Laura Colbert, executive director of Georgians for a Healthy Future, agreed the issues of drug prices and transparency, coupled with the role PBMs play in the equation, will come up…
Tag: public health
Updated: December 18, 2020
The Georgians for a Healthy Future team is continuing to monitor the COVID-19 (coronavirus) outbreak closely. As always, GHF strives to be a resource for Georgia consumers. While things continue to change quickly during this health care pandemic, we will share practical advice and actionable information to help you navigate a confusing time and find the answers you need. Here we present information about how to access health care services and what to expect from your health insurance coverage when you do. We will keep the corresponding blog post updated as things change and with links to helpful resources as they become available.
Georgia’s statewide shelter in place ended on April 30, 2020 for most Georgians. Vulnerable populations including those who are medically fragile and elderly should continue to shelter in place until June 12, 2020.
Governor Kemp also extended Georgia’s public health state of emergency through January 08, 2020. He also issued executive orders requiring businesses to operate by strict social distancing and sanitation rules through May 13, 2020. As of June 1, 2020 restaurants are still required to abide by 39 restrictions to open their dining rooms.
We encourage all of you to continue to help prevent the spread of the virus by taking the necessary steps to “flatten the curve” including staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
If you are experiencing symptoms of COVID-19 or may need a test
If you believe that you are experiencing symptoms of COVID-19 or have been exposed to the novel coronavirus, call your primary care doctor or an urgent care clinic. Let them know you think you may have COVID-19, so they can take the proper precautions and direct you to available testing sites. You may also call the Georgia Department of Public Health on their COVID-19 hotline at 844-442-2681. Public health officials are urging people not show up unannounced at a doctor’s office, emergency room or other health care facility.
The Centers for Disease Control and Prevention have a Coronavirus Self-Checker which may be a helpful tool if you think you are experiencing symptoms of the virus.
You can find out more about COVID-19, its symptoms, what to do if you think you are sick, and other COVID-19 information at dph.georgia.gov/novelcoronavirus.
COVID-19 testing is available for all Georgians, regardless of whether you have coronavirus symptoms. Anyone can call their local health department to get scheduled for testing. They can also download the Augusta University ExpressCare app, visit augustahealth.org, or call (706) 721-1852.
Effective May 7, 2020, COVID-19 testing is available to all Georgians who request it, whether they have symptoms or not. Call your local health department to schedule an appointment at a location near you and to inquire if testing is free.
What to expect from your health insurance
If you have insurance, make sure to use it for any testing and medical exams related to COVID-19 and any other medical services you may need during this time.
The COVID-19 crisis has caused many Georgians to lose their jobs and also lose their employer-sponsored health care coverage. If you have lost your coverage or have had a drop in your income, you may be eligible for Medicaid or financial assistance to buy health insurance through the Affordable Care Act. Please read the If You Lose Your Job section below.
If you have Medicaid or PeachCare for Kids
If you and your family have lost your source of income in this crisis, or are in lower-income work with no health coverage, enrolling in Medicaid may be an option for you.
Medicaid provides all “medically-necessary” services to its members. During the national public health emergency period, your Medicaid coverage will cover the cost of a COVID-19 test. If you are diagnosed with COVID-19 and need medical treatment, Medicaid should also cover those costs.
If you need other health care services during this time, check with your Medicaid insurance company and doctor to see if you can have a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person.
Georgia’s Department of Community Health (DCH) has announced that Medicaid & PeachCare members will not owe any co-payments for any health service from May 1, 2020 until the end of the national public health emergency.
No one can willingly lose their Medicaid coverage during the public health emergency. If you lose your Medicaid coverage during this time, contact your Medicaid insurance company.
If you have private insurance
If you have insurance through your job, the State Health Benefit Plan, or the Affordable Care Act marketplace (also called healthcare.gov), use it for any testing or medical exams related to COVID-19. The Families First Act requires that health plans and insurers cover testing for COVID-19 so your test should be free. If someone wants to charge you for a test, call the DPH’s COVID-19 hotline.
If you are diagnosed with COVID-19 and require medical treatment, you should expect to pay some out-of-pocket costs like your deductible.
As of March 21, 2020 Cigna, Humana, Aetna, and UnitedHealthcare have waived cost-sharing for COVID-19 treatment. Aetna and Cigna have pledged to waive COVID-19 treatment costs for qualified medical bills until June 1, 2020. Humana has not announced an end date to their COVID-19 cost-sharing policy.
