Medicaid Matters: Maintaining independence for seniors

Charlie Ellison is 87 years old and a long time resident of Dalton, Georgia. Charlie is one of over half a million seniors and people with disabilities in Georgia who depend on Medicaid and Medicare to live and function in their communities.

After suffering a fall while living alone in 2016, Charlie’s nervous system was damaged and he was no longer able to live independently. He attended physical therapy for ten months and lived at a nursing home in Dalton during this time which he paid for out of pocket.

Now that Charlie has Medicaid coverage, he is able to visit RossWoods Adult Day Services every day and enjoys engaging in activities with others his age. He is also able to live at home with his daughter and son-in-law who help take care of him, rather than in a nursing home where he had less independence and fewer activities to keep him healthy and active.

Before Charlie’s fall, he was already managing diabetes and high blood pressure, and had a pacemaker in his chest. Charlie’s Medicaid coverage picks up the costs of some of his medications that are not covered by Medicare, which ensures Charlie remains as healthy and independent as possible.

For 168,000 seniors like Charlie who typically rely on low, fixed incomes, Medicaid makes the difference and helps to pay the costs of their Medicare coverage, and for some, it provides additional health benefits not covered through Medicare. For others, Medicaid allows them to age with dignity in their communities by covering needed home and living adaptations like chair lifts, wheelchair ramps, or engaging day programs with trained staff.


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 why it’s important.

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! Read and share our latest storybook here!


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Legislative Update: Week 2

General Assembly meets for joint budget hearings

Last week the Georgia General Assembly met for the joint budget hearings during which Senate and House legislators heard from agency leaders and Governor Brian Kemp about the proposed current and upcoming state budgets. This year’s budgetary considerations consist of requested changes to the current FY 2019 state budget which will run through June 30th and proposals for the FY 2020 general state budget, which will begin on July 1st.

The House will now craft the budget requests into legislation and continue its funding considerations. Both chambers reconvened yesterday, January 28th, for the fifth day of legislative session.


2019 joint session budget hearings
Budget requests presented to the General Assembly

Last week, the General Assembly heard from department commissioners and other leaders regarding their budget requests for the amended FY 2019 budget (sometimes called the “little budget”) and the upcoming FY 2020 budget (called the “big budget”). Here we highlight some of the primary asks made by the state agencies that most impact consumer health. For more detailed budget analysis, please see the Georgia Budget and Policy Institute’s Overview of Georgia’s 2020 Fiscal Year Budget document.

 


Department of Community Health 

The Department of Community Health (DCH) oversees Medicaid, PeachCare, and other state health care programs. Commissioner Berry requested an increase of $71 million in the amended FY 2019 budget to include $33.7 million for growth in Medicaid expense and $18.7 million for the Indigent Care Trust Fund, which draws down additional federal money for Disproportionate Share Hospital payments.

Commissioner Berry’s most significant request in the FY 2020 budget was an increase of $92 million to offset a reduction in the federal cost-sharing payments for Medicaid and PeachCare for Kids. Georgia’s Federal Medical Assistance Percentage (FMAP) rate will drop from 67.62% to 67.30% for Medicaid and from 100% to 88.61% for PeachCare for Kids, prompting the funding request.


Department of Behavioral Health and Developmental Disabilities 

The Department of Behavioral Health and Developmental Disabilities (DBHDD) provides treatment, support services, and assistance to Georgians with disabilities, behavioral health challenges, and substance use disorders. Commissioner Fitzgerald’s request for the little budget mirrored the Governor’s recommendations to add $8.4 million for the Georgia Apex Program to provide support counselors for mental health services in high schools.

Commissioner Fitzgerald requested that the big budget include an increase of $78.6 million for the Department. The additional funds would be partially compromised of an additional $10.2 million for behavioral health crisis beds, $2.5 million for supported housing, and 125 new slots for NOW and COMP waivers to reduce the current waiting list.


Department of Human Services

The Department of Human Services (DHS) delivers a wide range of human services designed to promote self-sufficiency, safety and well-being for all Georgians. Commissioner Crittenden requested that the big budget include $849,951 to increase funds for 50 additional Medicaid eligibility caseworkers.


