Georgians for a Healthy Future's (GHF) 2015 policy agenda focused on closing Georgia's coverage gap, ensuring access to quality healthcare for Medicaid and PeachCare beneficiaries, maximizing enrollment and a positive consumer experience for private health insurance, increasing Georgia's tobacco tax, and reinvesting in public health. The presentation provided background on these issues, GHF's role in advocating for related policies, and resources for attendees to get involved in the legislative process through advocacy opportunities like meeting with their legislators.
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Health care policy and advocacy in the 2015
1. Health Care Policy and
Advocacy in the 2015
Legislative Session
LAURA COLBERT, MPH, CHES
COMMUNITY OUTREACH MANAGER
GEORGIANS FOR A HEALTHY FUTURE
2. Objectives
• At the end of this presentation, you should:
◦ Be familiar with GHF’s 2015 policy agenda
◦ Know how to contact your legislators
◦ Know where to find advocacy resources
3. Georgia’s health policy environment
• Republican Governor
• Republican Senate and House
◦ 10 health professionals
• Anti-ACA sentiment
• Struggling rural hospital system
5. Close Georgia’s coverage gap
• 300,000 in the coverage gap
(incomes < 100%FPL)
• 200,000 who do not have an
affordable coverage option (100-
138% FPL)
• Who’s in the coverage gap:
• Veterans
• Working parents
• Low-wage workers
6. Close Georgia’s coverage gap
• Closing the coverage gap:
◦ Helps Georgia families
◦ Benefits Georgia’s economy
◦ Supports Georgia’s rural hospital system
◦ Will help you or someone you know
• To let your legislators know that you think
Georgia should close it’s coverage gap, visit:
healthyfuturega.org/issues/cover-georgia
Scroll down to the purple postcard and click
the link.
7. Ensure access to quality health care services
for Medicaid and PeachCare beneficiaries
BACKGROUND
• Medicaid: Very low-income parents & older
adults, and people with disabilities
• PeachCare: low- to middle-income children
(up to 247% FPL)
• Enrollment:
◦ 1.2 million children (42% of GA’s kids)
◦ ½ million adults
◦ 12.9% (Sept. 2013 to Oct. 2014)
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
8. Maximize enrollment and ensure a positive
consumer experience for Georgians with private
health insurance
BACKGROUND
• Many newly covered Georgians
◦ Open Enrollment 1 (OE1)—316,543 enrollments
◦ OE2—398,000+ enrollments as of Jan. 9
◦ If you need to enroll:
◦ www.healthcare.gov
◦ Call 855-899-6092
• About 6 million Georgians have private
insurance coverage
• King v. Burwell
GHF’S ROLE
• Ensure that
◦ Plans remain affordable
◦ Consumers have the tools and info. necessary to
understand their plans and receive the
appropriate care
◦ Provider networks and formularies are adequate
and transparent
◦ Consumer protections are in place and enforced
9. Increase Georgia’s tobacco tax
BACKGROUND
• Current tax= $0.37
• National average= $1.54
• For every penny increase in tax, state revenue
increases by $5 million
• Every 10% increase retail price of a pack of
cigarettes = corresponding ~4% decrease in
cigarette consumption
◦ Reductions among youth= 7%
GHF’S ROLE
• Suggested tax increase of $1.23
◦ Resulting annual revenue increase of ~$400
million
• Partnership formed with American Heart
Association, American Lung Association,
American Cancer Society
10. Re-invest in public health to support a
healthy and prosperous state
BACKGROUND
Georgia= Ranked 38th overall for health
Georgia Dept. of Public Health
• FY2015 budget: $205 million
◦ 5% of GA’s health spending
• Per capita investment in PH:
◦ 2001: $19.77
◦ 2015: $18.25
GHF’S ROLE
• Demonstrate value and importance of PH
◦ spending by local PH dept. can save lives
currently lost from preventable disease
◦ investment in prevention programs health
care costs and economic productivity
◦ ROI for community-based, proven PH
programs=$5.60 for every $1 investment
• Educate policy makers
11. For more information
• Georgians for a Healthy Future—healthyfuturega.org
• Georgia Budget and Policy Institute—gbpi.org
• Robert Wood Johnson Foundation—rwjf.org
• Kaiser Family Foundation—kff.org
• Tobacco Free Kids—tobaccofreekids.org
• America’s Health Rankings—americashealthrankings.org
• Georgia Health News— georgiahealthnews.org
14. Legislator sees need for new law or changes in existing law and decides to introduce bill
1. Legislator goes to Office of Legislative Counsel. There, attorney advises legislator on legal issues and drafts bill.
2. Legislator files bill with Clerk of the House or Secretary of the Senate
3. On legislative day after filing, bill is formally introduced. In chamber, bill is read during period of first readings.
4. Immediately after first reading, presiding officer assigns bill to a standing committee
5. In House only, on next legislative day, Clerk reads bills title (second reading) in chamber, although actually bill is now in
committee.
In Senate, second reading comes after bill is reported favorably from committee
15. 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.
16. 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.
17. Advocacy opportunities within the
legislative process
1. Ideas for new law or changes to existing law
2. Committee hearings and votes
◦ House
◦ Senate
3. Floor debates and votes
◦ House
◦ Senate
18. Contact your legislators
• To find out who your legislators are
◦ Healthyfuturega.org → “Advocacy Center” tab → Contact Your Legislators
• In person
◦ Appointment at their office
◦ Get coffee with small group
◦ “On the ropes” (during legislative session)
• Phone
• Email
19. How to talk to your legislators
• Hook
◦ Tell them who
you are, where
you live, and
why you are
contacting
them
• Line
o Why is this
issue
important
to you?
