2016 ga legislative preview

A Look Ahead at Health Care Policy in the 2016 Georgia Legislative Session

Laura Colbert, MPH, CHESMeredith Gonsahn, MPHJanuary 21, 2015

Georgians for a Healthy Future

Webinar objectives

• At the end of the presentation, attendees should be able to:– State one of GHF’s legislative policy priorities– List a health care advocacy opportunity during the

upcoming session– Find Georgia-specific resources about health care policy and

advocacy

Georgia’s health care policy environment

• Republican Governor• Republican Senate and House

• ~30 health, insurance professionals

• Evolving ACA sentiment• Struggling rural hospital

system• Poor state health outcomes

• America’s Health Rankings=40

2016 Policy Priorities

Close Georgia’s coverage gap

• 300,000 uninsured Georgians• 37% white, 36% black, 22% Hispanic• 60% ages 18 to 39•Working in construction & trucking, food service, grocery stores, retail, education & child care

Economy•$8 billion per year in new economic activity•$220 million per year in new tax revenue

When Georgia closes its coverage gapEveryone benefits

People•Affordable health care access for 300,000 Georgians•Financial, health peace of mind

Health Care Industry•$3 billion in federal money annually•Reduce uncompensated care costs for all hospitals•Help struggling rural hospitals

Workforce•56,000 new jobs created

Georgia can map its own route to coverage.

Georgia is in the Driver’s Seat!

COVERAGE

Georgia can hit the brakes at any time.

Set and enforce network adequacy standards for all health plans in Georgia

• Insured consumers don’t always get what they pay for

• What is an adequate network?

• Ultimate power to set standards lies with Georgia

Background GHF’s Role

• Actively engaged in state policy development

• Support the adoption of the NAIC 2016 Model Act with GA-specific modifications including quantitative standards

• GA Department of Insurance enforcement

End surprise out-of-network bills

• Surprise bills are just that!

• Little to no protections exist for consumers

• Georgia legislators are actively engaged in the issue

Background GHF’s Role

• Partnering with Georgia Watch to support legislation that holds consumers harmless

Ensure provider directory accuracy and usability

• Provider directories are an important tool

• Often, directories are inaccurate and hard-to-use

• Current standards fall short of ensuring accuracy

Background GHF’s Role• Actively engaged in

state policy development

• Support legislation that sets basic standards for provider directory accuracy and usability

.

Remove unnecessary restrictions on consumer education and assistance

• HB 943 (2014)—Health Care Freedom Act• Prohibits GA from setting up

state-run health care exchange

• Prohibits any state entity from participating in federal navigator program

• Prohibits state entities from using resources to influence public opinion in support of Medicaid expansion

Background GHF’s Role

• GHF’s Getting Georgia Covered report• ID’ed

confusion about HB 943 as a barrier to enrollment

• GHF supports lifting this restriction

.

Ensure access to quality health care services Medicaid and PeachCare

• Medicaid: Children, very low-income parents & older adults, and people with disabilities

• PeachCare: low- to middle-income children (up to 247% FPL)

• Enrollment: -1.975 million Georgians (majority children)-12.7% between July 2013 & July 2015

Background GHF’s Role

• Support and highlight policies that:• Facilitate continuous

coverage and enrollment• Preserve and expand

access to care• Improve health

outcomes• Maintenance of the

enhanced primary care provider reimbursement rate

.

Prevent youth substance use disorders through utilizing SBIRT in Medicaid

• Youth substance use disorders can be reduced through prevention

• Screening, Brief Intervention, and Referral to Treatment (SBIRT)

• “Turning on” Medicaid codes will promote greater use of SBIRT

Background GHF’s Role

• Somebody Finally Asked Me Campaign • Supports the activation of

Medicaid codes for reimbursement of SBIRT services for youth.

