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GHF comments on six-month extension of postpartum Medicaid coverage proposal

During the 2020 Georgia legislative session, House Health & Human Services Chairwoman Sharon Cooper sponsored HB 1114. The bill allows eligible mothers to receive Medicaid coverage for six months after giving birth, up from the current 60-day limit.  

Currently pregnant women and new mothers are covered by Medicaid only up to 60 days after their birth or miscarriage. Georgia has very strict Medicaid eligibility rules for Georgia parents outside of this 60-day period and Georgia has not expanded Medicaid to other low-income adults. For these reasons, many mothers who try to apply for Medicaid after the 60-day period are ineligible and become uninsured.

Georgia’s alarming maternal mortality and morbidity outcomes prompted Georgia leaders to examine the problem and propose solutions. State leaders agreed that extending Medicaid coverage from 60-days postpartum to six months for women with incomes at or below 225% of the federal poverty level (FPL) would be a step in the right direction. This move improves access and consistent care during the more of the postpartum period.

Georgia’s Department of Community Health invited public comment on the proposal from October 8, 2020 to November 9, 2020. During this comment period, individuals and organizations were able to provide their input at two public hearings or in writing.

GHF offered its qualified support of the proposal. GHF urged the state to to go further by extending coverage to twelve months. We also recommended an expansion of Medicaid to all low-income adults. Both of these moves would optimize Medicaid’s benefits and access to care for women throughout the postpartum period and beyond. You can read GHF’s full comment letter here.


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Governor Kemp’s health care plans approved: What do they mean and what’s next

Both of Governor Kemp’s health care proposals were approved by federal health officials in the last two weeks. Unfortunately, both proposals fall short of the bold, evidence-based action that Georgians need their state leaders to take. These plans may impact you or people you know. While some details of the plans are still being sorted out, we have tried to answer some of your early questions here. As we learn more and these plans roll out, GHF will keep you updated with the information you need to get covered, stay covered, and help your loved ones do the same.

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A consumer health advocates guide to the 2020 elections: U.S. President

This year, no Georgian has been left untouched by the health or economic impacts of COVID-19. America’s failure to control the pandemic has spotlighted the importance of public policy decisions that prioritize health and wellness. The consequences of underfunding essential public health infrastructure and Medicaid, and the disparate impact that public policies have no Black Americans and other people of color is clear. National, state, and local leaders, many elected by the public, are responsible for the policy decisions made ahead of and in response to COVID-19, its economic fallout, and the movement for racial justice.

This election season (October 12 to November 3, 2020), Georgians have the opportunity to learn more about these elected positions, the decision-making power each has, and how those positions impact their health and the well-being of Georgians. This year, Georgians will cast their votes for the U.S. President, members of U.S. Congress, state legislators, state supreme court judges, and other positions.

Pictures from the Georgia state capitol featuring GHF and health advocates
Pictures from the Georgia state capitol featuring GHF and health advocates

In this blog, we cover the U.S. President’s impact on the health and well-being of Georgians and their families. 

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Ten Health Care Questions for Georgia Candidates

Decorative: Pictures from the Georgia state capitol featuring GHF staff and health advocates
Pictures from the Georgia state capitol featuring GHF and health advocates

This year, no Georgian has been left untouched by the health or economic impacts of COVID-19. America’s singular failure to control the pandemic has spotlighted the importance of public policy decisions that prioritize health and wellness. The consequences of underfunding essential public health infrastructure and Medicaid, and the disparate impact that public policies have no Black Americans and other people of color is clear. National, state, and local leaders, many elected by the public, are responsible for the policy decisions made ahead of and in response to COVID-19, its economic fallout, and the movement for racial justice.

Ahead of the 2020 election season (October to November 3, 2020), Georgians have the opportunity to learn more about these elected positions, the decision-making power each has, and how those positions impact their health and the well-being of Georgians. This year, Georgians will cast their votes for the U.S. President, members of U.S. Congress, state legislators, state supreme court judges, and other positions.

