Healthcare.gov is open for business from November 1 to December 15, 2020. Georgians can now shop for comprehensive, affordable health plans and enroll in coverage. Nine out of 10 Georgians qualify for financial help to lower their premiums and other costs! Make sure that you are covered in 2021!

Most Georgians who qualify for health insurance & financial help through the Affordable Care Act (also called “Obamacare”) are still uninsured. If you or people you know need more information about how health insurance works, how to enroll in coverage, or what to do after you have signed up, we have you covered! Check out and share these tools so you and your networks can get covered and stay covered:

• Frequently Asked Questions about health insurance
• My Health Insurance User’s Manual
  Available in English and Spanish
• My Health Resource Guide
• Get Covered. Stay Covered. video series

A recent poll from the Kaiser Family Foundation found that 45% of Americans reported that the COVID-19 crisis has harmed their mental health. Anxiety and fear are common with people concerned about contracting the virus, a loved one getting sick, and the economic impact of the crisis, including job loss, lost income, and loss of health care coverage.

Georgia non-profits and state agencies have come together to ensure resources and supports are available for Georgians who need help with their mental health. The following list provides information and links to resources to help get all of us through these difficult times.

If you need to talk to someone:

• National Suicide Prevention Lifeline
  Call 1-800-273-8255 or use the chat option on their webpage
  en Espanol: 888-628-9454
  Deaf and hard-of-hearing: 1-800-799-4889
  Open 24/7. We can all help prevent suicide. The Lifeline provides free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.

• Georgia Mental Health Consumer Network’s Peer2Peer Warm Line
  Call 888-945-1414
  Open 24/7/365 providing peer support over the phone. Support is available to all Georgians experiencing anxiety or stress, or who need support through the pandemic. Please call any time.

• Georgia Council on Substance Abuse’s CARES Warm Line
  Call or text 844-326-5400
  Open every day, 8:30 am to 11 pm. FREE, confidential, and available to anyone who has questions about addiction and recovery, needs someone to listen to them or wants to talk with someone who is also in recovery from substance use disorders.

• Georgia COVID-19 Emotional support line
  Call 866-399-8938
  Open 24/7. This confidential line offers assistance for those needing emotional support or resource information as a result of the COVID-19 pandemic. The support line is staffed by volunteers, including mental health professionals and others who have been trained in crisis counseling. This is part of a partnership between the Georgia Department of Behavioral Health & Developmental Disabilities, Beacon Health Options, and Behavioral Health Link.

If you need a support group:

• The Georgia Council on Substance Abuse is offering a FREE and confidential series of virtual All Recovery Meetings for those who want to stay connected during COVID-19. To learn more about GCSA and find the most up-to-date meeting times, visit their FaceBook page.
• NAMI Georgia and their local chapters around the state offer virtual support meetings for people with mental illness and family members. To get more information about the meetings, call (770) 408-0625 or email programs@namiga.org.

If you want to learn skills or information about mental health:

COVID-19 and your mental health:

• Learn self-care strategies and get the care you need to help you cope with resources and tips from the Mayo Clinic.
• Mental Health and COVID-19 information and resources, Mental Health America
• Teach Kids Coping Skills, Children’s Healthcare of Atlanta Strong4Life

If you have health coverage:

• Medicaid – If you need mental health or substance use recovery services during this time, check with your Medicaid insurance company and doctor to see if you can schedule a safe, socially distanced in-person appointment or a “virtual appointment” using the internet, video call, or telephone call, instead of going in-person. The contact information for your Medicaid insurance company is on the back of your insurance card.
• Private insurance – If you need mental health or substance use recovery services during this time, call your insurance company using the number on the back of your insurance card or visit their website to search for an in-network health care provider near you who offers the services that you need.
• Uninsured – If you need mental health care services during this time, call the Georgia Crisis & Access Line at 800-715-4225, visit the GCAL website, or download the MyGCAL app to find free or low-cost, local mental health & substance abuse services. Georgians should not let their insurance status get in the way of getting needed support or treatment.
• You can find more insurance information and resources (including how your insurance will cover COVID-19 testing & treatment) on our COVID-19: Your health coverage, health care, & well-being blog.