The Department of Public Health did not present during the joint budget hearings last week and the Department of Insurance did not have any budgetary requests that were specifically health related. We will include summaries from both departments as we learn more.


GHF has you covered
Stay up-to-date with the legislative session

GHF will be monitoring legislative activity on a number of critical consumer health care topics. Along with our weekly legislative updates and timely analysis of bills, we have the tools you need to stay in touch with health policy under the Gold Dome.


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GHF kicks off 2019 with Health Care Unscrambled breakfast

Georgians for a Healthy Future’s ninth annual Health Care Unscrambled breakfast built on previous years’ successes with another standing room-only crowd.

This year’s program began with a personal story from consumer Lori Murdock, who bravely shared her experience struggling to manage a chronic disease without health insurance because she was caught in Georgia’s coverage gap. Lori’s experience illustrates the pressing need to provide health insurance to all Georgians regardless of income.

 

Following Lori was our bipartisan legislative panel. This year’s legislative panelists were:

Each panelist provided updates on emerging health care trends impacting Georgia and took questions from the audience about what health issues are likely to be taken up in the 2019 legislative session. Topics included Medicaid expansion, surprise out of network medical billing, access to mental health,  network adequacy, Certificate of Need reform, social determinants of health, rural health care access, federal health care reform, and affordability of health care. All three panelists shared an optimistic vision for health care in this years legislative session.

This year’s key note speaker was Dr. David Blumenthal, President of the Commonwealth Fund. Dr. Blumenthal brought a wealth of knowledge and insight to our conversation about how innovations in health care and coverage can help us achieve better health outcomes for all Georgians. He led the discussion by comparing Georgia’s health outcomes to those of our neighboring states, and then provided an agenda for improvement. He emphasized that Georgia is unlikely to overcome poor health outcomes unless state leadership improves insurance coverage, as demonstrated by the Commonwealth Fund’s own research on Medicaid expansion’s impacts on population health. Dr. Blumenthal also shared the importance of investments in the social determinants of health for improving health outcomes and ultimately saving money. Dr. Blumenthal’s presentation can be accessed here and the Georgia scorecard from the Commonwealth Fund can be found here.

To see photos, review materials, and get more information about this year’s Health Care Unscrambled event, please visit the event page.

For more event pictures visit our Facebook photo album. 


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Medicaid Matters: The impact of coverage for Georgians

Medicaid provides health care coverage to almost two million Georgians, including 1.3 million children across the state and 500,000 seniors and people with disabilities. It’s comprehensive coverage provides needed health care services that would otherwise be unaffordable to low-income Georgia families and individuals in communities across the state. Because Medicaid is so fundamental to Georgians and Georgia’s health care system, GHF is highlighting it in two new resources!

The Medicaid Matters to Georgia storybook shares the real health care stories of Georgia children and families. Georgians from across the state share the important role that Medicaid plays in their lives. Hear directly from Sherry, Travis, Oliver, and others about their experiences. Oppositely, Mary, Susie, and other uninsured Georgians share how Medicaid coverage could improve their lives if state policy makers closed Georgia’s coverage gap.

 

 

Our new Medicaid Matters for Georgia fact sheet is updated with what you need know about Medicaid. This one-page fact sheet outlines who is eligible for Medicaid in Georgia, what health services and supports are covered, and why Medicaid is a good investment for Georgia.

 

GHF’s new resources bring attention to the difference Medicaid makes in the lives of Georgians every day and the potential it has to serve those who are currently uninsured. We hope these new resources help policymakers, advocates, and consumers from across the state better understand the importance of ensuring all Georgians have access to quality, affordable healthcare. We invite you to read and share both with your friends, colleagues, and partners.

 


Georgians for a Healthy Future is partnering with community groups across the state to host Georgia Voices for Medicaid events. If you are interested in learning more about Georgia’s Medicaid program, who it covers, how it benefits the state, and how you can be a strong health care advocate, you should attend! Check out our events page to see if we have any Georgia Voices for Medicaid events happening near you or contact Alyssa Green at agreen@healthyfuturega.org if you would like to schedule one in your community.