If you purchased coverage outside of the ACA marketplace or you have a short-term plan or health-sharing ministry, call your insurance company to find out how they are covering COVID-19 testing and treatment. The cost-sharing requirement under the Families First Act does not apply to people who are enrolled in non-ACA compliant plans (ex: short-term plans).
If you need other health care services during this time, check with your insurance company and doctor to see if you can have a “virtual appointment” using the internet, a video call, or a telephone call instead of going in-person.
In order to ensure people affected by COVID-19 have access to health care Georgia’s Insurance Commissioner issued a directive on March 20, 2020, that instructed health insurers to refrain from canceling health policies due to non-payment. That directive expires on May 31st. If you are behind on your premium payments or expect to be, call your insurance company right away to see if they can offer a payment plan, financial assistance, or other help to keep you enrolled.
If you have Medicare
Medicare covers the lab tests for COVID-19. You pay no out-of-pocket costs. All necessary hospitalizations are also covered by Medicare, including hospitalizations for quarantine. More information about Medicare’s coverage and services is available here.
If you are uninsured
If you need a COVID-19 test, contact your local public health department to find a testing site and to ask whether the test will be free. Request that they waive any testing costs.
If you need other health care services during this time, find a local community clinic, or apply for financial assistance through a hospital charity care program. Georgians should not let their insurance status get in the way of getting needed testing or treatment.
If you lose your job
Many Georgians across the economy have lost their jobs and may be at risk of losing their coverage. If this is your situation, you can keep yourself and your family covered during this health crisis. You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. When you begin the enrollment process, healthcare.gov will ask you about your estimated income for 2020 and will let you know if you qualify for financial help to lower your premiums and other cost-sharing.
For free help with the enrollment process, contact these organizations:
- Insure Georgia, insurega.org, 866-988-8246
- The Health Initiative, thehealthinitiative.org, 404-688-2524 (leave a voicemail in the general mailbox)
Coverage through the ACA marketplace (healthcare.gov) covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Call your insurance company for more information.
If you are unable to enroll in a health insurance plan, you may have other options through services such as a community clinic, which can connect you with the care you need.
Resources for you and your loved ones
During this uncertain time, many of our partner organizations are doing the hard work of finding and centralizing the information that you and your loved ones may need. Here are a few that we think are most helpful. We will continue to update this list with actionable resources and information so you can stay healthy, safe, and well.
- COVID-19 guidance and information
- Information from public health experts: Visit the Georgia Department of Public Health’s website for the latest guidance and updates about COVID-19 in Georgia.
- Coronavirus resources for people who are not strong readers: Georgia State University has published a library coronavirus materials for people who may not have strong reading or literacy skills. They have included materials up to a 9th-grade reading level.
- COVID-19 guidance and information for people who do not speak English as a first language:
- Google Drive folder with resources in 20 languages, collected and maintained by the Center for Pan Asian Community Services
- The GSU School of Public Health’s Prevention Research Center has compiled COVID-19 information sheets (from CDC & the International Rescue Committee) in 25 languages
- Make sure your basic needs and finances are taken care of:
- If you need help finding food:
- Food Bank of Northeast Georgia: Visit www.foodbanknega.org, click “Need Help”. Call the office at (706) 354 8191
- Atlanta Community Food Bank: Text the word FINDFOOD to 888-976-2232 with your ZIP code and street address and you will be sent a list of the three closest distribution centers.
Text service also available in Spanish, using the word COMIDA
- Georgia Mountain Food Bank: uses the same system as Atlanta Community Food Bank
- Golden Harvest Food Bank Visit www.goldenharvest.org, click on ‘Find Help’ at the top of the page, you will be taken to a map where you can enter your zip code to find the nearest food distributor
- Middle Georgia Community Food Bank–Call 211 and you will be connected with an associate who will be able to tell you where you can find food
- Feeding the Valley Food Bank: Visit feedingthevalley.org, on the front page, enter your zip code into the ‘Need Food’ box and you will be shown the closest food pantries to your location
- America’s Second Harvest of Coastal Georgia: Visit helpendhunger.org, select ‘Find Food’ on the homepage, you will be taken to a map where you can enter your zip code or county to be shown the nearest food distribution centers
- Second Harvest of South Georgia: Visit feedingsga.org, select ‘Find Help’ in the ‘Learn’ section at the top of the page, you will be taken to a map where you can find the closest distributors to you
- COVID-19 stimulus payments: The IRS has published a way for people to receive their recovery refund (also called COVID-19 stimulus payments) even if you were not required to file taxes in 2019. Details are available here.