If you want to help:

• If you have completed Mental Health First Aid training and are interested in volunteering to provide support via the Georgia COVID-19 Emotional Support Line please email your name and contact info to MHFAvolunteer@dbhdd.ga.gov

In March 2019, Georgia lawmakers approved SB 106, the Patients First Act. The new law allows Georgia to use two kinds of health care waivers to make changes to health coverage in the state. These waiver plans could affect you, your friends, family, neighbors, and Georgians all across the state and the way you access and pay for health care.

(Waivers allow a state to set aside or “waive” certain requirements imposed by the federal government and try new models of providing health coverage and care.)

The state has hired Deloitte as a consultant to work with state leaders to develop the waiver plans. Georgia’s decision-makers have proposed an aggressive timeline and aim to finalize the waiver plans by the end of 2019.

Two types of waiver plans

Two types of plans are being developed by state leaders: an 1115 waiver and a 1332 waiver. An 1115 waiver allows Georgia to make changes to the state’s Medicaid program. Medicaid is the state’s health insurance program that covers kids, some low-income parents, seniors, and people with disabilities, and pregnant women. SB 106 limits the 1115 waiver to cover people making up to the poverty line (about $12,000 a year for an individual or $26,000 for a family of four). Medicaid expansion, which GHF has advocated for, would extend public coverage to people with incomes just above the poverty line (138% of the federal poverty line.) A successful way to use an 1115 waiver would be to cover everyone under the poverty line and exclude barriers to coverage such as burdensome paperwork requirements, confusing cost-sharing, or counterproductive lock-out periods.

A 1332 waiver allows the state to make changes to private insurance and the health insurance marketplace. About 450,000 Georgians buy their health coverage through the marketplace. Most of these Georgians receive federal tax credits to cover some or all of their premium costs. (Another 827,600 of Georgians are eligible for private coverage and financial help to buy it but have not yet enrolled.) A successful way to use a 1332 waiver is to establish a “reinsurance program” to reduce premium costs. This waiver should also ensure all plans continue to cover the essential health benefits (like prescription drugs) and maintain protections for people with preexisting conditions.

You can weigh in!

Now is the time to ensure that Georgia gets a plan that will provide comprehensive coverage to as many people as possible. Thousands of Georgians across the state could gain health care coverage through the Patients First proposals. While positive intentions have been expressed by Georgia’s elected officials about the forthcoming waivers, none has yet committed to ensuring all Georgians have a pathway to comprehensive, affordable coverage.

For every 1115 and 1332 waiver that the state wants to pursue, Georgia’s policymakers must seek input from the public. Because there are required state and federal public comment periods for each waiver proposal, there will be at least four public comment periods (a state and federal period for an 1115 waiver and a state and federal period for a 1332 waiver). These are your chances to help shape and influence health care in Georgia!

GHF and our Cover Georgia partners will let you know when the public comment periods begin and end and we will provide an easy way for you to have your say. Make a plan to submit comments during every public comment period so that state leaders know how their ideas will impact you and your family! Your story can help make a difference for thousands of Georgians and can support positive changes in health care coverage.

To learn more, visit coverga.org and download our new Happening Now fact sheet! Follow #CoverGA on FaceBook and Twitter for the most current updates!

In late 2018, Georgians for a Healthy Future was awarded a General Operating Support grant from the Community Foundation for Greater Atlanta. The Foundation works to connect the passions of philanthropists with the purposes of nonprofits. Awards were given through a highly competitive process and we are excited about this partnership as we continue to work to ensure quality, affordable health care for all Georgians.

GHF was one of twenty-nine nonprofits to have received this highly competitive General Operating support grant from the Community Foundation for Greater Atlanta. Seven nonprofits, including GHF, were awarded grants to support well-being and “ensure a healthy region where all residents have access to quality health care and nutritious food.”

With the support of the Community Foundation for Greater Atlanta, GHF continues to offer Georgians the tools and information they need to become effective health advocates for themselves and their communities, inject the consumer perspective into health care stories in the media, and convene partner groups in coalition to strengthen our collective ability to advocate for the needs of Georgians across the state. We are ecstatic to have been among the select organizations who share our vision and drive to improve the lives of the people of Georgia. We look forward to continuing our work as the voice for Georgia health care consumers with the support of the Community Foundation for Greater Atlanta.

Read the Foundation’s December 2018 press release.

