contact Senate Appropriations Chair Jack Hill and House Appropriations Chair Terry England and let them know you support Medicaid payment parity.

Other issues we’re watching.

Medicaid Expansion

There has been no action to date on closing the coverage gap by expanding Medicaid. Please contact your legislators and the leaders of the Health and Human Services and Appropriations Committees to ask them to hold hearings on this important issue.

Click here to let your state senator and representative know that you support closing Georgia’s coverage gap.

Tobacco Tax

Georgians for a Healthy Future and our coalition partners continue to support a $1.23/pack increase in Georgia’s tobacco tax to bring us in line with the national average, decrease smoking rates, and bring in needed revenue for health care investments in our state. All eyes in the House and Senate have been on the transportation funding proposal unveiled last week on the House side, which did not include an increase in the tobacco tax. However, the Senate is expected to take a more diversified approach in this area and the possibility of a tobacco tax increase may be on the table. We will continue to monitor this issue and will let you know when advocacy opportunities arise.

Other Health-Related Bills

Senate Bill 1, which would require insurance companies to provide limited autism benefits for Georgians enrolled in certain individual and small group plans passed the Senate and is now on the House side. A hearing has not been scheduled for the bill on the House side.

Senate Bill 74, which would authorize tax credits for donors to health charity organizations, has been introduced in the Senate and referred to the Senate Finance Committee.

Georgia’s Medicaid patients could face longer wait times for doctor’s appointments without legislative action. That’s because a nation-wide bump in primary care provider reimbursement rates expired at the end of 2014, triggering a need for state action. This temporary rate bump resulted in an average eight percent increase in appointment availability, according to a new study published in the New England Journal of Medicine. The study examined ten states, including Georgia, and concluded that payment rate increases are an effective strategy for enhancing access to primary care services. According to a participating physician in Texas, his practice was able to double the amount of Medicaid patients seen during the two year time the pay bump was in effect.  By restoring the rate bump, known as Medicaid payment parity, Georgia policymakers can help ensure patients get timely access to primary care in an appropriate setting and help keep patients from ending up in the emergency room.

Rural hospitals provide the foundation for the economic vitality and population health of small communities throughout Georgia. Despite this essential role, the future of our rural hospitals-and the access to care they provide for rural Georgians-is in jeopardy. Eight rural hospitals have closed since 2001, four of them since the start of 2013.

While a comprehensive strategy is needed to address this problem, closing the coverage gap in Georgia would be an important first step to stabilizing our state’s rural hospitals and maintaining access to care for Georgians living in rural communities.

In a report we are submitting to the Rural Hospital Stabilization Committee this week, Georgians for a Healthy Future, Georgia Budget & Policy Institute, Georgia Watch, Families First, and twelve additional consumer and community-focused nonprofits recommend that the committee seriously weigh the option to tap the federal dollars on the table for Georgia to close its coverage gap. Closing the coverage gap by expanding Medicaid would not only mean access to health insurance for low-income Georgians living in rural communities but would also trigger an infusion of federal dollars into rural hospitals to help them keep their doors open and serve their communities.

The Rural Hospital Stabilization Committee, created by Governor Deal earlier this year to identify the needs of the rural hospital community and provide potential solutions; to increase the flow of communication between hospitals and the state; and improve access to care, is holding its third meeting tomorrow in Lavonia. If someone from your part of the state is serving on the committee, please consider asking them to support closing Georgia’s coverage gap.

Please also ask your State Representative and State Senator to support closing the coverage gap in Georgia.  Click here to send your state legislators a postcard that lets them know that you support closing Georgia’s coverage gap.

The full report to the committee is available here. Key facts from the report include:

• In 2012, Georgia hospitals provided more than $1.6 billion in unpaid care, an increase of about $60 million from 2011. Most of this unpaid care goes to provide services to uninsured Georgians, many of whom fall in the coverage gap
• Hospitals in states that have closed the coverage gap are projected to save up to $4.2 billion.Hospitals in states that have opted not to address their coverage gaps are projected to save a comparatively small $1.5 billion this year
• Georgia’s hospitals could receive $1 billion more in Medicaid spending every year on behalf of newly-eligible Medicaid enrollees (those currently in the coverage gap)
• If Georgia contributes the estimated $2.1 billion to implement Medicaid expansion, the State stands to gain a Federal infusion of $31 billion over the next ten years. This new federal money would help create more than 56,000 jobs statewide and generate more than $6.5 billion in new economic activity every year with the help of http://paydayloan-consolidation.com/.

The 2014 Georgia Legislative Session has ended. Thank you to so many of you for reaching out to your legislators during this past session to let them know that covering Georgia’s uninsured and improving access to health care for all Georgians are important priorities for you. Thank you to the dozens of committed advocates who joined us for Cover Georgia day at the Capitol, and thank you to the more than 8,000 of you who signed the Cover Georgia petition to express your support for the Medicaid expansion.

This was a disappointing legislative session for health care consumers. HB 990, which prohibits Medicaid expansion without prior legislative approval, and the portions of HB 707 (amended onto HB 943) that would prevent state entities from serving as health insurance navigators, prohibit the state from setting up a health insurance exchange, and limit the ability of state and local employees to advocate for the Medicaid expansion passed through the General Assembly. While some of the most harmful elements of HB 707 were removed before its final passage, this bill sends a horrible message to Georgia health care consumers who seek information about how to enroll in and utilize the new health insurance options available to them through the Affordable Care Act.

On the upside, hundreds of Georgians are enrolling each day in health insurance. At last count, more than 139,000 Georgians have enrolled in health care coverage through the Health Insurance Marketplace, and Georgians for a Healthy Future is actively working alongside our coalition partners to maximize enrollment leading up to the March 31^st deadline. And despite the setbacks of the 2014 Legislative Session, the Cover Georgia coalition will continue to advocate for covering our state’s uninsured, strengthening our state’s health care delivery system, and growing the economy by implementing the Medicaid expansion.

Thank you again for your continued support and advocacy!