Increase Georgia’s tobacco tax

• Current tax= $0.37• National average= $1.54• For every penny increase

in tax, state revenue increases by $5 million

• Every 10% retail price of a pack of cigarettes = corresponding ~4% in cigarette consumption • among youth= 7%

Background GHF’s Role

• Suggested tax increase of $1.23

Resulting annual revenue increase of ~$600 million

• Partnership formed with American Heart Association, American Lung Association, American Cancer Society, March of Dimes, others

Expected health care legislation

Expected health care legislation

• FY 2017 budget•Medicaid payment parity• Increased health coverage costs for non-certified school workers

•HB 768—ABLE legislation•HB 722—medical marijuana production•HB 700—”Medical necessity” definition•Medical lien reform bill• Provider directories• Surprise out-of-network medical bills

Georgia’s legislative process

Legislator sees need for new law or changes in existing law and decides to introduce bill1. Legislator goes to Office of Legislative Counsel 2. Legislator files bill 3. Bill is formally introduced during period of first readings4. Bill is assigned to a standing committee5. In House only, 2nd reading on next legislative day (but bill is

in committee) In Senate, 2nd reading comes after bill is reported favorably from committee

6. Bill considered by committee. Author and other legislators may testify. If controversial, public hearings may be held.

7. Bill is reported favorably by committee and returned to Clerk or Secretary.

8. Clerk or Secretary prepares a General Calendar of Bills favorably reported from committee.

9. The Rules Committee of each house meets and from bills on General Calendar prepares a Rules Calendar for the next day’s floor consideration.

10.Presiding officer calls up bills from the Rules Calendar for floor consideration.

11.Once presiding officer calls bill up from Rules Calendar, Clerk or Secretary reads bill’s title (third reading). Bill is now ready for floor debate, amendments, and voting.

12.After debate, main question is called and members vote. If bill is approved by a majority of total membership of that house, it is sent to the other house.

13.If second house passes bill, it is returned to house where bill was introduced. If changes are accepted….

If first house rejects changes and second house insists, a conference committee may be appointed. If committee report is accepted by both houses….14.Bill is enrolled and sent to Governor (if requested). Otherwise, all enrolled

bills sent to Governor following adjournment sine die.15.Governor may sign bill or do nothing, and bill becomes law.

Governor may veto bill, which requires two-thirds of members of each house to override.

16.Act becomes effective the following July 1, unless a different effective date is provided in act.

Advocacy opportunities within the legislative process

1. Ideas for new law or changes to existing law

2. Committee hearings and votes– Provide testimony– Submit comments

3. Floor debates and votes– Contact your legislators

Contact your legislators

In personAppointment at their officeGet coffee with small group“On the ropes” (during legislative session)

Phone

Email

To find out who your legislators areHealthyfuturega.org → “Get Involved” tab → Contact Your Legislator

How to talk to your legislators

Tell them who you are, where you live, and why you are contacting them

The “ask”—what do you want your legislator to do?

Why is this issue important to you?

Share your story at healthyfuturega.org, “Get Involved” section

Invite us to present in your community

Sign the petition at Coverga.org

Join a coalition

Advocacy opportunities

Advocacy Resources

• Georgians for a Healthy Future— healthyfuturega.org– Georgia Health Action Network– Consumer Health Advocates Guide– FB & Twitter: @healthyfuturega– Events— healthyfuturega.org/events

• Getting What You Pay For policy forum• Feb 2, 8 am, Georgia Freight Depot

• Georgia Health News— georgiahealthnews.com• Georgia General Assembly— legis.ga.gov• Families USA— familiesusa.org

References

• Medicaid– www.medicaid.gov/medicaid-chip-program-information/by

-state/georgia.html– dch.georgia.gov/sites/dch.georgia.gov/files/

2015AnnualReport-1.pdf – www.medicaid.gov/medicaid-chip-program-information/pr

ogram-information/downloads/july-2015-enrollment-report.pdf

Thank you!Laura ColbertDirector of Outreach & Partnershipslcolbert@healthyfuturega.org

Meredith GonsahnHealth Policy Analystmgonsahn@healthyfuturega.org

100 Edgewood Avenue, Suite 1015Atlanta, GA 30303Phone: 404-567-5016Fax: 404-935-9885info@healthyfuturega.orghealthyfuturega.org

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