The 2019 Georgia legislative session is over but we are not finished! 

Yesterday was Sine Die at the Georgia General Assembly – the last day of the 2019 legislative session. This year’s session saw the approval of several bills that will surely impact consumers’ health and finances in positive ways if approved by the Governor. Efforts to address step therapy so patients have access to needed therapies and housing so that families can be assured of safe, healthy places to live have been multi-year efforts by consumer and family advocates. These bills now move to the Governor’s desk for his consideration and signature.

The impact of other bills is less certain. SB 106 may bring sweeping changes to Georgia’s health care landscape but the details have yet to be laid out. The passage of legislation is only the first step in a health reform process in which your voice and advocacy will be needed. (Learn more about the next steps and what to expect in our latest blog post and in the section below.)

Check out our summary of the more notable health bills of the 2019 session below and a full list of health care-related legislation at GHF’s legislative tracker.

Our priorities

Governor Kemp signs Patients First Act into law but its impacts on Georgians still uncertain

SB 106, the Patients First Act, moved quickly through the Georgia General Assembly this session and was signed into law by Governor Kemp last week. As we have reported, the bill allows the state to pursue an 1115 waiver to make changes to Georgia’s Medicaid program that may include expanding coverage to more poor adults and a 1332 state innovation waiver to make changes to private insurance in the state.

Now that the bill is signed, what’s next? You are critical to ensuring that the waivers created from SB 106 lead Georgia to the healthy future that we all want. Your advocacy, stories, and input are necessary. Read our new blog so you know what to expect and how you can help ensure all Georgians have meaningful, affordable health coverage.

Step therapy legislation approved

HB 63, sponsored by Rep. Sharon Cooper, will require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. Step therapy is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the higher-cost treatment prescribed by a patient’s physician. The bill received final approval by the House on Tuesday

Call Governor Kemp at 404-656-1776 and ask that he sign HB 63.

Surprise billing legislation fails to cross the finish line

Surprise billing legislation faced familiar roadblocks this year when provider groups and insurers could not come to agreement about payments for out-of-network care. There were late efforts to revive some or all of HB 84 and SB 56 but neither succeeded. (Both bills are covered in detail in our Februrary 11th legislative update.) We are grateful to Chairman Richard Smith and Chairman Hufstetler for their work on this important issue and hope to find a resolution for consumers in the next legislative session.

Healthy housing legislation passes

GHF, as part of the Healthy Housing Georgia coalition, supported HB 346. This bill will prohibit retaliation by a landlord against a tenant for complaining to Code Enforcement about unsafe or unhealthy housing conditions like the presence of mold, radon, rodents, insect infestations, or lead. If the Governor signs the bill into law, Georgia will join the ranks of forty-one other states that have already implemented similar legislation to protect tenants against retaliatory evictions. (For more details on the legislation, see our March 5th legislative update.)

Call Governor Kemp at 404-656-1776 and ask that he sign HB 346.

Sine Die Recap

HB 30: Amended FY 2019 Budget | SIGNED BY GOVERNOR

HB 30 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2019. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on Tuesday, March 12th.

HB 31: FY 2020 Budget | PASSED

HB 31 is the budget document for the coming state fiscal year which will run from July 1, 2019 to June 30, 2020. The budget includes several new investments in behavioral health and mostly maintains funding for other health care programs and priorities. For more information on the health care highlights in the proposed FY 2020 budget, read the Community Health and Behavioral Health budget overviews from the Georgia Budget & Policy Institute.

HB 37: Expand Medicaid Now Act | DID NOT PASS

HB 37, sponsored by Rep. Bob Trammell, expands Medicaid in Georgia as envisioned by the Affordable Care Act by increasing Medicaid eligibility for adults up to 138% of the federal poverty guidelines (FPL). This is equivalent to $17,236 annually for an individual and $29,435 for a family of three.

HB 158: Improve Medicaid patient access to effective HIV treatment | DID NOT PASS*

HB 158, sponsored by Rep. Deborah Silcox, requires that Medicaid recipients have the same access to antiretroviral drugs used to treat HIV and AIDS as to those included in the formulary established for the Georgia AIDS Drug Assistance Program. This change would allow for increased continuity of care for people living with HIV/AIDS in Georgia. *Although HB 158 did not get a Senate vote, it received favorable comments in the Senate Health Committee, after passing the House unanimously. In recognition of the broad support of this effort, Georgia’s Medicaid agency has committed to the bill sponsor to implement the intent of the legislation.