• Sinker
o The “ask”—
what do
you want
your
legislator to
do?
20. Advocacy opportunities
• Jan. 27th—Coverage Day at the Capitol
◦ Advocate for closing Georgia’s coverage gap! GHF will provide breakfast, short
advocacy training, talking points, and materials. RSVP by emailing
lcolbert@healthyfuturega.org.
• Send a postcard
◦ Visit healthyfuturega.org/issues/cover-georgia. Scroll down to the purple
postcard and click the link.
• Share your story
◦ Visit healthyfuturega.org/advocacy/mystory to tell us your health care story
22. References
• Ensure access…for Medicaid and PeachCare beneficiaries
1. http://www.medicaid.gov/medicaid-chip-program-information/by-state/georgia.html
2. http://dch.georgia.gov/sites/dch.georgia.gov/files/PRESENTATION%20--
%20House%20Community%20Health%20Subcommittee_February%202014%20--%202.4.2014.pdf
• Increase GA’s tobacco tax
1. www.Tobaccofreekids.org
• Reinvest in Public Health
1. http://cdnfiles.americashealthrankings.org/SiteFiles/StateSummaries/Georgia-Health-Summary-2014.pdf
2. http://gbpi.org/wp-content/uploads/2013/07/Georgia-Budget-Primer-2014-Health-Care-Section.pdf
3. http://gbpi.org/wp-content/uploads/2013/02/fy2014_Budget-Analysis_Public_Healthpdf.pdf
4. http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf72446
23. Thank you!
Laura Colbert
Community Outreach Manager
Georgians for a Healthy Future
Office: 404-890-5804
lcolbert@healthyfuturega.org
www.healthyfuturega.org
Hinweis der Redaktion
Overview of GHF
Our mission is to build and mobilize a unified voice, vision and leadership to achieve a healthy future for all Georgians. Our vision is of a day in which all Georgians have access to the quality, affordable health care they need to live healthy lives and contribute to the health of their communities. Each year, we develop public policy priorities to move Georgia closer to this vision. Our three-pronged approach includes:
1. outreach, education & engagement with consumers and communities;
2. building and mobilizing coalitions by providing leadership, coordination, & strategic direction, and
3. public policy advocacy through engagement with key decision-makers.
Sen. Dean Burke--physician
Sen. Chuck Hufstetler--anesthetist
Sen. Rene Untermann—insurance executive
Rep. Bruce Broaderick—pharmacist
Rep. Debbie Buckner—Health educator
Rep. Sharon Cooper—nurse, medical administrator
Rep. Butch Parrish—pharmacist
Rep. Jason Spencer—Physician’s assistant
Rep. Ron Stevens—pharmacist
Rep. Ben Watson--physician
Ensure access to quality health care services for Medicaid and PeachCare beneficiaries. The Medicaid and PeachCare for Kids programs provide health insurance for many of our state’s most vulnerable citizens, including low-income children, some low-income parents, and people with disabilities. Enrollment in these programs is growing as uninsured families explore health insurance options and find that their children meet the eligibility criteria. This presents an opportunity to bring down our state’s uninsured rate and improve access to care. Georgians for a Healthy Future will support policies that facilitate continuous coverage and enrollment, preserve and expand access to care, and improve health outcomes. Specifically, in 2015 Georgians for a Healthy Future will advocate for maintenance of the enhanced primary care provider reimbursement rate that was temporarily funded through federal dollars. Sustaining this enhanced reimbursement rate is necessary to ensure adequate provider networks.
Maximize enrollment, retention, and a positive consumer experience for Georgians with private health insurance. Georgia consumers are enrolling in private health plans at a rapid pace. As more Georgians enter this market, it is critical that these plans remain affordable; that consumers have the tools and information they need to understand their plans and access appropriate care; that provider networks and formularies are adequate to ensure meaningful access to all covered benefits; and that consumer protections are in place and enforced. Georgians for a Healthy Future will advocate at the state and national level for legislative and administrative approaches to ensure a positive consumer experience.
Notes from Cindy:
Tere is a need to educate legislators and policymakers on these issues from the consumer perspective;
King v Burwell could threaten access to subsidies and we want to start thinking about a Plan B there
That there is a process at NAIC around network adequacy.
Increase the tobacco tax. 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 it is in other states. Increasing the tobacco tax to the national average will reduce youth smoking, addiction, and the burden of chronic disease in our state. Increasing Georgia’s tobacco tax will also bring much-needed revenue to our state which can be invested in health care coverage, access, and prevention.
Dept. of Public Health (DPH) operates a variety of population-based health programs like immunizations, health screenings, infection control, health promotion (healthy eating, physical activity, injury reduction), reproductive health, health-related disaster response, monitoring and evaluation, etc.
Re-invest in public health. Our state’s public health system plays a critical role by vaccinating children, monitoring and preventing epidemics and chronic diseases, ensuring safe food and water, and providing both clinical and community-based preventive services. Despite an increasing need for these services and a growing awareness of the importance of social determinants to community health outcomes, Georgia’s per capita public health spending is among the lowest in the nation and our public health infrastructure has sustained severe budget cuts in recent years. This has harmed Georgia’s ability to conduct meaningful health planning and prevention initiatives that can lead to improved population health and productivity. Georgians for a Healthy Future supports re-investment in public health and prevention.
ROI for public health: http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf72446
Notes: Our work around this issue is bigger than just DPH’s budget. The state of Georgia needs to value and invest in public health
In later slides, I’ve highlighted in green the steps that offer a good opportunity for advocacy.
1& 2 are really the more important steps. By the time a bill gets to the floor, the outcome is pretty much known.