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!

Action Alert—Stop HB 707!

House Bill 707 would prohibit the state of Georgia from leveraging federal dollars to cover the uninsured and from providing consumer assistance to Georgians enrolling in health insurance. HB 707 was designed and promoted by the tea party to prevent hard-working Georgians from accessing health care, and it is in danger of becoming law in Georgia. We need your voice! Georgia citizens deserve better than to have the door slammed in their face when they seek out information about how to cover themselves and their family. Our state’s struggling hospitals and uninsured citizens deserve an honest policy discussion about Medicaid expansion, not a gag order on state and local employees. Call Lt. Governor Casey Cagle at 404-656-5030 and your state senator (locate your state senator here) and ask them to oppose HB 707.

House Bill 707 would:

1. Prohibit any state agency, department or political subdivision from using resources or spending funds to advocate for the expansion of Medicaid. This would stifle conversation and analysis about how to leverage federal dollars from covering the state’s uninsured.

2. Prohibit the state of Georgia from running an insurance exchange or accepting federal dollars related to an exchange. This broad language could stop quality local programs that provide assistance to vulnerable Georgians getting coverage through the exchange.

3. End the University of Georgia Health Navigator Program. Currently, the University of Georgia is providing enrollment assistance to consumers seeking out health insurance with federal grant money. HB 707 would prohibit UGA from sitting down with uninsured consumers and helping them enroll in a private health insurance plan.

4. Prohibit the Commissioner of Insurance from investigating or enforcing any alleged violation of federal health insurance requirements mandated by the Affordable Care Act. Under HB 707, if a consumer has been treated unfairly by their health insurance company, they may have no state recourse.

HB 707 has already passed the state House of Representatives and may be up for a vote in the State Senate early next week. We need your voice to prevent this harmful bill from becoming law!

Thanks to Carolyn Ingram from the Center for Health Care Strategies for serving as the keynote speaker for Georgians for a Healthy Future’s 4th annual Health Care Unscrambled policy breakfast event! Carolyn’s presentation described opportunities for flexibility with respect to the Medicaid program and provided illuminating examples from a handful of states taking innovative approaches. Carolyn’s presentation is available here.

The following opinion piece by Georgians for a Healthy Future’s Executive Director Cindy Zeldin originally appeared in today’s Atlanta Journal-Constitution.

Large majorities of young adults say they need and value health insurance, yet people in this age group are far more likely to be uninsured than children, seniors or older adults. Thirty-five percent of Georgians between 18 and 34 are uninsured. How can something so important be so elusive?

Until now, the health insurance of millenials had largely been neglected by public policy, leaving them with few options that provided adequate benefits at an affordable cost.

Most Americans get health insurance as a workplace benefit. They get a substantial employer contribution and receive these benefits on a pre-tax basis. Today’s young adults, however, are entering the job market in a tough economy. They are less likely to land jobs with health insurance. They often cobble together internships and part-time work to gain experience and make ends meet. For too many young adults, there simply has been no viable pathway to coverage.

The tide is turning. An estimated 3.1 million young adults nationwide — and 123,000 here in Georgia — have gained coverage as a direct result of an Affordable Care Act provision that allows parents to keep their children on policies up to age 26. This popular and effective public policy change was just a first step. The new health insurance exchanges will provide options for young adults who previously had nowhere to go.

These plans provide decent benefits and, in many cases, access to tax credits to make them affordable. The tax credits, available to individuals with annual incomes between $11,490 and $45,960, can be taken either at the time health insurance is purchased or at tax time. Some moderate-income individuals also can get help with out-of-pocket expenses.

For millenials who had been underwhelmed with the health insurance options available to them in the past, this is a breath of fresh air. For example, maternity coverage had been nearly impossible to secure in the Georgia non-group market for young couples ready to start a family. Now, this important benefit will be available.

While it is true some young adults enrolled in old plans may see higher premiums, many of those old plans didn’t provide adequate protection. Further, young adults who had a pre-existing chronic helath condition were locked out of the market entirely, a practice insurance companies must discontinue.

 The private insurance plans available through the exchanges won’t meet the needs of all young adults in Georgia. Those who have incomes that place them below the poverty line will likely remain uninsured unless Georgia expands its Medicaid program.

Most young adults want what Americans of all ages want: the peace of mind that comes with knowing that an unexpected cancer diagnosis or accident doesn’t equal financial ruin, and that they have access to basic medical services. The new coverage options are finally leveling the playing field for this generation. It’s about time.

During the 2013 Legislative Session, our state policymakers passed HR 107, which created a joint study committee on Medicaid reform. The purpose of the committee is to evaluate the state’s Medicaid program, examine best practices in other states, and plan for the future of the program. Many health care advocates monitored the legislation closely during the past Legislative Session because of the important role that Medicaid plays in providing health care services to our state’s most vulnerable citizens. The first meeting date for the study commission has been announced and will be held on August 28th from 10am – 12pm. The location for the meeting has not yet been announced, but more information about the committee is available here.

Georgia ranks 9th in the nation in the number of uninsured adults with a mental illness who could gain coverage through the Medicaid expansion, according to a new report from the National Alliance on Mental Illness (NAMI). The NAMI report describes the barriers that people with mental illness face in accessing services and the important role that Medicaid plays in connecting people to services so they can be healthy and productive members of their communities. Expanding Medicaid in Georgia is a major opportunity to change the lives of more than 86,000 low-income uninsured adults with mental illness in Georgia–if you haven’t already, please sign the petition in support of expanding Medicaid in Georgia and join us in our campaign to Cover Georgia!  The full NAMI report on Medicaid and mental health is available here.

Please do help, share awareness and spread kindness. Feel free to visit About Leslie Zebel
.