HB 217: Needle exchange | PASSED

HB 217, sponsored by Rep. Houston Gaines, decriminalizes the act of working or volunteering for a syringe services program, a step towards legalizing the programs. Distributing clean hypodermic syringes and needles to people who use injection drugs (e.g. heroin) helps to prevent the spread of HIV and Hepatitis C, and does not increase the likelihood that people will newly take up injections drug use.

HB 290: PrEP pilot program | PASSED

HB 290, sponsored by Rep. Sharon Cooper, would establish a pilot program to provide preexposure prophylaxis (PrEP) drug assistance or services to persons at risk of being infected with HIV. PrEP is a medication taken by people who are HIV-negative to reduce their risk for infection. The pilot program would provide PrEP to people in counties identified by the Centers for Disease Control & Prevention as at risk of HIV outbreaks due to a high rate of opioid use and participants would receive regular HIV testing and related support services.

HB 83: Recess legislation | PASSED

HB 83, sponsored by Representative Demetrius Douglas, would require a daily 30-minute recess for all students in grades K-5 unless they have already had a physical education class or structured activity time in the day. This bill now sits in the Senate Rules committee and awaits a vote on the Senate floor. To learn more about the impact of recess on children’s physical and mental health, read this fact sheet from Voices for Georgia’s Children.

HB 321: Medicaid financing program | PASSED

HB 321, sponsored by Rep. Jodi Lott, would extend the sunset provision of the hospital provider fee for five years. The hospital payment program, which draws down additional federal funding, provides almost $1 billion annually to the state’s Medicaid budget. More information about HB 321 is available here.

HB 514: Georgia Mental Health Reform and Innovation Commission | PASSED

HB 514, sponsored by Rep. Kevin Tanner, would create the Georgia Mental Health Reform and Innovation Commission which would work to analyze and offer improvements to the state’s mental health system and run through at least June 30, 2020. Within the Commission, several subcommittees would be established to include Children and Adolescent Mental Health; Involuntary Commitment; Hospital and Short-Term Care Facilities; Mental Health Courts and Corrections; and Workforce and System Development.

SB 16: Interstate Medical Licensure Compact Act | PASSED

SB 16, sponsored by Sen. Kay Kirkpatrick, would allow Georgia to enter the “Interstate Medical Licensure Compact” which allows health care providers to more easily obtain licenses to practice in multiple states. It also provides Georgia’s Medical Board with easier access to investigative and disciplinary information about providers from other states, an important protective measure for Georgia patients.

HB 233: Pharmacy Anti-Steering and Transparency Act | PASSED

HB 233, sponsored by Rep. David Knight, would prohibit pharmacies from sharing patient data for commercial purposes and prohibit pharmacy benefit managers (PBMs) from steering patients to PBM-owned pharmacies. It also requires such pharmacies to file an annual disclosure statement of its affiliates. Pharmacy benefit managers are companies that manage the prescription drug benefit of your health plan.

SB 195: Prescription Drug Benefits Freedom of Information and Consumer Protection Act | DID NOT PASS

SB 195, sponsored by Senator Chuck Hufstetler, this bill would make it easier for consumers to know what prescription medications are covered by their health insurance plan and better understand the likely costs by requiring health insurers to conspicuously post on their website information about their drug formulary in a current and searchable format. A drug formulary is the list of prescription medicines that your health insurer agrees to pay for or partially pay for. SB 195 would also standardize and speed up the process for consumers and providers to request prior authorization for necessary prescription drugs.

HB 186: Certificate of Need Reform | PASSED

HB 186, sponsored by Rep. Ron Stephens, will create a new category for general cancer hospitals as part of an agreement with Cancer Treatment Centers of America that would allow more Georgia patients to be seen. This bill will also limit who can object to a provider’s Certificate of Need application for expanding hospital services. The change would limit objections to only come from health care facilities that provide similar services and are located within a thirty-five mile radius.