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A consumer health advocates guide to the 2018 elections: Georgia’s Insurance Commissioner

The race to be Georgia’s Insurance Commissioner is one of the most overlooked statewide races on the ballot this November, despite the position’s impact on the health and finances of almost all Georgians.

Georgia’s Office of Insurance and Safety Fire Commissioner (commonly referred to as the Department of Insurance or DOI) is headed by Georgia’s Insurance Commissioner. The Department oversees health, auto, long-term care, and other insurance products that can be regulated by the state. For Georgians who have individual or small-group insurance (about 2.6 million Georgians), the Insurance Commissioner has a direct impact on their insurance rates, their ability to access needed health services, and the extent to which their coverage is transparent and fair.

Georgia’s Insurance Commissioner is a constitutional officer in Georgia and is elected by Georgia voters for a four-year term. The Commissioner and the Department are tasked with regulating insurance companies and licensing insurance agents operating in Georgia and overseeing state fire safety initiatives, in addition to other non-health-related duties.

Because the Insurance Commissioner is primarily responsible for overseeing private health insurance in Georgia, they are key to how the Affordable Care Act and its consumer protections are implemented in the state. For example, the ACA requires that insurance companies justify any premium rate increases of more than 10% through a process called “rate review”. The Commissioner and Department staff determine how strong and transparent to make Georgia’s rate review process, and in doing so, determine how accountable insurers must be as they ask consumers for more dollars out of their household budgets.

The Commissioner and DOI are also responsible for ensuring that health plans do not design their benefits so that they discriminate against certain types of consumers. For example, if a health plan only covers one type of HIV medication and only at the highest cost-sharing level of the plan, the Commissioner could instruct his department to examine whether the plan’s design constitutes discrimination against people living with HIV. Similarly, health plans are required to cover mental health and substance use treatment services at the same level as they cover physical health services. If the Commissioner is lax in overseeing the enforcement of these laws, consumers could be financially blocked from receiving the health services that they need.

The Commissioner and his office also license insurance agents selling health insurance plans and other consumer products, as well as Georgia’s health insurance navigators. The position of “navigator” was created and funded through the Affordable Care Act in order to provide free, local, unbiased assistance for consumer enrolling into health coverage through the Marketplace. Currently, Georgia’s navigators have to meet unnecessarily burdensome licensing requirements and pay a large fee in order to be licensed by the state, something that Georgia’s next Insurance Commissioner has the power to address.

The Department of Insurance is further charged with protecting Georgia citizens from insurance fraud, mediating disputes between consumers and insurance companies, and assisting consumers with questions. The Georgia Department of Insurance has historically been under-resourced and, as a result, has struggled to carry out these tasks in a robust way. Georgia’s next Commissioner will be integral in advocating for the budget and resources needed to assist and support Georgia consumers across all insurance products.

Georgia’s next Insurance Commissioner will have a significant role in shaping the state’s health care landscape over the next four years or more. Whether and how the state addresses issues like access to care, health care affordability, the opioid crisis, and the sustainability of the rural health care system may be decided by voters at the ballot box this November.


This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2018 election on timely consumer health issues. Please check out our previous blogs in the series:

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.


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A consumer health advocates guide to the 2018 elections: Georgia’s General Assembly

Early voting is underway ahead of the upcoming November 6th Election Day. Georgians across the state are heading to the polls to cast their votes for Governor, Insurance Commissioner, state legislators and other elected positions, and voters’ decisions about the candidates in each race will have a critical impact on consumers health issues in Georgia.

All of Georgia’s state legislative seats are on the ballot this fall and a record number of seats are being competitively contested. The resulting changes in the General Assembly could have a big impact on the future of health and health care for Georgia consumers.

Georgia’s General Assembly is made up of two chambers: the House of Representatives and the Senate. Georgia has one of the largest state legislatures in the nation with a total of 236 members, made up of 56 Senators and 180 Representatives. Every Georgia resident has one Georgia Senator and one Georgia House member, both of whom are up for re-election every two years.