As Georgia candidates on this fall’s ballot crisscross the state or their districts asking for support, voters will consider their positions 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.

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A consumer health advocates guide to the 2020 elections: U.S. Congress

Three images of people advocating for health care at the Capitol

This year, no Georgian has been left untouched by the health or economic impacts of COVID-19. America’s singular failure to control the pandemic has spotlighted the importance of public policy decisions that prioritize the health and wellness of populations, the consequences of underfunding essential public infrastructure (like departments of public health), and the disparate impact that public policies have had on Black Americans and other people of color. National, state, and local leaders, many elected by the public, are responsible for the policy decisions made ahead of and in response to COVID-19, its economic fallout, and the movement for racial justice.

Ahead of the 2020 election season (October to November 3, 2020), Georgians have the opportunity to learn more about these elected positions, the decision-making power each has, and how those positions impact their health and the well-being of Georgians. This year, Georgians will cast their votes for the U.S. President, members of U.S. Congress, state legislators, state supreme court judges, and other positions. Voters’ decisions about the candidates in each race will have an unprecedented impact on consumers health issues in Georgia as we continue to battle through the current health crisis.

In this blog, we cover the U.S. Congress’s impact on the health and well-being of Georgians and their families. To jump to a specific section, click these links:

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Legislative Update: Steep budget cuts and significant health bills close 2020 session

Sine Die

Georgia’s 2020 legislative session comes to a close

Friday, June 26, marked the final day of the 2020 Georgia legislative session. This year’s Sine Die (the last day of the legislative session) came after a months-long suspension due to safety concerns over COVID-19. The final two-week legislative sprint brought the approval of a number of bills that will benefit consumers if approved by the Governor. Unfortunately, this progress comes against a backdrop of steep budget cuts that will put many Georgians at risk, especially those who are most marginalized.

Below you will find an overview of the approved state budget, summaries of notable health-related legislation, and short status reports on other health bills. GHF’s legislative tracker is updated so you can check on the health bills you were watching this session.


General Assembly passes FY2021 state budget

Legislators’ primary responsibility upon returning to the state capitol this month was to finish and pass the FY 2021 state budget, which goes into effect this Wednesday, July 1. On Thursday, the Georgia House and Senate passed a state budget that includes $2.2 billion in budget cuts for the FY 2021 budget. Although cuts were reduced from 14% to 10%, the approved budget curtails funds to many critical health care programs and social services. Notable changes to this year’s budget include:

  • Department of Behavioral Health and Developmental Disabilities: $91 million cut
    • One-third of the cuts ($29 million) comes from adult developmental disability services 
    • Another third ($29.9 million) comes from child and adult mental health services
  • Department of Community Health: Increase of $178 million
    • Increase in funds due to a higher projected growth for Medicaid
    • $19.7 million added to provide six-months of Medicaid coverage for new mothers (see below for more info.)
  • Department of Public Health: $8.2 million cut
    • Funding restored for grants to local health departments
    • No reduction in funding for maternal mortality review board

The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. Voice’s for Georgia’s Children also has a relatively easy-to-read version of the budget changes here.


Our priorities

General Assembly passes four bills to reform PBM practices in Georgia 

This year’s Georgia General Assembly took a keen interest in pharmacy benefit managers (commonly called PBMs). PBMs are companies that manage prescription drug benefits for health insurance companies. In order to secure lower prices on medications, PBMs have adopted practices that are seen as burdensome by pharmacies, restrictive and hard-to-navigate by consumers, and opaque by elected officials. The following four PBM bills were passed last week in an effort to increase patient access to and decrease costs of medications:

  • HB 918, sponsored by Rep. Sharon Cooper, limits the practices of PBMs as they audit pharmacies so that pharmacies can more easily meet audit requests. The bill gives the benefit of the doubt to pharmacies when small or innocuous mistakes are discovered.
  • HB 946, sponsored by Rep. Matt Knight, and SB 313 by Senator Dean Burke are companion bills with the same legislative language. Both bills would require that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. The bills also increase fines on PBMs when they “steer” consumers to specific pharmacies and disallows PBMs from building drug formularies (lists of covered medicines) in a way that discriminates against people with prescription drug needs.
  • HB 991, sponsored by Rep. Matt Hatchet, establishes an oversight committee which will oversee the contracts and subcontracts under the State Health Benefit Plan (covers state employees and their families), Medicaid, and PeachCare for Kids. This legislation aims to increase transparency around the pharmacy benefit managers contracted by these plans. The oversight committee is made of nine members, one of whom must be a consumer covered by one of the state health plans.

Bill to increase taxes and raise the age of purchase for vaping products passes

Multiple pieces of legislation were introduced this year that would change the way Georgia regulates tobacco, vaping devices and other nicotine products. Ultimately, only SB 375, sponsored by Senator Jeff Mullins, saw final passage. The bill will establish a 7% tax on vaping products and would increase the age at which Georgians are allowed to purchase tobacco and vaping products to 21 years of age. This increase in the so-called “age of purchase” brings state law in line with federal law.


Legislation to establish an All Payer Claims Database passed

SB 482, sponsored by Senator Dean Burke, builds on Georgia’s new surprise billing legislation (HB 888). HB 888 authorizes Georgia’s Department of Insurance to establish an all payer claims database (APCD) that will inform the surprise billing payment resolution process. APCDs can be a powerful tool that can also help policymakers, stakeholders, and advocates develop better understandings of health care costs, use of services, population trends, and disparities.

SB 482 goes farther than HB 888 by setting up an advisory body to assist in the creation of the APCD and establishing the purposes of the APCD, among other provisions. The advisory body does not currently include consumer representation. 

The creation of Georgia’s APCD is subject to appropriations. It was not funded in the FY2021 budget but state leaders have expressed optimism about funding it in future state budgets and attracting private funds to help support its development.


Surprise billing legislation awaits Governor’s signature

The Surprise Billing Consumer Protection Act (House Bill 888), was recently passed by the General Assembly and now heads to Governor Kemp’s desk for his signature.

This bill will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers. After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how legislation will work and what consumers may expect.

After the bill is signed by the Governor, GHF & Georgia Watch will monitor and publish more information about how the legislation will work and what consumers may expect.


Postpartum Medicaid coverage bill passed and funded

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth, up from the current 60-day limit. The General Assembly approved the legislation and funding ($19.7 million) last week. HB 1114 now heads to Governor Kemp’s desk for his signature.

In order for this change to take effect, the Georgia Department of Community Health will need approval from federal health officials.


Sine Die recap

HB 792: Amended FY 2020 Budget | SIGNED BY GOVERNOR HB 792 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2020. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on March 17th.


HB 793: FY 2020 Budget | SIGNED BY GOVERNOR HB 793 is the budget document for the coming state fiscal year which will run from July 1, 2020 to June 30, 2021. The budget includes several steep cuts to behavioral health and other health care programs. 


HB 719:  Effort to modernize HIV laws | DID NOT PASS HB 719, sponsored by Rep. Deborah Silcox, would modernize Georgia’s HIV-related laws and make progress towards decriminalizing HIV. Current Georgia law deems it a felony for people living with HIV to have sex or donate blood without disclosing their status, or for spitting at or using bodily fluids on a law enforcement officer. Under HB 719 only the act of having sex without disclosing a person’s HIV status would remain illegal.


HB 789: Creation of a surprise bill rating system | PASSED HB 789, sponsored by Rep. Mark Newton, would create a surprise bill rating system based upon the number of certain physician specialty groups contracted with a hospital within a health insurer’s network. 


HB 842: Gracie’s Law – organ transplant discrimination | DID NOT PASS HB 842, sponsored by Rep. Rick Williams, would protect people with disabilities from being removed from organ donor waiting lists because of their disabilities.