HB 197: Establishment of Strategic Integrated Data System | PASSED

HB 197, sponsored by Rep. Katie Dempsey, will establish the Strategic Integrated Data System through the Office of Planning and Budget. The data system would capture de-identified information about the physical and mental health and social services beign provided to Georgians across the state. The goal of the system is to provide a central source of date about state services that can be used by state agencies, lawmakers, and researchers to make programs more effective and cost-efficient.

HB 323: Regulation and licensure of pharmacy benefits managers | PASSED

HB 323, sponsored by Rep. David Knight, will provide a good first step in drug transparency from pharmacy benefits managers (PBMs.) PBMs will have to report how much they receive in rebates from pharmaceutical manufacturers to the Department of Insurance and how much of those savings are being passed on to customers, although the information are not required to be reported to the legislature or the public.

GHF has you covered

Stay up-to-date with the legislative session

GHF has been 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.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide. (Contact Michelle Conde at mconde@healthyfuturega.org for a printed copy.)

Legislative Update: Week 8

Crossover Day brings legislative action late into the night

Last Thursday was the 28th day of the Georgia legislative session, which is also referred to as Crossover Day. Crossover Day is the final day for a bill to cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. This week’s legislative update provides a rundown of consumer health legislation: which bills made it through and which did not. You can see a list of all the bills we’re tracking here. (Note: After a flurry of activity last week, we are still working to update our legislative tracker with the current status of each bill. So while many of the bills are updated, it is best to find the bill you are interested in and click through to find the full information on the bill’s statis on legis.ga.gov.

Our priorities

Surprise billing legislation moves forward

SB 56, sponsored by Senator Chuck Hufstetler, received approval by the full Senate on Wednesday and may be considered by the House Insurance Committee in the coming weeks. The legislation aims to improve transparency for consumers who may be subject to a surprise out-of-network bill. This bill would disallow surprise billing in emergency situations but does not prohibit surprise billing in non-emergency situations like when a physician uses an out-of-network laboratory for diagnostic tests. This bill now sits in the House Insurance committee. (For more details on the legislation, see our February 11th legislative update.)

Legislation to fully expand coverage stalls; Patients First Act advances

HB 37, the Expand Medicaid Now Act, and SB 36 sponsored by Representative Bob Trammell and Senator Steve Henson respectively, did not receive hearings and did not cross over last week. Each bill was written to expand Medicaid in Georgia as envisioned by the Affordable Care Act.

Meanwhile SB 106, the Patients First Act, has moved quickly through the Senate in the weeks before Crossover Day. The legislation, as written, would allow the Department of Community Health to request an 1115 waiver to extend Medicaid coverage to adults making up to 100% of the federal poverty level (FPL) ($12,490 annually for an individual). This “partial expansion” would leave out thousands of new-poor Georgians who are meant to be similarly covered according to federal health law and will likely cost the state more to cover fewer people. Additionally, the bill allows the Governor to make potentially tremendous changes to private health insurance in Georgia through 1332 waivers with little accountability. The bill will now awaits a hearing from the House’s Special Committee on Access to Quality Healthcare.

Healthy housing legislation moves to Senate committee

Georgians for a Healthy Future is a member of the Healthy Housing Georgia coalition because evidence shows the strong and firect influence housing has on a person’s health. The coalition supports HB 346, which would prohibit retaliation by a landlord against a tenant for complaining to Code Enforcement about unsafe or unhealthy housing conditions like the presence of mold, radon, rodents, insect infestations, or lead. Georgia is the only state in the country that does not protect tenants against unsafe and uninhabitable housing conditions with a “warranty of habitability.” This bill now sits in the Senate Judiciary committee. (For more details on the legislation, see our March 5th legislative update.)

Crossover day recap

HB 30: Amended FY 2019 Budget | CROSSED OVER

HB 30 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2019. The “little budget” has passed both chambers of the General Assembly and been signed by the Governor. The amended budget went into effect on Saturday, March 9th.

HB 31: FY 2020 Budget | CROSSED OVER

HB 31 is the budget document for the coming state fiscal year which will run from July 1, 2019 to June 30, 2020. The budget includes several new investments in behavioral health and mostly maintains funding for other health care programs and priorities. The Senate will continue to hold hearings on the “big budget” this week. For more information on the health care highlights in the proposed FY 2020 budget, read the Community Health and Behavioral Health budget overviews from the Georgia Budget & Policy Institute.

