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Conversation on coverage needed

This column was authored by Cindy Zeldin, Georgians for a Healthy Future’s Executive Director, and originally appeared in the Atlanta Journal-Constitution on September 28th, 2015.

 

Earlier this month, the Georgia Department of Community Health announced that it had abandoned plans — at least for now — to seek flexibility in Georgia’s Medicaid program to allow for expanded coverage and an innovative delivery-of-care model for the patient populations served by Grady Health System in Atlanta and Memorial Health in Savannah.

 

 

While this pilot program would have been fairly limited, it was designed with the changing health care landscape in mind and in the spirit of making the health system work better for patients. The proposal relied on an integrated care model with primary care medical homes, care coordination, data sharing and a focus on prevention. The costs to the state would have been nominal — negligible, even — as Grady offered to foot the bill. That this effort is not moving forward is a disappointment, but it should not be a conversation-ender.

 

 

For years, the nation’s uninsured rate appeared stuck at a stubbornly high level. This had implications for individuals and families who couldn’t access the care they needed, for communities and health systems that experienced spillover effects, and for overall health and productivity. Over the past year and a half, the tide has turned. The uninsured rate has steadily declined, and in some states it has plummeted to less than 5 percent.

 

 

It is a time of tremendous change in health care, yet this change is being felt unevenly. According to a recent Gallup-Healthways survey, states that both established their own health exchange (or a partnership exchange) and expanded Medicaid saw greater declines in their uninsured rates than states that did neither. States that viewed the changing health care landscape as an opportunity, and the Affordable Care Act as a toolbox, to improve coverage saw far better results than those who did not.

 

 

Many states taking this “opportunity and toolbox” approach are now building on the foundation of high coverage rates to invest in prevention, improve access to care and enhance value for consumers, often in collaboration with local health care stakeholders.

 

 

Kentucky, for example, has reduced its uninsured rate from over 20 percent to 9 percent since 2013. Combined with an intentional focus on prevention, this has translated to a more-than doubling of the number of screenings for breast, cervical and colon cancer and of dental and physical exams. Other states like Oregon are developing initiatives to contain costs, improve quality and achieve better price transparency for consumers.

 

 

Of course, not every promising initiative will be a smashing success, but the pace of innovation and advancement is historic for American health policy. Here in Georgia, approximately 500,000 people enrolled in coverage through the Health Insurance Marketplace, an exciting development that has helped bring our state’s uninsured rate down to just above 15 percent. In normal times, with all else being equal, this would be extraordinary.

 

 

And while this achievement is transformative for the people and communities impacted, these are not normal times for the health system. Georgia’s uninsured rate remains among the nation’s highest, and our health outcomes, among the nation’s poorest. Without a more deliberate focus on coverage, access, value and outcomes, Georgia risks falling further behind other parts of the country. We cannot continue to do less with less.

 

 

The demise of the Grady experiment, while a disappointment, should be a conversation starter about moving Georgia towards an “opportunity and toolbox” mindset. To date, our state has stayed on the sidelines while others have moved forward, but we don’t have to remain there.

 

 

The evidence is beginning to pour in from around the country, and we can take the most promising initiatives out there and use them to inform a uniquely Georgia approach. The clearest evidence we have shows us the decision by the majority of states (30 and counting) to expand Medicaid is foundational in transforming the health system. The Grady initiative, while not Medicaid expansion, was at its heart a delivery system reform that was predicated on moving its target population into coverage as a first and necessary step.

 

 

We cannot make progress as a state if 15 percent of our population is uninsured. Too many Georgians fall into a coverage gap our leaders can fix. Medicaid expansion should be on the table, not as a perfect solution, but as a necessary first step.

 

 

 


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Medicaid celebrates 50 years!

Over the past 50 years, Medicaid has ensured that our family members, friends, and neighbors have the quality health care they need. Be it our seniors accessing long term care services, kids seeing a doctor, or people with disabilities living independently, millions of people are better off because of this critical program.

Medicaid has also shown itself to be an effective and cost-efficient program. Administrative costs are substantially lower than private insurance and because people using Medicaid have access to preventive services, small issues can be addressed before they end up as big, costly illnesses.

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Children in particular benefit from Medicaid. Studies show that kids with coverage show up at school ready to learn, are more likely to graduate from college, and end up with more earning potential as adults. In fact, more than 1 million Georgia children (about 35% of kids in our state) currently get their health care coverage through Medicaid.

As we reflect on what Medicaid has meant for children and families here in Georgia, it has been nothing short of transformative. And while about 1.9 million Georgians overall benefit from the essential health care access that Medicaid provides, approximately 300,000 Georgians are still stuck in a coverage gap: they don’t qualify for Medicaid under its existing stringent standards, aren’t offered coverage at work, and earn too little to qualify for tax credits through the Health Insurance Marketplace. The majority of states have accepted federal funding to close this gap, but Georgia hasn’t yet taken that step. Closing this gap and extending Medicaid coverage to all low-income Georgians would be a powerful tool for improving the health of individuals and families throughout our state.

catalyst3finalAt Georgians for a Healthy Future we are proud to advocate for the Medicaid program that has been proven to improve health and saves lives. For the millions of Americans, and many Georgians, whose quality of life has been improved because of Medicaid, we’re so happy to celebrate the 50th anniversary of the life-changing program.