HB 987: Protection of elderly persons | PASSED HB 987, sponsored by Rep. Sharon Cooper, would increase training requirements for staff members in elderly care facilities and raises the number of staff who would have to be on site at any given time to watch over residents. It would also increase fines for violations or if a facility causes a resident’s death.


SB 303: Georgia Right to Shop Act | PASSED SB 303, sponsored by Senator Ben Watson, Chairman of the Senate Health & Human Services committee, would require that health insurers to put on their website an interactive feature that allows consumers to estimate their out of pocket costs for a particular health care service and compare quality metrics between providers, among other things. Insurers would also have to provide a phone number that consumers can call to get the same information. 


SB 352: Online provider directories | DID NOT PASS SB 352, sponsored by Senator Burke, would allow consumers to see providers at in-network rates for their entire plan year, if the provider is listed as in-network at the time a person enrolls in their health plan. The providers included in a consumer’s insurance plan network changes regularly throughout the year and this bill would assure that the provider network advertised at the time of enrollment is the provider network they are able to access all year long.


SB 408: Family Care Act Sunset Removal | PASSED SB 408, sponsored by Senator Brian Strickland, would extend the sunset on the Family Care Act to July 1, 2023. The Family Care Act allows employees to use sick time to care for ill family members. 


GHF has you covered

Stay up-to-date with the legislative session and COVID-19
 

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.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.


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Legislative Update: Medicaid coverage for new moms, tobacco tax increase, & action on state budget

Legislative Update: Week 11

Final days of 2020 legislative session set as General Assembly debates budget cuts

Last week legislators returned to the Capitol to complete their work on the FY 2021 state budget and address key legislative priorities. On Friday, the Georgia Senate passed a state budget that cuts $2.6 billion in spending during the upcoming year. This budget includes deep cuts to K-12 education and to critical health care programs, which we have detailed below along with next steps in the budget process.

On Saturday, the General Assembly set the calendar for the remainder of the legislative session. Both chambers will convene every day this week and plan to conclude their 2020 business this Friday, June 26th, likely late in the evening.

Don’t miss the bevy of action alerts in this week’s email. Scroll down for actions you can take to make improve Medicaid coverage for new mothers, increase Georgia’s tobacco tax, and protect Georgia’s budget from drastic cuts.


Surprise Billing Legislation Unanimously Approved By Senate

Surprise billing legislation heads to Governor’s desk

Last week, the Georgia Senate unanimously approved the Surprise Billing Consumer Protection Act (House Bill 888), bringing Georgia one step away from ending onerous surprise medical bills. HB 888 now heads to Governor Kemp’s desk for his signature. The Governor is expected to sign the bill as he pointed to this issue as a high priority during his January State of the State address.

This bill will mark a huge win for Georgians as it will ban surprise billing in emergency and non-emergency situations beginning January 1, 2021. This success comes after years-long debate among Georgia legislators. Georgians for a Healthy Future and Georgia Watch are pleased to work closely with the Governor and Lieutenant Governor’s offices, Chairman Richard Smith, Senator Hufstetler, and Representative Lee Hawkins to finally bring a resolution to Georgia consumers.  Please call these leaders and thank them for their support and dedication to this issue:

  • Gov. Brian Kemp: 404-656-1776
  • Lt. Gov. Geoff Duncan: 404-656-5030
  • Senator Chuck Hufstetler: 404-656-0034
  • Chairman Richard Smith: 404-656-5141
  • Representative Lee Hawkins: 404-656-7855

Legislation to Extend Postpartum Medicaid Coverage Moves Ahead

Postpartum Medicaid coverage bill heads to Senate floor today

HB 1114, sponsored by Rep. Sharon Cooper, would allow new mothers to receive Medicaid coverage for six months after giving birth. After unanimous approval in the Senate Health and Human Services committee last week, this legislation heads to the Senate floor for a vote today. 

