Georgians for a Healthy Future is spearheading Cover Georgia, a new coalition in support of expanding Medicaid in our state to cover the uninsured.  As part of this on-going effort, we will explore what is at stake for Georgia families and consumers as policymakers weigh this option in the coming months.

In 2014, Georgia consumers with incomes between 100% and 400% of the federal poverty level (FPL), or roughly between $11,170 and $44,680 for an individual, will be eligible for tax credits to purchase health insurance through the new federally facilitated health insurance exchange. Adults with incomes below 100% FPL, however, will not be eligible for these tax credits. This is because the Affordable Care Act envisions individuals with incomes this low becoming eligible for Medicaid through an expansion of that program.

If Georgia fails to adopt this expansion, this would create a “coverage gap,” leaving many Georgians with no options for affordable health coverage. This infographic helps explain how this would play out for two Georgians: Jan would make too much money to be eligible for Medicaid but would not make enough to access tax credits to purchase affordable private health insurance (a typical health insurance policy would consume nearly her entire income).  Meanwhile, John would be able to purchase insurance in the exchange with a tax credit, making health insurance reasonable for his budget.  This is simply not fair. All Georgians should have a pathway to affordable health care coverage. To learn more about Cover Georgia and to join our efforts, click here.

Approximately 1.9 million Georgians are uninsured, among the highest in the nation. Our new interactive resource, Mapping Georgia’s Uninsured, visually displays detailed information on Georgia’s uninsured population by age, income, and region. Click on the shaded regions within each map to see the total number of uninsured by age and income, uninsured rate, and the number of Georgians who would be eligible for Medicaid within each region if Georgia policymakers chose to expand the program. This mapping resource is part of our Cover Georgia initiative to educate policymakers and the public about Georgia’s uninsured, the benefits of coverage, and the opportunity the Medicaid expansion presents for Georgia patients, consumers, providers, and the state’s economy. To view the interactive maps, click here.

Georgians for a Healthy Future is excited to announce that Jonathan Cohn of The New Republic will be the keynote speaker for our third annual Health Care Unscrambled policy breakfast on January 10, 2013! We hope you’ll join us for this important event that brings together health care consumer advocates, stakeholders, and policymakers for a look ahead to the biggest health policy issues facing Georgia in the coming year. Jonathan’s full bio is below.

Jonathan Cohn covers domestic policy and politics for The New Republic, with a particular emphasis on social welfare, labor, and health care. He is also the author of Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price.

Jonathan has been recognized in the pages of the Washington Post as “one of the nation’s leading experts on health care policy” and in the New York Times as “one of the best health care writers out there.” An item from Time suggested he “may be the smartest, most well-sourced health care writer in the country.”

Jonathan has won the Sidney Hillman and Harry Chapin media awards. He has also been a finalist for the Robert F. Kennedy Book Award, the New York Public Library’s Helen Bernstein Book Award, and the Livingston Award for Young Journalists. Jonathan, who is presently a member of the National Academy of Social Insurance, has been a senior fellow with Demos, a media fellow with the Kaiser Family Foundation, and a Griffith Leadership fellow at the University of Michigan. He is a frequent public speaker and radio/television analyst.

Jonathan grew up in South Florida, where he became a devoted fan of the Miami Dolphins, and graduated from Harvard University, where he became a devoted fan of the Boston Red Sox. But his biggest devotion is to his wife and two children, with whom he lives in Ann Arbor, Michigan.

This week’s election results removed any uncertainty about the Affordable Care Act’s future: the health reform law is here to stay. Now it is time to do the hard work of ensuring that health reform meets its promise in Georgia and that health care consumers have access to meaningful and affordable coverage.

Over the past three days, several news stories have outlined the key next steps and decision points for Georgia policymakers on Medicaid and the private health insurance marketplace, and many of them turned to Georgians for a Healthy Future to explain the implications for Georgia health care consumers. All articles are linked below.

Georgia expected to spar over Medicaid expansion in election aftermath

The Augusta Chronicle  | November 8, 2012

Big healthcare decisions loom for state in election’s wake

Atlanta Journal-Constitution  | November 7, 2012

Deal: No state exchange likely under Obamacare

11 Alive News  | November 8, 2012

Deal suggests Ga. unlikely to run health exchange

Columbus Ledger-Enquirer  | November 7, 2012

Health care law lives — and Ga. faces big choices

Georgia Health News  | November 7, 2012

Perhaps the biggest issue for Georgia’s policymakers to consider in the coming months is the Medicaid expansion. Leveraging the resources on the table to expand Medicaid will improve access to care, strengthen our state’s health care delivery system, and bolster Georgia’s economy. If your organization would like to join the Cover Georgia coalition in support of expanding Medicaid, email Georgians for a Healthy Future’s Outreach and Advocacy Director Amanda Ptashkin.