 

More about Medicaid in Georgia!


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#donttakemycare

King v. Burwell

Sometime this month, the Supreme Court will rule on King v. Burwell, a case that could have major implications for Georgia health care consumers. The Court will rule on whether the ACA allows consumers to receive tax credits to help pay for health insurance in the 34 states including Georgia that use healthcare.gov, the federally facilitated marketplace.  Here in Georgia, nearly 9 in 10 Georgians who enrolled in coverage this year accessed tax credits that made that coverage affordable.  A ruling for the challenger in King v. Burwell would place coverage at risk for more than 400,000 Georgians. GHF is working to keep you informed and updated with all the latest on this case. Here’s what you need to know.


#Donttakemycare

Got Covered - CorneliaCornelia Hinton, a recent college graduate at age 26, was no longer eligible to remain on her parents’ health insurance plan. Affordability (enhanced by a tax credit) was Cornelia’s main concern when enrolling in health insurance through the Marketplace. After her subsidy was applied, Cornelia’s plan cost her $83/month.

Cornelia is just one of the 400,000 Georgians whose coverage hangs in the balance. Let’s show our support for her and for the hundreds of thousands of Georgians who finally have access to health care and financial peace of mind. Spread the word. #DontTakeMyCare

Read more stories like Cornelia’s.


GHF SPEAKS OUT

Georgia leaders, experts weigh in on Obamacare AJC 

CindyZeldin_Headshot - Copy“A door that had been closed to too many Georgians for too long has finally been opened, and consumers have responded. The individuals and families who have walked through this door come from all corners of our state and from all walks of life. But they share a combination of relief and pride at finally enrolling in health insurance that fits within their budget. If the Court rules for the challengers, these newly enrolled Georgians will be looking to our state leaders for answers. Our state’s leadership should commit to use every tool in the toolbox to allow consumers to maintain access to marketplace health insurance and to the tax credits that have helped make it affordable.”

Read the full article.


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Local News Highlight

In Republican Stronghold, Worries About End of Obamacare
Bloomberg Politics | Margaret Newkirk
In Georgia’s Gwinnett County where Republicans rule, few really love Obamacare. Few want to lose it either…As the U.S. Supreme Court prepares to rule on a case that could make Obamacare’s private insurance unaffordable in Georgia and at least 33 other states, Gwinnett, where all five of the county commissioners belong to the Republican Party that has been leading the fight against the health care law, illustrates how for many the program has become a fact of life. Obamacare is both groused about and accepted, like taxes and the weather.
Obamacare ruling could kill coverage for 413,000 in Georgia
AJC | Misty Williams

“I’m not a big Obama fan, but I don’t know how anybody could be against this,” Wilson said. “Prisoners get all of their health care paid for, so why can’t someone who’s worked all their lives also get some help?” Yet conservatives in Georgia and across the nation are just that – staunchly opposed to the Affordable Care Act, its mandate that most Americans buy insurance and its use of billions of taxpayer dollars to help pay for Obamacare plans.

Read full story.


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Coverage gap update

While Georgia has made little progress on closing its coverage gap, the subject is a hot topic elsewhere.

  • Montana has closed its coverage gap! As the 29th state to close the gap, Montana will provide 70,000 Montanans with quality, affordable health care coverage.  The state is currently working with CMS to gain approval for its expansion proposal.
  • Face Off in Florida–The debate over closing the coverage gap is as hot as sunburnt skin after spring break! Floridians have seen a sudden and unexpected adjournment of the legislative session, a stand-off with HHS over the low-income pool (LIP), and their governor file suit against the federal government.  The debate is far from over as the legislature plans to reconvene in June to complete their legislative responsibilities.
  • Policy makers in both Alaska and Louisiana are discussing if and how to close their coverage gaps.  While their legislators debate whether or not to close the coverage gap during a special session, polls show that Alaskans are hugely in favor of the policy.  In Louisiana, Gov. Jindal remains opposed to the idea of closing his state’s coverage gap, but legislators are discussing their options.

While Montana closes its gap and other states think through their options, more and more studies are revealing that closing the coverage gap is good for states! It saves money in state budgets and facilitates job growth, especially in the health care sector.  Families USA summarized the new data in a recent blog post.

Medicaid Expansion 4.15


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Getting Georgia covered: lessons learned from Open Enrollment 2

You’re Invited!

May 13, 2015 from 11:30 to 2:00

Georgia Railroad Freight Depot; Blue Room

Sign up here!