Currently, pregnant women covered by Medicaid are covered only up to 60 days after their birth or miscarriage. Due to restrictive Medicaid eligibility requirements for Georgia parents and because Georgia has not expanded Medicaid to all low-income adults, many mothers who try to apply for Medicaid after the 60 days are ineligible and become uninsured.

Action alert: Contact your state senator now and encourage their support for the passage and funding of this important piece of legislation! The Senate will convene at noon and a vote on HB 1114 is expected soon after.


 Progress on Tobacco Tax Increase

Resolution to increase tobacco tax moves ahead in Senate

On Friday, the Senate Finance Committee approved SR 435, sponsored by Senator Randy Robertson, aimed at increasing the tobacco tax rate from 37 cents to $1.35 per pack. We thank the members of the Senate Finance Committee for their quick action to find and approve new revenue to improve health in Georgia. Raising Georgia’s tobacco tax could bring in as much as $600 million annually and help to lower smoking rates among youth and adults.

Action alert

  1. Please contact members of the Senate Rules Committee and ask them to approve the bill for a vote on the Senate floor.
  2. Call or email your state senator today and encourage their support for this important piece of legislation!


Georgia Senate Passes State Budger that Includes Deep Cuts

Key health programs see cuts of $250 million

Last Thursday, the Senate passed its version of the FY2021 budget, which will begin July 1, 2020. The budget includes deep cuts to many state agencies, including 12 furlough days for staff and hiring freezes. The Georgia Budget & Policy Institute provides a fuller picture of the budget cuts here. State agencies and programs that directly impact the health of Georgians were not spared in the budget cuts:  

  • Department of Behavioral Health & Developmental Disabilities would see a cut of $122 million total, with the biggest cuts focused on services for adults with developmental disabilities, child and adolescent mental health services, (including prevention programs and supported education services), housing vouchers for people with mental illnesses and other adult mental health services, and adult substance use recovery services.
  • Department of Public Health would see a cut of $27.4 million total. More than half of that cut ($13.9 million) would come from a reduction in grants to local health departments and another $4.9 million would be cut from health promotion funds.
  • Department of Human Services (which includes the Dept. of Family & Children Services, Division of Aging Services, and other agencies serving vulnerable populations) would see a cut of $100 million. The funding cut would require 50 Dept. of Family & Children Services office to close and consolidate, exacerbating the limited access of families to food assistance, cash assistance for families with children, and other social services. 
  • Georgia’s Medicaid agency, the Department of Community Health, was able to offset $205 million in cuts because the federal government has increased its support of the Medicaid and PeachCare programs as part of the federal coronavirus relief packages, although some cuts were still made in the DCH budget.

 The budget is now being considered by a conference committee made up of members from both the House and Senate. Please contact these conference committee members to let them know that they can avert these steep budget cuts by considering new revenue options. Several common sense proposals (Increasing Georgia’s tobacco tax, expanding Medicaid, reclaiming the health insurance assessmentamong other options) could increase revenue without impacting the amount of taxes paid by the vast majority of Georgia families. Contact the budget conference committee members today!

  • Senator Mike Dugan: 404-656-7872
  • Senator Blake Tillery: 404-656-0089
  • Senate Butch Miller: 404-656-6578
  • Representative Terry England: 404-463-2247
  • Representative Jon Burns: 404-656-5052
  • Representative Jan Jones: 404-656-5072

Pharmacy Benefit Manager Legislation Keeps Moving

Two bills to reform PBM practices in Georgia move forward 

Georgia’s House and Senate continued their efforts last week to better regulate how pharmacy benefit managers operate in Georgia. Pharmacy benefit managers (commonly called PBMs) are companies that manage prescription drug benefits for health insurance companies. After presenting a revised version of SB 313, Senator Dean Burke’s bill was approved by the House Special Committee on Access to Quality Health Care. The revised version requires that PBMs count third-party financial assistance or coupons towards a consumer’s out-of-pocket costs when the medicine is a brand-name that 1) does not have a generic or 2) a patient obtained the prescription through step-therapy, prior authorization, or their health insurance plan’s appeals process. This protection will benefit many Georgians with expensive prescriptions. GHF will detail the other revisions included in SB 313 in future email updates.