HB 37: Expand Medicaid Now Act | DID NOT CROSS OVER

HB 37, sponsored by Rep. Bob Trammell, expands Medicaid in Georgia as envisioned by the Affordable Care Act by increasing Medicaid eligibility for adults up to 138% of the federal poverty guidelines (FPL). This is equivalent to $17,236 annually for an individual and $29,435 for a family of three.

HB 63: Step therapy legislation: CROSSED OVER

HB 63, sponsored by Rep. Sharon Cooper, would require health insurance plans to establish step therapy protocols and outline a process for health care providers to request exceptions. Step therapy is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the higher-cost treatment prescribed by a patient’s physician.

HB 84: Provider network transparency | DID NOT CROSS OVER

HB 84, sponsored by Rep. Richard Smith, increases transparency related to possible surprise medical bills. The legislation requires that information on billing and the providers that a consumer may encounter during a course of care must be provided to the consumer at their request. In circumstances where a consumer receives a surprise bill, HB 84 also allows for arbitration between the consumer and the health care provider, the specifics of which would be determined by Georgia’s Department of Insurance.

HB 158: Improve Medicaid patient access to effective HIV treatment | CROSSED OVER

HB 158, sponsored by Rep. Deborah Silcox, requires that Medicaid recipients have the same access to antiretroviral drugs used to treat HIV and AIDS as to those included in the formulary established for the Georgia AIDS Drug Assistance Program. This change would allow for increased continuity of care for people living with HIV/AIDS in Georgia.

HB 198: Eliminate certificate of need requirements | DID NOT CROSS OVER

HB 198, sponsored by Rep. Matt Hatchett, would change the certificate of need process that is used to regulate health care facilities. The bill also included requirements for increasing transparency of hospital financial information and an increase in the rural hospital tax credit from $60 million to $100 million.

HB 217: Needle exchange program | CROSSED OVER

HB 217, sponsored by Rep. Houston Gaines, decriminalizes the act of working or volunteering for a syringe services program, a step towards legalizing the programs. Distributing clean hypodermic syringes and needles to people who use injection drugs (e.g. heroin) helps to prevent the spread of HIV and Hepatitis C, and does not increase the likelihood that people will newly take up injections drug use.

HB 290: PrEP pilot program | CROSSED OVER

HB 290, sponsored by Rep. Sharon Cooper, would establish a pilot program to provide preexposure prophylaxis (PrEP) drug assistance or services to persons at risk of being infected with HIV. PrEP is a medication taken by people who are HIV-negative to reduce their risk for infection. The pilot program would provide PrEP to people in counties identified by the Centers for Disease Control & Prevention as at risk of HIV outbreaks due to a high rate of opioid use and participants would receive regular HIV testing and related support services.

HB 321: Medicaid financing program | CROSSED OVER

HB 321, sponsored by Rep. Jodi Lott, would extend the sunset provision of the hospital provider fee for five years. The hospital payment program, which draws down additional federal funding, provides almost $1 billion annually to the state’s Medicaid budget. More information about HB 321 is available here.

HB 514: Georgia Mental Health Reform and Innovation Commission | CROSSED OVER

HB 514, sponsored by Rep. Kevin Tanner, would create the Georgia Mental Health Reform and Innovation Commission through at least June 30, 2020. Within the Commission, several subcommittees would be established to include Children and Adolescent Mental Health; Involuntary Commitment; Hospital and Short-Term Care Facilities; Mental Health Courts and Corrections; and Workforce and System Development.

SB 16: Interstate Medical Licensure Compact Act | CROSSED OVER

SB 16, sponsored by Sen. Kay Kirkpatrick, would allow Georgia to enter the “Interstate Medical Licensure Compact Act” which allows health care providers to more easily obtain licenses to practice in multiple states. It also provides Georgia’s Medical Board with easier access to investigative and disciplinary information about providers from other states, an important protective measure for Georgia patients.

SB 74: Eliminate certificate of need requirements | DID NOT CROSS OVER

SB 74, sponsored by Senator Matt Brass, would eliminate certificate of need requirements for all health care facilities except certain long-term care facilities and services. This bill is the Senate companion piece to HB 198. Both bills aim to change the current certificate of need structure which regulates hospitals in Georgia.

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.