More than half a million Georgians signed up for health insurance during the open enrollment period that ended this past February (OE2). These strong enrollment numbers mean that more Georgians have access to the health care services they need and the peace of mind that comes from knowing that they are covered. What drove this success story for health care consumers in Georgia? Please join us for a conversation with representatives of the organizations most active in OE2 to learn lessons about their strategies, successes, and challenges that you can apply to your work. After their presentations, you will have the opportunity to ask your most pressing questions about health coverage in Georgia.  Lunch will be provided.

 

Panelists

Enroll America: Danté McKay, Georgia State Director

GHF: Whitney Griggs, Consumer Education Specialist

InsureGA: Sarah Sessoms, Executive Director

SEEDCO:  Lisa Stein, Vice President Work and Family Supports

US Dept. of Health & Human Services: Dr. Pamela Roshell, Region 4 Director

While this is a free event, please RSVP so we can order enough food.


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GHF welcomes new navigator!

 

 

PranayPranaya Rana joined Georgians for a Healthy Future this week as our new Navigator! In this role, Pranaya will work with consumers to help them enroll in health insurance through the Marketplace.  Pranaya is a former Lieutenant from the Nepalese Army Elite Forces. He has served as a U.N. Peacekeeper in post-earthquake Haiti and as a Refugee Resettlement Program Officer in Connecticut before he came to Kennesaw State University, Georgia to pursue his Ph.D. in International Conflict Management in 2012.   He has been working as a certified Healthcare Navigator in Metro Atlanta since the first open enrollment began in 2013. He recently completed his 6 months long Navigator’s term at Georgia Watch before joining Georgians For a Healthy Future.  He specializes in refugees and international communities and has served a wide variety of international communities enroll into affordable healthcare using a community specific service model developed through continued outreach, education and  needs assessment. He is Fluent in Nepali and Hindi besides English, and, speaks Urdu and intermediate French. If you’d like to contact Pranaya, he can be reached by email or by phone at 404-567-5016.


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Tax-time special enrollment period

 

 

taxesDid you go without health insurance in 2014 and are now subject to a tax penalty? Good news! – You may still be able to enroll in coverage through the Health Insurance Marketplace. Starting last Saturday, March 15th, some people who are facing a fine on their taxes for not having coverage can now enroll in the Marketplace through a time-limited special enrollment period. To be eligible for this special enrollment period, you must not be currently enrolled in health insurance, attest that you owe the penalty for 2014, and attest that you first became aware of the penalty when you filed your 2014 taxes. This tax-related special enrollment period will run through April 30th, 2015.  Click here to learn more about who can qualify for this special enrollment period.


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Join us for health advocates day at the capitol!

 

informationPlease join us on Wednesday, March 25, from 8:45 am to mid-day for a morning of advocacy!  GHF will provide individuals and organizations with the opportunity to advocate for the important health issues that matter to you in the closing days of this legislative session.  You may want to advocate for closing the coverage gap, Medicaid payment parity, raising the tobacco tax, the Family Care Act, rural health care access, or another health policy issue.  You’re all invited to participate!  We’ll provide breakfast, an advocacy training, and an opportunity to share and network with other health advocates.

To sign up, click here.  If you have any questions, please contact Laura Colbert.

 


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An advocate’s guide to King v Burwell

suprme court

On Wednesday, the Supreme Court heard oral arguments for the much anticipated King v. Burwell case, a case that threatens to eliminate tax credits to buy health insurance through the Affordable Care Act (ACA) marketplaces in approximately three dozen states, including Georgia.

Here at GHF, we are happy that the ACA is working and that more than 536,000 Georgians were able to access affordable health care coverage through the Health Insurance Marketplace during the most recent open enrollment period. We look forward to the Supreme Court’s decision in King v. Burwell and hope that it will be a positive outcome for the 461,000 Georgians who currently receive tax credits through the ACA. For now, health care coverage and tax subsidies for Georgia’s consumers remain unchanged.

There has been a lot of news coverage of the case this week and there are many resources available to help advocates communicate about the case to their supporters and stakeholders.

  • The Commonwealth Fund has a series of issue briefs about how subsidy shutdowns could affect consumers, health insurers, health care providers, and states. Each comes with a summary infographic.
  • The Commonwealth Fund also has an interactive map of the potential impact of a subsidy shutdown on each state.
  • Community Catalyst mapped the potential impact by congressional district.
  • The Urban Institute has put together a report about the implications of King v. Burwell on uninsured rates, changes in types of coverage, and costs of insurance.

 


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So you have coverage…now what?

If you have recently gained health insurance through the Health Insurance Marketplace, it may seem like you need to learn a whole new language to understand your coverage. Health insurance can be confusing, especially if you have never had it before or haven’t had it in a while. Just understanding a few key terms, such as premium, deductible and co-pay, will go a long way in helping you use your health insurance effectively. Click here for a simple guide to help you understand your new coverage. Additionally, if you are having trouble using your health insurance you can contact Whitney Griggs, GHF’s Consumer Education Specialist, at wgriggs@healthyfuturega.org or at (404) 567-5016, extension 5.


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