Additionally, Rep. Knight’s HB 946 was approved by the Senate Insurance & Labor Committee on Friday and was passed by the full Senate today. The bill will return to the House for an “agree” to the bill’s amendments before it heads to the Governor’s desk.
 

(For an overview of both bills in their original forms, please read our March 2nd legislative update.)


GHF has you covered

Stay up-to-date with the legislative session and COVID-19
 

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.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.





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Legislative Update: Surprise billing moves ahead, budget cuts, & Georgia Can’t Wait!

Legislative Update: Week 10

The 2020 legislative session has resumed

Yesterday Georgia’s General Assembly resumed the 2020 legislative session after being suspended in March due to safety concerns over COVID-19. Legislators returned to the Capitol on Monday to pick up their work on the state budget and key pieces of legislation. The last ten days of legislative session will be dedicated primarily to the FY 2021 state budget to which Governor Kemp has proposed 11% cuts. Read the State Budget Cuts Are Not Inevitable section below to find out how you can take action for a state budget that supports the health and wellness of Georgians.


Senate committee approves surprise billing legislation

Critical surprise billing legislation heads toward finish line

Earlier this year, companion bills (SB 359 and HB 888) were introduced in the House and Senate to ban surprise out-of-network medical billing (also called surprise billing) in emergency and non-emergency situations. In a rare Sunday meeting, HB 888 was approved by the Senate Health & Human Services Committee. The Senate Rules Committee acted quickly today and approved the bill for a vote on the Senate floor tomorrow, Wednesday, June 17th. Please call your state senator today and encourage their support for this important piece of legislation!


New revenue can improve health in Georgia

State budget cuts are not inevitable

Because of the economic slow-down caused by COVID-19, Georgia’s revenues from sales taxes and other sources have dropped substantially. This has prompted the Governor to call for an 11% cut in state spending. Deep cuts to already-skeletal services and programs will disproportionately harm communities of color and rural communities, weaken Georgia’s health care system as it continues to respond to the pandemic, and curb the state’s ability to recover economically. GHF was one of 37 groups to send a letter to Governor Kemp and state lawmakers last week calling on them to raise new revenues rather than slash spending. New sources of revenue that can also improve health for Georgians include: 

  • Raising Georgia’s tobacco tax — an increase of $1 per pack would bring in $400 million each year and reduce smoking rates in Georgia
  • Expanding Medicaid— in addition to providing health coverage to 500,000 Georgians, Georgia would draw down $3 billion in federal funds each year
  • Re-claiming the health insurance assessment—by collecting the revenue from this existing tax, Georgia could bring in $360 million each year to make health insurance more affordable for consumers and small businesses

Ask Governor Kemp and your state lawmakers today to avert budget cuts and improve health in Georgia by raising state revenue!  


Georgia Can’t Wait!

Thank you for a successful Virtual Day of Action!

GHF and Cover Georgia welcomed legislators back on to work yesterday by urging them to take action to expand Medicaid. During yesterday’s virtual Day of Action, participants like you sent 500 messages to Governor Kemp and your legislators encouraging them to act immediately to protect the health and financial well-being of 560,000 Georgians by closing Georgia’s coverage gap! Thank you for your advocacy!

If you didn’t get a chance to contact your lawmakers yesterday, call or email today and ask them to act now to close Georgia’s coverage gap!


GHF has you covered

Stay up-to-date with the legislative session and COVID-19

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.

GHF is dedicated to helping you understand and navigate the effects of the COVID-19 pandemic. We have the information you need to stay up-to-date with the latest developments.


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Health insurance options for Georgians during COVID-19

Line of diverse workers with umbrellas symbolizing health insurance

More than 1 million Georgians have lost their health coverage due to job loss during the COVID-19 pandemic. If this is your situation, you can keep yourself and your family covered during this health crisis.