• Sign up for the Georgia Health Action Network (GHAN) to receive action alerts that let you know when there are opportunities for advocacy and action
• Track health-related legislation
• Updated for 2019: GHF’s annual Consumer Health Advocate’s Guide. (Contact Michelle Conde at mconde@healthyfuturega.org for a printed copy.)

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:

• Senator Kay Kirkpatrick
• Representative Debbie Buckner
• Representative Lee Hawkins

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. 

Georgians for a Healthy Future released its 2019 policy priorities at this morning’s ninth annual Health Care Unscrambled legislative breakfast. These annual priorities outline the issues that GHF believes are most pressing for Georgia consumers and are best addressed by the state legislature. GHF will work to move all of these issues forward by engaging state policy makers, consumers, and coalition partners throughout the legislative session and the remainder of the year.

1. Increase the number of Georgians with health insurance.

Georgia’s uninsured rate hit a historic low of 12.9% in 2016, but remains one of the highest uninsured rates in the country because Georgia has not accepted federal funds to cover low-income Georgians. Approximately 240,000 Georgians remain stuck in the resulting coverage gap. These Georgians do not qualify for Medicaid under current rules and do not earn enough money to qualify for financial help through the Marketplace. Georgians for a Healthy Future supports closing this gap by extending health insurance to all Georgians with incomes up to 138 percent of the federal poverty level.

2. Stabilize Georgia’s health insurance Marketplace

Almost half a million Georgians are enrolled in health care coverage through the health insurance Marketplace. While Georgia’s Marketplace has proven robust, the last two years have brought declines in enrollments, as federal policy changes have undercut its stability. Other states have taken steps to shore up their markets by implementing state reinsurance programs, instituting state-level consumer protections and enforcement mechanisms, limiting the sale of short-term junk plans, and investing in outreach & enrollment. Georgians for a Healthy Future supports policies that promote affordable, comprehensive coverage and a competitive, stable Marketplace.

3. Ensure access to care and financial protections for consumers purchasing private health insurance.

When consumers enroll in a health insurance plan, they should have reasonable access to all covered services in the plan. As narrow provider networks become more common, health care consumers are at increased risk of not being able to access the medical services and providers they need without going out-of-network and receiving surprise out-of-network medical bills. In 2015, the National Association of Insurance Commissioners adopted a network adequacy model act for states. Georgians for a Healthy Future supports using this act as a foundation to develop quantitative standards for Georgia. Georgians for a Healthy Future further supports legislation that will hold consumers harmless when consumers end up with out-of-network bills despite making appropriate efforts to stay in network or because inadequate provider networks require them to go out of network to receive the services that they need.

4. Set and enforce standards that provide for equitable coverage of mental health and substance use treatment services by health plans.

The 2008 passage of the Mental Health Parity and Addiction Equity Act (Parity Act) required that health plans cover behavioral health services as they would physical health services. The Parity Act is only meaningful if health plans are implementing it well, consumers and providers understand how it works, and there is appropriate oversight. GHF supports legislation that sets standards and oversight procedures to ensure that Georgia consumers receive the coverage for mental health and substance use disorder benefits to which they are entitled by law and for which they have paid.

5. Prevent nicotine use and addiction by young Georgians

Georgia has one of the lowest tobacco taxes in the country at just 37 cents per pack, which makes tobacco much more accessible to youth in Georgia than in many other states. Moreover, Georgia does not apply an excise tax on the nicotine-delivery devices (e.g. e-cigarettes, vaping pens) that are preferred by young people today. For price-sensitive young people, increasing the price of tobacco and nicotine products decreases use and addiction, and the burden of chronic disease in Georgia. Georgians for a Healthy Future supports legislation to increase Georgia’s tobacco tax by at least $1 and to add an equitable excise tax on all nicotine delivery devices.

6. Support partners in integrating health and equity in the policies across every sector to address social determinants of health that prevent equitable access to care and equitable health status.

Factors outside the health system such as adequate housing, education, and economic opportunity impact the health of individuals, families, and communities. Left unaddressed, these and other complicating factors can inhibit the effectiveness of approaches that are strictly within the health system. Georgians for a Healthy Future supports policies that aim to advance health and health equity by addressing the social determinants of health.

To download GHF’s 2019 policy priorities, click here.

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.

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.