- Avoid scams: What Consumers Need to Know About COVID-19 Scams, Georgia Watch
- Direct financial assistance: Patient Advocates Fund’s COVID Care Recovery Fund delivers $500 in direct financial aid to eligible patients who need non-medical, cost-of-living help as a result of their diagnosis of COVID-19.
- Financial health during COVID-19: Financial Resilience Center, National Disability Institute
- Health Care:
- Resources for people with developmental disabilities:
- COVID-19 Resources for Georgians with Developmental Disabilities, Georgia Council on Developmental Disabilities
- Staying mentally healthy and keeping your recovery: Behavioral Health in the time of COVID-19 by Georgians for a Healthy Future
- Keeping children healthy and well:
- COVID-19 latest information and resources, Voices for Georgia’s Children and Georgia Statewide Afterschool Network
- Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life
- Transitioning Into Your Family’s New “Normal”, Children’s Healthcare of Atlanta
- Five-Minute Coronavirus Stress Resets, The New York Times
- Resources for pregnant families during COVID-19: Healthy Mothers, Healthy Babies Coalition of Georgia has put together a toolkit for families navigating pregnancy, labor, and the postpartum period in Georgia during COVID-19
- Community Health Workers
- Information and Resources for Community Health Workers: This information kit was created for CHWs serving in Georgia to supplement the robust list of information provided by the National Association of Community Health Workers.
Like many of you, our team is monitoring the COVID-19 (coronavirus) outbreak closely. We hope you and your loved ones are healthy and well during these uncertain times.
We are grateful for the actions of Georgia leaders to protect the health and safety of individuals and communities across the state. We encourage all of you to help prevent the spread of the virus by staying home, avoiding group gatherings, washing your hands, practicing good hygiene, and following the guidance of public health experts.
Unfortunately, this outbreak has exposed the many shortcomings of our nation’s health care system while reinforcing how important it is for all Georgians and people across the country to have access to health coverage and care. While our policymakers and health system leaders are acting quickly to expand Georgians’ pathways to testing, treatment, and care, many Georgians currently lack health care coverage or are at risk of losing it as a result of the virus. Georgia’s elected leaders should act immediately to close Georgia’s coverage gap and extend Medicaid coverage to all low-income Georgians. Closing the Medicaid coverage gap supports good health by ensuring that people confronting COVID-19 do not go untracked and untreated. This is one of several critical steps Georgia leaders should take to promote the health and economic security of all Georgians during this unprecedented health crisis.
We will continue to monitor the spread of COVID-19 and encourage state leadership to take effective action to provide access to health care for all Georgians. Thank you for your continued support.
GHF’s Executive Director Laura Colbert provided testimony to the House Special Committee on Access to Quality Health Care on SB 106 and the risks this legislation poses for consumers as it is currently written.
Testimony of Laura Colbert, GHF’s Executive Director
March 20, 2019
“Thank you Chairman Smith and members of the committee. My name is Laura Colbert and I am the ED of GHF. We represent health care consumers across Georgia and work to build a future in which all Georgians have the quality, affordable health coverage and care they need to live healthy lives and contribute to the health of their communities.
First, we want to thank Governor Kemp, Senator Tillery and Representative Lott for your work on this bill. We are excited that this very important conversation is moving forward. We appreciate your open door and on-going dialogue with us on this issue.
Like my colleagues before me, GHF agrees with the goals of this bill and we are pleased by the prospect of meaningful coverage for 240,000 Georgians who live below the poverty line. We are to balance that with our consternation that 200,000 uninsured Georgians who make just more than the poverty line may remain uncovered by this bill as it’s written.
Georgians with insurance coverage are healthier, better able to work and go to school, have less medical debt and better credit scores, and have healthier families, among other benefits. While Georgians below the poverty line are sure to reap these benefits after gaining coverage, those just above it likely will not if SB 106 is not amended to specifically include them.
Based on other states’ coverage expansions and the affordability information provided to you by Ms. Haynes at Georgia Watch, it is clear that many near-poor constituents are likely to face significant cost-related barriers to health care, even with the ACA’s financial assistance. While Georgians in this income range can afford more than those below the poverty line, it is unrealistic to expect them to pay as much as 20% of a person’s $14,000 yearly wage or a family of four’s $30,000 salary for health care. An investment that large for families barely making ends meet effectively keeps them locked out of the health care system, only experiencing the benefits of coverage in emergency situations. The financial protection and access to care provided by Medicaid can better serve as the stepping stones for these families to climb into Georgia’s middle class.
Georgia is at the table now, and we have the opportunity to get this right for all Georgians on the first try.