You have three main pathways to coverage:

  1. Affordable Care Act
    • With financial assistance—half of Georgians who lose their insurance will qualify for ACA coverage with financial help to lower the premium they pay each month. In some cases, you may see lower deductibles & co-pays too.
    • Without financial assistance—some Georgians, despite a job loss, will still make too much for financial help but you should still shop for coverage to see if there’s a plan that fits your new budget.
  2. Medicaid & PeachCare for Kids—About 25% of Georgians losing their health coverage may qualify for Medicaid. Georgians most likely to qualify for Medicaid coverage include children, low-income pregnant women, and very low-income parents. Other Georgians who qualify for Medicaid are people with disabilities, seniors, and low-income women with breast or cervical cancer.
  3. COBRA—in most cases, you will be able to find less expensive coverage from the ACA marketplace. COBRA may be the best option for you if it is important that you maintain a consistent provider (pregnant women, people with chronic or complex conditions).

Some Georgians who have lost their health coverage due to job loss will fall in Georgia’s coverage gap because the state has not expanded Medicaid. That means they can’t get financial help through the ACA and they also don’t qualify for Medicaid.

If you are in the coverage gap because you lost your job, please read the If you are uninsured section (click to go directly there). Then contact Georgians for a Healthy Future at 404-567-5016 x 4 to learn how you can share your story and help fix the problem!


Affordable Care Act (ACA) coverage

You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. You only qualify for coverage for 60 days after you lose your health coverage, so shop and enroll as soon as possible. Visit healthcare.gov to shop and enroll.

Financial assistance is available!

When you begin the shopping/enrollment process, healthcare.gov will ask you about your estimated income for 2020. With that information healthcare.gov will let you know if you qualify for financial help to lower your premiums and other costs. Most Georgians qualify for financial help!

When you estimate your income, include the money you made from your job before you were laid off, any unemployment checks that you expect to receive, and any money that you expect to make from getting re-hired/a new job later in the year. Do not count your stimulus check as income!

Table that is titled "You are likely to qualify for financial help if your income falls in these ranges".

For free help with the enrollment process, contact Insure Georgia at insurega.org or 866-988-8246.

Coverage through the ACA marketplace covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Contact your insurance company for more information.


Medicaid & PeachCare for Kids

You can enroll yourself, your family, or your children in Medicaid or PeachCare for Kids at any time, if you qualify. Enroll at gateway.ga.gov.

Cartoon mom and child standing together

Children are most likely to quality for Medicaid and PeachCare. Pregnant women and some parents may be eligible for Medicaid coverage depending on your monthly income. (The amount of unemployment you get from Georgia counts as income but the additional $600 per week from the federal government does not.)

Click here to see if you can qualify as a parent and to see if your kids qualify. If you are pregnant, you must make less than these amounts to qualify for Medicaid:

Medicaid is required to cover COVID-19 testing and treatment for free. In addition, you do not have to pay any Medicaid or PeachCare premiums or co-pays during the COVID-19 national emergency.

If you have or enroll in Medicaid coverage, you cannot be disenrolled (kicked off) during the COVID-19 national emergency.

If you have questions about Medicaid and whether you qualify, call the Georgia Division for Family & Children Services at 877-423-4746.

You may also contact Atlanta Legal Aid (find the phone number for your county here) or Georgia Legal Services Program at 1-800-498-9469 with questions or concerns.


If you are uninsured/unable to get health coverage

Do not skip or avoid health care just because you are uninsured! You can get free or low-cost health services at:


References & resources

COVID-19 Town Hall PowerPoint slides by Center on Budget & Policy Priorities
Frequently Asked Questions by Center on Budget & Policy Priorities


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Four ways to celebrate Medicaid Awareness Month with GHF!

April is Medicaid Awareness Month!

