Child-Only Policies, Telemedicine & Medicaid Expansion in Georgia Legislative Spotlight

As the Georgia legislative session gets into full swing this month, many events are being held around the Capitol to help legislators get acquainted (or reacquainted) with each other, their constituents, and the issues and organizations impacting the state as a whole. The recent Healthcare Unscrambled event put on by Georgians for a Healthy Future highlighted three big areas of legislative interest:

Child-Only Health Insurance Policies
While technically not the most important priority, as it was signed into law with the support of Georgians for a Healthy Future in late 2012, the re-introduction of child-only policies to Georgia could prove to be an important educational stepping stone for Georgia’s one in five uninsured citizens. It will certainly give families insight into what services are available to their children at certain price levels through certain carriers.

While Georgia Insurance and Safety Fire Commissioner Ralph T. Hudgens was happy the bill passed, he noted during the event that he was not legally able to put any sort of pricing restrictions on these policies. A quick call to an Aetna broker and Kaiser Permanente representative regarding child-only policies (available through January 31, 2013) found extremely different pricing levels for similar age groups. These calls also highlighted the fact that insurance carriers themselves don’t have many answers when it comes to how the insurance landscape will change for families in 2014. They simply just don’t know at this point.

Hudgens and fellow panelists Representative Pat Gardner and Representative Sharon Cooper seemed very supportive of telemedicine initiatives in Georgia, especially in terms of reaching patients in rural populations, combating the nationwide shortage of primary care physicians, and potentially driving down healthcare costs. Perhaps Georgia will take advantage of the recently introduced Federal Communications Commission program that will award up to $400 million annually to help develop broadband networks in support of rural telemedicine and health record access.

As with most everything in healthcare, the access to telemedicine for a patient with private insurance will be determined by the insurance company/payer.

Medicaid Expansion
And speaking of coverage, Cooper and Gartner had very differing opinions on expanding Medicaid in Georgia. Representative Cooper is fighting against it, and asked the audience, why expand access to healthcare when Georgia doesn’t have enough physicians to provide that care? Representative Gartner took the opposite view, stating that expanding Medicaid is a great bargain for Georgia, as the state will get the most federal money in the shortest amount of time.

Georgians for a Healthy Future is certainly for it, and took the opportunity to unveil an entirely new advocacy campaign in support of it. Cover Georgia is a coalition of consumer and patient advocates, providers and industry stakeholders who have come together around a common goal: covering Georgia’s uninsured by expanding Medicaid.

“The Supreme Court decision in June of 2012 made the Medicaid expansion a hot topic for states,” explains Amanda Ptashkin, J.D. ” Their ruling made what was once a mandatory part of the law now optional, but it also left the consequences of that decision all the more dire for some of our most vulnerable citizens. The Cover Georgia coalition is demonstrating that the expansion is not only good for individual health care consumers, but also good for our health care infrastructure, and also the state economy.  If we move forward with the expansion, an estimated 600,000 Georgians will gain coverage.  The state will be infused with federal dollars to help fund the expansion that will go directly to doctors, hospitals and other providers and that will help rebuild local economies and strengthen our state.

“On the other hand,” she continued, “if we do not move forward with the expansion, individuals between our current eligibility levels and 100% of FPL (federal poverty level) will have no options for affordable health care and will fall into a coverage gap.  Additionally, the money that all Georgians spend in federal taxes will go to fund other states’ expansions.

“For states that decide to move forward with the expansion, it will take effect on January 1, 2014. The first three years of the expansion will be 100% funded by the federal government, eventually scaling back to 90% by 2020. If Georgia opts to forgo the expansion, but then decides in 2020 that it is the right thing to do, we will get that 90% match rate but will have missed out on the three years of 100% support, and in the meantime continue to have one of the highest rates of uninsured and worse health outcomes. The sooner a decision is made to move forward, the better.”

The Medicaid and child-only policies face similar problems. Increased access to insurance is great, but won’t mean much if policies are priced too high to cover those that need it most. Similarly, increased access to healthcare via Medicaid is great, but won’t mean much if those who sign up for the program end up having trouble getting into see a physician. It will be interesting to see how the Georgia legislature will handle this issue, and the impact it will have on patients, in the coming months.

Those interested in learning more about the legislature’s current and future plans for healthcare in Georgia should make plans to attend the Technology Association of Georgia Health Society’s Healthcare IT Legislative Update at the Georgia Capitol on Thursday, Jan. 24th. Georgia State Senator Buddy Carter, Vice Chairman of Health and Human Services Committee, State Representative Larry J. “Butch” Parrish, Representative Ron Stephens, Chairman, Economic Development and Tourism Committee, and representatives from McKesson, eHealth Services Group and Georgia HIMSS will be on hand.

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