That is why we recommend that this committee amend the bill to expand eligibility to 133% FPL and cover more Georgians for fewer state dollars. Georgia is at the table now, and we have the opportunity to get this right for all Georgians on the first try. Or consider removing the percentage provision altogether so that the bill is silent on the exact income limit, providing flexibility to the state to negotiate the waiver specifics that work best for Georgians and Georgia’s budget, particularly in the likely event that CMS is unable to provide an enhanced match rate for a partial expansion.
I also want to briefly turn to the second part of the bill concerning Section 1332 State Innovation waivers. A 1332 waiver to establish a reinsurance program would help thousands of Georgians by reducing insurance premiums and attracting more insurers to the marketplace. GHF stands in support of such efforts. However, the legislation as currently written is so broad that it leaves the door open to many more changes, some of which could destabilize Georgia’s marketplace and jeopardize access to care for Georgians covered by individual or small-group health insurance.
We recommend that this committee consider narrowing the scope of an allowable 1332 waiver by specifying that the state is authorized to establish a reinsurance program or, if other proposals may be considered, lay out criteria that any innovation waiver must meet. Georgians for a Healthy Future has laid out four criteria that we believe are critical to ensuring that any 1332 waiver benefits consumers without putting vulnerable groups at risk.
We appreciate your consideration of our suggestions and hope that we can act as a resource for the state as it drafts these waivers. Thank you very much for your time and your efforts on behalf of all of the health care consumers in your districts.”
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.
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
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.
Georgia consistently ranks poorly among states in children’s mental health services, this year ranking 51st in a report from the Commonwealth Fund. However, state leadership has been adamant about improving Georgia’s system of care through the infusion of additional dollars for children’s mental health services in the state budget and through innovative programs like Project Advancing Wellness and Resilience Education (AWARE).
Georgia Project AWARE is a youth mental health initiative focused on improving the experiences of school-aged youth in Georgia, and is funded by a grant from the Substance Abuse and Mental Health Services Agency (SAMHSA) to the Georgia Department of Education (GaDOE).
The purpose of Georgia’s Project AWARE is “to increase awareness of mental health issues among school-aged youth; provide training in Youth Mental Health First Aid; and connect children, youth, and families who may have behavioral health issues with appropriate services.”
The four main goals of Georgia Project AWARE are:
- Increase participation of families, youth, and communities and mental health providers in efforts to identify the mental health resources available to meet the needs of students and families;
- Increase awareness and identification of mental health and behavior concerns, and student and family access to mental health providers through the PBIS framework in Georgia Project AWARE (GPA) schools;
- Increase the percentage of Georgia youth and families receiving needed mental health services through collaboration between school systems and community mental health providers; and
- Train educators, first responders, parents and youth group leaders to respond to mental health needs of youth by providing free training in Youth Mental Health First Aid (YMHFA).
Georgia’s Project AWARE grant supports the participation of three Georgia school systems: Griffin-Spalding County School System, Muscogee County School District, and Newton County Schools. The GaDOE has partnered with these school districts to provide training in Youth Mental Health First Aid and to develop innovative ways to connect youth and families to community-based mental health services.
Through Project AWARE, elementary and middle school teachers conduct universal screenings of their students and the screening results are used in two ways. School-, grade-, and classroom-level data is used to guide decisions about what universal supports or programs may be needed to better support the social and emotional needs of students. For example, if the results of the screening show high rates of anxiety for an entire grade of students, school leaders and teachers may make changes to school practices that may contribute to student anxiety or implement a program to help reduce or address the anxiety students are feeling.
Individual level screening results are used to identify those students who could benefit from extra social and emotional supports. These students are then connected to the appropriate behavioral services through partnerships the schools have developed with community-based providers.
Georgia Project AWARE has already screened a total of 18,713 students in 29 schools. Georgia State University’s Center for Leadership in Disability and the Center for Research on School Safety, School Climate and Classroom Management provide support for the program through analysis of the screening results and trainings for school leadership and staff.
In Getting to know Project AWARE: Part II, we’ll learn more about Youth Mental Health First Aid and how it helps educators meet the social and emotional needs of their students.
To learn more about Georgia Project AWARE:
- Visit the Georgia Department of Education (GaDOE)
- Read more from the Substance Abuse and Mental Health Services Agency (SAMHSA)
- Read the latest issue of the Georgia Project AWARE Digest
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:
- Eight questions for health care voters to ask Georgia candidates
- Governor blog
- General Assembly Blog
*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.