Four ways to celebrate Medicaid Awareness Month with GHF

April is Medicaid Awareness Month and GHF is celebrating!

Medicaid covers half of Georgia kids, half of births in the state, and three out of four Georgians in long-term care (like nursing homes). Without Medicaid, low-income Georgia families would have almost no way to enroll in health coverage. Now, Medicaid is proving even more important to Georgia’s health as our state battles the coronavirus. Medicaid is expanding the number of providers available to treat Georgians during the pandemic and keeping Georgians covered when they may have lost their coverage otherwise.

GHF is celebrating Medicaid Awareness Month and we want you to join us! Here are four ways you can celebrate:


Medicaid as Part of the COVID-19 Response

Medicaid is meant for this moment

Medicaid is key to Georgia’s COVID-19 response efforts. Not only is it providing coverage for 2 million Georgians in the midst of this pandemic, but Medicaid is also one of the fastest ways for the federal government to send money to Georgia and health care providers struggling to meet the needs of Georgia patients and families. Medicaid’s flexibility has allowed more doctors and other providers to step up and make themselves available to treat Georgians with and without COVID-19. Medicaid’s flexibility has also allowed new mothers, children, and many other Georgians to keep their coverage for the duration of the public health emergency when otherwise they may have lost it.

Our partners at Voices for Georgia’s Children are tracking the ways that Medicaid is meeting this moment for Georgians. Check out their weekly tracking sheet to keep up! 

Even as Medicaid is helping Georgia respond to COVID-19, it could be doing even more! Before the pandemic, an estimated 500,000 low-income Georgians were uninsured because Georgia has not expanded Medicaid to provide them with health insurance. One million Georgians lost their jobs in the last month, so that number is surely higher now. Governor Kemp and Georgia’s state legislators can easily provide these Georgians with the same health benefits that are available to people in similar situations in 37 other states. Tell Governor Kemp and state legislators to expand Medicaid now.


Need information about Georgia Medicaid? GHF has you covered!

As thousands of Georgians lose their jobs each week, many are also losing their health coverage. Some may qualify for Medicaid as a result. If you, your loved ones, or your patients or clients need information about how to qualify, enroll, and use Medicaid, GHF has the information and resources to get you started:

  • Affordable Health Care for Your Children: This fact sheet is written for parents and provides information about the coverage options available to their children.
  • For Uninsured Parents: Because parents need health care too, this fact sheet helps parents understand how they can access health care services or find coverage. (The information is also applicable to any uninsured adult.)
  • Medicaid in Georgia: Part of GHF’s Get Enrolled. Stay Enrolled toolkit, this fact sheet is meant for individuals and families who may be eligible for Medicaid. It tells you how to apply, what happens after you apply, how to find a doctor, and what health services are covered by Medicaid.
  • Medicaid Income Guidelines for Parents, Caregivers, and Kids: Developed for social workers, nurses, counselors, and other professionals who help people meet their basic needs, this fact sheet lays out the income eligibility guidelines for Medicaid for Georgia children and parent/caregivers. Find out if your patients and clients may qualify for coverage.

Medicaid Matters: Coverage saves lives

Queenesther is the mother of five children living in Albany, GA. She and her children, all under the age of 10, receive health care coverage and care through Medicaid. Last year, Queenesther underwent surgery to remove an ectopic pregnancy that was causing severe health issues and could have been fatal.

“Had it not been for Medicaid I wouldn’t have been able to get it removed and who knows what would have happened,” she said, reflecting on the importance of Medicaid for herself and her family. 

Queenesther is fortunate to have Medicaid coverage because Georgia makes it very difficult for parents to qualify. Read more of Queenesther’s story on our blog or in GHF’s Medicaid storybook, Medicaid Matters to Georgia.

Your story is powerful. Share it with us! Stories put a face to health care issues in Georgia and inform state leaders about what their constituents need as they make policy decisions. When you share your story, you help others understand the issue and you influence how our state responds to this unprecedented moment.


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