Today, Georgians for a Healthy Future’s Executive Director Cindy Zeldin presented to the annual Georgia Women’s Assembly, organized by Georgia Women for a Change, on the Medicaid expansion and why it matters for women. We know that covering Georgia’s uninsured by implementing the Medicaid expansion will improve access to care, provide resources for the state’s health care delivery system, and bolster Georgia’s economy. But what about women in particular? Medicaid today provides a lifeline for many women, serving as a source of coverage for low and moderate-income pregnant women, low-income mothers, and low-income women diagnosed with breast or cervical cancer. Yet too many women are left out. Expanding Medicaid will extend that lifeline to more low-income moms and low-income women without children who aren’t eligible for Medicaid today.  More than two-thirds of uninsured women report difficulty accessing care, which tells us that too many women who want and need an entry point to the health care system to meet basic medical needs cannot get it today. The Medicaid expansion will help open that door. Another reason to Cover Georgia!

To download Cindy Zeldin’s power point presentation from the Georgia Women’s Assembly, click here.

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 policymakers are currently weighing the opportunity to cover an estimated 650,000 uninsured Georgians through an expansion of the Medicaid program. Under the Affordable Care Act, states can create a new category of eligibility for Medicaid to cover low-income individuals and families, financed almost entirely with federal dollars. Implementing this expansion is the only viable way to cover Georgia’s low-income uninsured, and it will pump resources into our state’s health care delivery system. We can’t miss this opportunity to improve access to health care and to strengthen Georgia’s health care economy, but we need your voice to make it happen.

Health care consumer and patient advocacy groups, providers, stakeholders, and community groups are coming together under the Cover Georgia umbrella to show support for expanding Medicaid, and we invite you to join us. If you are interested in getting involved in this discussion, please contact Amanda Ptashkin.

In November, the Cover Georgia campaign will unveil a website full of resources to help you better understand and advocate for the Medicaid expansion with policymakers and in your community. In the meantime, please visit Families USA’s Medicaid Expansion Center, with links to studies and reports about the value of Medicaid, and the Center on Budget and Policy Priorities’ Tool Kit for State Advocates on the Medicaid expansion.

#CoverGeorgia

Gaining health care coverage through Medicaid improves access to care, reduces financial strain, and saves lives. Those are some of the takeaways from an engaging and enlightening forum hosted this morning by the Georgia Budget and Policy Institute. The featured speakers, Dr. Heidi Allen and Dr. Benjamin Sommers, presented research findings on the impact of gaining Medicaid coverage on health status and participated in a panel discussion moderated by GBPI’s Tim Sweeney and Georgians for a Healthy Future’s Cindy Zeldin about the implications for Georgia as our state’s policymakers weigh the costs and benefits of covering the uninsured in Georgia through an expansion of Medicaid. The audience was live tweeting the event under #covergeorgia, allowing those who missed to hear what the audience was saying as it was happening. You can read their tweets here. Georgia Health News also reported on the event (story here). To get involved with Cover Georgia, the emerging educational and advocacy effort to make the case for expanding Medicaid to cover Georgia’s uninsured, please e-mail Georgians for a Healthy Future’s Outreach & Advocacy Director, Amanda Ptashkin.

Here are some photos from today’s event.

This commentary originally appeared in the Atlanta Journal-Constitution on September 6th, 2012.

By Cindy Zeldin

Nearly 2 million Georgians are uninsured; that number is among the highest in the nation.

Georgia policymakers have long recognized this problem as a tragic reality for the one in five Georgians who struggle to access medical care when they need it, as a strain on our state’s health care delivery system, and as a weight on Georgia’s economy.

Until now, however, they haven’t had the tools and resources to comprehensively address it.

What has changed?

The Affordable Care Act  put in place a basic framework to ensure that all Americans have a pathway to affordable health care coverage. This framework has three key components. First, those of us who get health insurance at work as an employee benefit will continue to do so.Second, new health insurance marketplaces, or “exchanges,” will come on line in just over a year to help consumers who don’t have employee coverage at work find an affordable health plan that meets their needs. Third, a new category of eligibility for Medicaid was created for the lowest-income consumers, many of whom work in low-wage jobs that don’t come with health insurance, yet earn too little money to afford a private health insurance policy.

In June, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act but ruled that states could choose whether or not to implement that third component, the Medicaid expansion.

Covering the lowest-income uninsured through Medicaid will provide access to basic prevention and treatment services that uninsured Georgians lack today. A landmark study published last year by the National Bureau of Economic Research found that people who gained coverage through Medicaid were more likely to access preventive services and have a usual source of care than their uninsured counterparts. A study published in the New England Journal of Medicine found that states that expanded Medicaid saw lower mortality rates, even after taking into account a range of other factors, than their neighboring states who did not.

In other words, if you want to improve health care outcomes, expanding Medicaid is a proven way to accomplish this goal.

The benefits to Georgia of expanding Medicaid go far beyond the 650,000 uninsured Georgians who stand to gain coverage. Because the Medicaid expansion is financed almost entirely with federal dollars, an infusion of resources will be pumped into our state’s health care delivery system.