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:
- Eight questions for health care voters to ask Georgia candidates
- A consumer health advocates guide to the 2018 elections: Georgia’s Governor
*Georgians for a Healthy Future is a non-partisan, 501(c)3 organization. We do not endorse or support any candidates or political party.
Georgians for a Healthy Future hosted another Georgia Voices for Medicaid training on Friday, August 10th in partnership with the Athens Clarke County Library. The Georgia Voices for Medicaid trainings are designed to give participants the knowledge and skills they need to advocate for timely, important health care issues impacting Georgians.
At last week’s training, participants learned that Georgia’s Medicaid program provides health insurance for half of Georgia’s children, and that it also covers low-income people with disabilities, seniors, and pregnant women. In Clarke and Barrow counties, 15,830 and 10,845 residents respectively are covered through Medicaid. Alyssa Green, GHF’s Outreach & Education Manager, shared testimonials from several Georgians who are covered by Medicaid to demonstrate the real benefits of coverage to training participants. Alyssa also introduced ways that participants can advocate for the health care issues that matter most to them, like protecting and improving the Medicaid program or bringing down health care costs.
The training concluded with an invitation for attendees to continue their health care advocacy work with GHF’s new Georgia Health Action Network (GHAN) program. GHAN is a volunteer-led program that fosters and supports grassroots health advocates who work alongside GHF to reach a day when all Georgians have access to the quality, affordable health care they need to live healthy lives and contribute to the health of their communities.
If you were unable to attend this Georgia Voices for Medicaid event, check out our upcoming trainings or contact Alyssa at firstname.lastname@example.org or 404-567-5016, ext. 2 to schedule a training in your community. You can also contact Alyssa learn more about GHF’s new Georgia Health Action Network.
Suicide is third leading cause of death among 10-24 year olds in Georgia. In order to combat this growing issue Governor Deal and the state legislature included an additional $21.4 million in the FY2019 state budget to improve and expand children’s behavioral health services. Out of that appropriation, $1,092,000 was directed to suicide prevention efforts, which will in part go towards expanding the capacity of the Georgia Crisis and Access Line (GCAL). GCAL provides 24/7 online and telephone support for Georgians who are seeking services for or in crisis as a result of developmental disabilities, mental health, or substance use conditions.
GCAL connects callers with trained professionals and clinicians who screen and assess the severity of callers’ need for service. The GCAL operators then provide the appropriate assistance, referrals to necessary services, or dispatch crisis services when needed. The call center can:
- Provide telephonic crisis intervention services,
- Dispatch mobile crisis teams or emergency services when needed,
- Assist individuals in finding an open crisis or detox bed across the state,
- Link individuals with urgent appointment services,
- Help individuals find a mental health, substance use treatment, or developmental disability provider in their area in a non-emergency; and
- Connect families and individuals with community-based support services.
GCAL also provides language assistance for people with limited English proficiency.
Even though GCAL’s name includes the word “crisis,” consumers do not need to be in crisis to call or visit the website. As mentioned above. GCAL provides non-emergency or crisis services. Call center staff are available to answer routine questions about behavioral health and provide callers with a choice of providers and assistance in scheduling appointments for service.
Georgia consumers can call 1-800-715-4225 or visit mygcal.com if they or someone they care for is facing a behavioral health crisis or in need of services. For more on how GCAL is making a difference in the lives of individuals and their families, check out this video from Voices for Georgia’s Children.
Queenesther is a 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.
Queenesther recently underwent surgery to remove an ectopic pregnancy that was causing severe health issues and could have proved 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. Because she was able to have the ectopic pregnancy removed quickly, Queenesther has been able to focus on caring for her young family and earning her degree.
Queenesther is fortunate compared to many low-income parents because Georgia makes it very difficult for parents to qualify for Medicaid coverage. Because Georgia’s Governor and the state legislature have so far refused to extend health coverage to most low-income parents (and other poor adults), parents must make less than 36% of the federal poverty line ($7656 annually for a family of three) to qualify for insurance through Medicaid. Parents who make between 36% and 100% of the federal poverty line ($9096-$25,100 annually for a family of four) are stuck in the coverage gap with no pathway to affordable coverage.
In Dougherty County, where Queenesther and her family live, 5,472 people, 22% of whom are parents, are stuck in the coverage gap but could be covered if Georgia’s policy makers extended insurance to this group. Like Queenesther, gaining coverage would enable them to better care for their children, pursue an education, and support their families.
For more on how parents and families would benefit from extending health insurance coverage, please revisit the Many Working Parents and Families in Georgia Would Benefit from Extending Medicaid Coverage report from GHF and the Georgetown Center on Children and Families.
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 its importance.
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.
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