Constitutionally, the General Assembly is only responsible for proposing and passing an annual state budget; however, during the body’s annual 40-day session, legislators also propose, debate, and pass laws for the state of Georgia, including those that regulate health care, health coverage, or that impact health through another sector (like education or transportation).  

All appropriations bills, which designate how state funds are to be spent, must originate in the House. Health care is the state’s second largest expenditure and made up almost 20% of this year’s annual budget. Each year, after the Governor proposes a state budget, the legislative leaders of the House turn the proposed budget into a bill for consideration by the House’s appropriations committee and then by the full chamber. When the House has approved the budget, the budget goes through the same process in the Senate. Once approved by both chambers, any differences are worked out in a conference committee, before sending the budget back to the Governor to be approved or vetoed.

The decisions made during the General Assembly’s budget considerations can have a big impact on health care and coverage for Georgians. For example, the General Assembly has over the last three years approved pay increases for primary care and OB-GYN doctors and dentists treating Medicaid patients, which improves access to care for the almost 2 million Georgians who rely on Medicaid for health coverage.

Members of the General Assembly may also propose laws to address issues of concern for their constituents. These issues can range from surprise out-of-network medical billing to the opioid crisis to Medicaid expansion to Georgia’s health insurance Marketplace. Many legislators receive ideas for legislation from concerns and complaints brought to them by their constituents (an important reason to get to know your legislators!).

Each year, hundreds of bills are proposed and only a fraction successfully pass both chambers. Health-related bills typically pass through the Health & Human Services and Insurance Committees in each chamber. Legislators can consider bills until Sine Die, the 40th and last day of the legislative session. When approved by both chambers, successful legislation goes to the Governor for approval or veto.

One of the most impactful pieces of health-related legislation passed by the state legislature in recent years is HB 990 (2014), which requires the General Assembly to approve any expansion of Medicaid. This bill effectively revoked the Governor’s ability to act independently to close Georgia’s coverage gap, making it more difficult to expand health coverage to low-income adults in Georgia. 

Georgia’s General Assembly will have many new faces after the upcoming election, each of whom will play a role in shaping the state’s health care landscape over the next two years or more. Whether and how the state addresses issues like access to care, health care affordability, the opioid crisis, and the sustainability of the rural health care system may be decided by voters at the ballot box this November.


This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2018 election on timely consumer health issues. Please check out our previous blogs in the series:

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.


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Stories from Georgia’s coverage gap: Rural Georgians left behind

Pricilla Epps is a 54-year-old former security guard who lives in Blakely, GA, a rural community in the southwest region of the state.

Two days after having a sudden stroke, Priscilla lost her job because she was unable to work her scheduled shifts as she recovered that week. Priscilla’s health insurance was provided by her employer, so she lost her health insurance coverage when she lost her job, leaving her on the hook for all of the hospital costs that accumulated as she received care for her stroke. After a two-day stay, Priscilla was told she would have to leave the hospital due to her inability to pay for the costs of in-patient care.

Experiencing dizziness, difficult walking, discomfort in her limbs, and frequent forgetfulness, Priscilla went to see Dr. Kinsell, the only available physician in Clay County, where she still receives the limited follow-up care she can afford. She is still unable to go back to work or live on her own, so Priscilla has been living with her daughter for the time being.

Like Priscilla, 360,000 low-income Georgians, many of whom are uninsured, live in small towns and rural areas across the state. These areas have the most at stake in the debate over whether or not to close the health care coverage gap. According to a new report from Georgetown University’s Center for Children and Families and the University of North Carolina’s Rural Health Project, Medicaid expansions in other states have cut the uninsured rate in rural areas by half, while Georgia has seen a much smaller decline from 43 percent to 38 percent among the same population.

For rural Georgia residents like Priscilla, health coverage would open doors to the physicians and services that they need to stay employed or get back to work. For rural communities like Blakely, more residents with health coverage could make the difference between keeping or losing the few remaining primary care physicians in the area.