If Georgia expands Medicaid, we stand to draw down approximately $14.5 billion in federal funds over the six-year period between 2014 and 2019, according to an analysis by the Urban Institute. In fact, Georgia taxpayers are already contributing towards the cost of the Medicaid expansion. It’s just a question of whether some of that money comes back to Georgia or whether we leave it on the table and allow it to be diverted to other states.

Last week, Gov. Nathan Deal announced that he did not intend to move forward with the Medicaid expansion, expressing concerns about the federal government’s long-term fiscal outlook. Just last month, states received word that they have an important element of flexibility: They can implement the Medicaid coverage expansion and, after a few years, if it isn’t working for them, they can withdraw.

There is no reason why Georgia can’t take advantage of the tools and resources before us to invest in our state’s health care economy today  and revisit our participation periodically to ensure that the federal government is meeting its end of the bargain and that the program works.

We have an unprecedented opportunity to improve the health of Georgia patients and consumers, strengthen our state’s health care delivery system, and bolster the state’s economy by moving forward with the Medicaid expansion.

Georgia policymakers should seize the moment and invest in our future.

On Friday, July 13 the Georgia Department of Community Health (DCH) announced plans for next steps in the “Medicaid Redesign.”  Over the past several months, DCH has convened task forces comprised of stakeholders and advocates to formally provide input into this process. At the same time, advocates have come together as the CARE-M coalition to develop recommendations based on best practices for vulnerable populations. This redesign process is separate from but parallel to the conversations currently taking place regarding whether or not to move forward with implementation of the Medicaid expansion authorized by the Affordable Care Act. Ultimately, both processes will have a big impact on coverage and access to care for health care consumers throughout Georgia.  In a press release, DCH said:

“Today, the Georgia Department of Community Health (DCH) announced that it will move forward with implementing key recommendations from its Medicaid and CHIP (Children’s Health Insurance Program) Redesign task forces and workgroups. It will not, however, pursue wholesale restructuring of Georgia’s Medicaid program at this time because of increasing uncertainty at the federal level.”

According to DCH, the changes that the state will move forward with include: 

• Proceeding with at-risk managed care to serve Georgia Families members

• Transitioning children in foster care to one designated vendor statewide within the new Georgia Families program

• Maintaining Georgia’s current Fee-For-Service structure for ABD populations and services

• Moving forward with Home and Community-based Services Rebalancing. This rebalancing will help move patients from skilled nursing facilities to home and community based services.

• Begin utilizing a value-based purchasing model. Value-based purchasing will allow DCH to continuously improve the quality of care for our members while better engaging our providers and ultimately containing costs.

• Creating a one-stop portal will improve accountability and efficiency. Specifically the portal will give health care providers better information about their members and their medical history, streamline their credentialing process, and present providers with a measurement of key performance metrics and allow them to monitor quality and outcomes compared to their peers.

• Creating a Common Pharmacy Preferred Drug List that will simplify the program and reduce administrative burden on providers

The Department has committed to continuing its work with the task forces and work group through the RFP process and past the go-live date.  As members of the Children and Families Task Force and Substance Use and Mental Health Working Group, Georgians for a Healthy Future staff will continue to provide a consumer voice in these discussions and will continue to advocate for greater access to care for Georgia’s most vulnerable citizens.  For more information about the redesign process, visit https://healthyfutprod.wpengine.com/issues/medicaid-and-peachcare-redesign.

Georgians for a Healthy Future and the Georgia Council on Substance Abuse are embarking on a joint project on substance abuse disorder policy and its intersection with health care policy! This is a 10-month health care initiative supported by a grant from Community Catalyst to develop and advocate for a continuum of comprehensive services that address the needs of people at risk of and who have a substance use disorder. For more information about substance abuse programs visit altustreatment.com

Starting in January 2014, the Affordable Care Act will require insurers to cover treatment for drug addiction the same way they would other chronic diseases.  As one of the required essential health benefits, for the first time all those enrolled in Medicaid will have access to the substance abuse services they need. Check it out if you need any help from professional to threat addiction.

The Medicaid expansion authorized under the Affordable Care Act also holds a tremendous opportunity to reach segments of the population who were previously ineligible for services (such as childless adults up to 138% FPL). However, this is not a forgone conclusion–the state may decide to opt out of the expansion.

Georgia policymakers have not yet decided whether they will move forward with the Medicaid expansion. With 1 in 5 Georgians currently uninsured, the Medicaid expansion has the promise of providing an essential pathway to health insurance and health care for approximately 600,000 to 900,000 Georgians. It is critical that policymakers hear from the consumers and communities who need this very basic access to health care.

In the weeks and months ahead, Georgians for a Healthy Future and the Georgia Council on Substance Abuse will mobilize to ensure that Georgia implements the Medicaid expansion, but we cannot do it without your help.  To join our efforts, email Amanda Ptashkin.

For more information about this collaboration, click here.