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 why it’s important.

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!


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A consumer health advocates guide to the 2018 elections: Georgia’s Governor

Early voting began last week ahead of the upcoming November 6th Election Day. Georgians across the state are heading to the polls to cast their votes for Governor, Insurance Commissioner, state legislators and other elected positions, and voters’ decisions about the candidates in each race will have a critical impact on consumers health issues in Georgia.

One of the most visible positions on the ballot and one that plays a meaningful role in health care policy for the state is Georgia’s Governor. The Governor heads the state’s executive branch, which is broadly responsible for implementing, supporting, and enforcing Georgia’s laws.

As head of the executive branch, the Governor has the authority to appoint and provide direction to the leaders of most of Georgia’s executive branch departments, including the Commissioners of the Departments of Community Health (the state’s Medicaid agency), Public Health, Behavioral Health and Developmental Disabilities, and Family and Children Services. Because most health-related programs in the state are run by one of these agencies, the ability to appoint department leadership provides the Governor with outsized influence on the direction, priorities, and initiatives within each.

Ahead of the state legislative session, the Governor has the added responsibility of proposing an annual state budget for the General Assembly’s consideration. Health care is regularly the state’s second largest expenditure, making up almost 20% of the annual budget. Aside from expected items like Medicaid expenditures, the Governor may propose special investments that promote his/her health-related priorities. For example, Georgia’s FY19 budget includes an additional $21.4 million to improve and expand children’s behavioral health services as recommended to Governor Deal by his Commission on Children’s Mental Health. Once the legislature has considered and passed a budget, the Governor has the power to veto or approve the spending plan.

At the end of each year’s legislative session, the Governor has 40 days to approve or veto (“veto” means “to reject”) legislation. Most laws passed by the General Assembly are approved but a few each year are rejected by the Governor because they are ill-informed, controversial, or contrary to the Governor’s priorities. In recent years, Governor Deal has vetoed some health-related laws like SB 357 in 2018, which would have established a Health Care Coordination and Innovation Council.

Once a bill is approved, the Governor may direct the executive branch agencies about how the law should be carried out. For example, if the Georgia General Assembly approves future legislation to expand Medicaid in Georgia, the Governor may provide the Commissioner of Community Health with instructions about how the expansion should be implemented, including program elements that make it easier or harder for people to enroll in or use their new coverage.

Georgia’s next Governor will have a significant role in shaping the state’s health care landscape over the next four years or more. Whether and how the state addresses issues like access to care, health care affordability, the opioid crisis, and the sustainability of the rural health care system may be decided by voters at the ballot box this November.


This blog is part of a series from Georgians for a Healthy Future to educate consumers about the impact of the 2018 election on timely consumer health issues. Please check out our previous blog, Eight questions for health care voters to ask Georgia candidates, where you can find a list of questions to help health care voters get to know the candidates on their ballots.

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.


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GHF welcomes two graduate students

Georgians for a Healthy Future regularly hosts graduate students from Georgia’s universities to help train and foster the state’s future health advocates. This semester, GHF is hosting two Master of Public Health students who will be working on projects that promote GHF’s policy and advocacy priorities.

Jessica joined Georgians for a Healthy Future in March as the Health Education & Advocacy Intern. In this role, she is responsible for developing an educational curriculum on Georgia’s Medicaid program and related educational materials. She is also assisting in the development of a multi-media curriculum to build advocacy skills in people with disabilities and other invested health advocates. She has a bachelor’s degree in Health Science from Truman State University in Missouri and is currently studying epidemiology in the MPH program at Georgia State University. Before going back to school, Jessica worked in HIV research at Emory University.

 

 

 

Kerris Solomon is pursuing a dual MPH/Juris Masters degree at Emory University. Although born and raised in Georgia, Kerris completed her undergraduate studies at St. John’s University in Queens, NY. After receiving her bachelor’s degree in Communication Science Disorders, she worked two years as a Web Master for a college in the metropolitan Atlanta area. She now uses that knowledge and experience as the Communications Chair on the Rollins Student Government Association’s executive board. Kerris is came to GHF as the Health Communications Intern. One of Kerris’ goals in the field of public health is to implement policy change within the country’s incarceration system. She wants to change how mental health is treated within prisons (solitary confinement, etc.), the difficulties of re-entry for returning citizens, and the cycle that it induces.

We welcome both Jessica and Kerris, and look forward to our work together.


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Eight questions for health care voters to ask of Georgia candidates

Georgians across the state are being asked to decide how they will cast their votes in November for positions such as Governor, Insurance Commissioner, state senator and state representative. The decisions made by voters about these elected positions will directly impact critical consumer health issues in Georgia like access to health care, affordability of health insurance, the opioid crisis, and the sustainability of the rural health care system.

As candidates crisscross the state or their districts asking for support, voters will consider their stances on a number of important issues including health care. To help voters make their decisions, we put together this list of questions for voters to ask of candidates about five timely and pressing consumer health care issues.

These questions can be used at town halls and candidate forums or posed to candidates via social media or in one-on-one conversations.

Closing the coverage gap
  • Over 240,000 Georgians make too little to receive financial help to buy private health insurance but do not qualify for Medicaid, meaning they fall into the Medicaid coverage gap. Many of the families who fall in the gap are hard-working people who work in industries that make up the backbone of our state: trucking, food service, and childcare. Do you support using federal funds to close the Medicaid coverage gap and offer affordable health coverage to these 240,000 Georgians while boosting the Georgia’s economy? Please explain.
  • A 2016 Department of Health and Human Services study showed that marketplace premiums were on average 7 percent lower in states that extended Medicaid to low-income residents. Do you support closing the Medicaid coverage gap as one method to reduce health care costs and lower the uninsurance rate for consumers in Georgia? Please explain.
Georgia’s health insurance marketplace
  • Health insurance premiums for Georgia consumers will rise by as much as 15 percent in 2019 due to the repeal of the individual mandate by Congress and the elimination of cost-sharing reductions, among other things. If elected, what improvements would you make to our health care system to ensure your constituents have access to high quality, comprehensive and affordable health insurance?
  • The federal government has expanded insurance companies’ ability to sell short-term plans that do not cover key services like mental health treatment or prescription drugs. These plans will increase health care costs and roll back consumer protections that many families in our state depend on. How do you think Georgia should regulate these plans?
Opioid/substance use crisis
  • In 2016, about three Georgians died each day from drug overdoses and thousands of Georgians live with substance use disorders regularly. To slow this crisis, a broad spectrum of strategies will be needed from prevention and early intervention to expanded access to treatment. If elected, what would you do to address the state’s substance use crisis?
 Communities left behind
  • Seven rural hospitals in Georgia have closed since 2010. Rural hospitals are often the largest employer in the area and are the economic engines that help to support local small businesses (like the flower shop or pharmacy). If elected, what will you do ensure that rural communities have adequate access to quality, affordable health care?
  • People of color in Georgia have shorter life expectancies, higher rates of chronic disease, and are more likely to be uninsured and live in medically underserved areas. The causes of these outcomes are complex and linked to reduced access to quality education, fewer economic opportunities, discrimination, and other social and economic factors. As (Governor/Insurance Commissioner/other position title), how would you address the health disparities experienced by people of color in Georgia?
Defending health care gains
  • Over the past two years Congress has repeatedly attempted to repeal the AffordableCare Act (ACA) and slash federal Medicaid funding that our state relies on, despite the fact that 74 percent of the public view the Medicaid program favorably. If elected, will you support/continue to support the program in the face of threats? Please explain.

 


Did you ask one of these questions to a candidate? Let us know! We want to know which questions were most helpful and how candidates are responding. Email Michelle Conde at mconde@healthyfuturega.org with your feedback.

 

 

*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.


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Dec 13, 2019
Commenters question state Medicaid waiver plan for work requirements
Jill Nolin

“The public comments are important because they become part of the legal record,” said Laura Colbert, who submitted a letter opposing the proposal on behalf of Georgians for a Healthy…

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