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Georgia Voices for Medicaid Presentation - Dougherty County
- 1. Georgia Voices for Medicaid Alyssa Green, Outreach and Education Manager
- 2. Georgians for a Healthy Future
- 3. Agenda • Pathways to healthcare coverage • What is Medicaid? • Medicaid supports…. • What’s next for Medicaid? • Becoming a health advocate
- 4. Pathways to coverage under the ACA Job-based coverage Individual/non-group (healthcare.gov) Public health insurance coverage Medicare TriCare (Veterans) Kids: PeachCare/Medicaid Medicaid
- 5. 1 in 5 of all Georgians 1 in 5 of all poor adults in Georgia* 1 in 2 of all children in Georgia *Poor is defined as ≤100% Federal Poverty Level Source: GBPI calculations based on data from U.S. Census Bureau and Georgia Department of Community Health Medicaid plays an important role in health coverage in Georgia
- 6. 5 The Federal Poverty Line is $12,140 for an individual and 16,460 for a couple.Not eligible Adult without dependent children Parent Aged, Blind, Disabled Breast, Cervical Cancer Nursing home & community care Pregnant women Children (Medicaid & PeachCare) 50%0% 100% 150% 200% 250% Children Eligibility Levels are cumulative Children Ages 6-19 Children Ages 1-5 Children Ages 0-1 PeachCare Source: Georgia Department of Community Health, thresholds rounded Who gets Medicaid in Georgia?
- 7. In Dougherty County: -19,727 in Dougherty County are on Medicaid • 14,330 are children • 2,384 are elderly -However, over 17,000 people in Dougherty County are uninsured. •More than 7,900 of these people are employed and still are not covered. -Over 1,200 uninsured are children.
- 8. The creation of the coverage gap Employer-based coverage Individual/non- group (healthcare.gov) (Coverage Gap) Public health insurance coverage Medicare Medicaid TriCare (Veterans) Kids: PeachCare/Medicai d
- 9. Georgia’s health insurance coverage gap • 430,000+ uninsured, low- income Georgians • Ineligible for Medicaid and do not earn enough for financial help on healthcare.gov
- 10. • 37% white, 36% Black, 22% Hispanic • 60% ages 18 to 39 • Working in construction, food service, grocery stores, retail, education & childcare, trucking Hard-working Georgians live in the coverage gap
- 11. Medicaid by a Different Name
- 12. Provide financial assistance to those who chose to seek care at home or in the community, instead of an institutional setting. NOW/COMP: allows seniors or those with disabilities to live independently in the community New Options Waiver (NOW): for those who need less intensive care and urgent needs Comprehensive Supports Program(COMP): for those who need out of home residential support and supervision or intensive in-home services Medicaid by a Different Name: Home and Community Based Services Waivers
- 13. Medicaid by a Different Name: ICWP (Independent Care Waiver Program): helps adult Medicaid recipients with physical disabilities live in the community CCSP (Community Care Services Program): for frail, older and disabled adults SOURCE (Service Options Using Resources in a Community Environment): provides non-medical care services Home and Community Based Services Waivers
- 14. GAPP (Georgia Pediatric Program): serves eligible children under 21 years of age who are medically fragile and in need of medically necessary skilled nursing care and/or medically necessary personal care support Katie Beckett Waiver- allows children with disabilities to receive care regardless of parental income Medicaid by a Different Name: For Children
- 15. Medicaid Supports Children • Covers 1.3 million children in Georgia • PeachCare builds on Medicaid • Covers 100% of current and former foster children in Georgia (~28,000 children)
- 16. Medicaid Supports Children EPSDT (Early Periodic Screening, Diagnosis, and Testing) • Screenings • Vision services • Dental services • Hearing services • Diagnostic services • Treatment
- 17. Medicaid Supports People with Disabilities Medicaid is the primary payer for essential long-term services and supports: • Nursing home care • Home- and community- based services • Wheelchairs, lifts, supportive housing services
- 18. Medicaid Supports Seniors • 185,404 seniors in Georgia are covered by Medicaid • Nursing home and long- term care is covered by Medicaid • Medicaid also provides resources that allow seniors to age in place
- 19. Medicaid supports pregnant women & newborns • Medicaid provides comprehensive care for women while pregnant, and up to 60 days post- partum • Pre-natal care can help detect serious health complications that are easier and cheaper to fix early on
- 20. COVID-19 & health coverage
- 21. No one can be willingly disenrolled from Medicaid during nat’l public health emergency What you need to know about Medicaid during COVID-19 No co-pays or premiums for Medicaid or PeachCare for Kids members during nat’l PH emergency All COVID-19 testing and related services covered by Medicaid Increased access to tele- health services for other health needs If diagnosed with COVID- 19, Medicaid will cover all costs
- 22. Temporary changes to Medicaid waiver services:NOW/COMP only • OT/PT/Speech & language therapy • Nutrition services • Behavior Supports Services • Registered Nursing Services • Support Coordination (including Intensive SC) • Supported Employment (limited scope) Temporarily allows telehealth for: For specific details, contact GA Dept. of Community Health or your caseworker
- 23. Temporary changes to Medicaid waiver services:I/DD services Annual caps are temporarily removed for: • Community living supports • Respite services • Specialized medical supplies • Community Access Family member caregivers can be paid to deliver these services to their family member: • Community Living Supports • Respite services (in- home and out-of- home) • Community Access For specific details, contact GA Dept. of Community Health or your caseworker
- 24. Medicaid: A first-responder during COVID- 19 • Federal govt increased Medicaid funding to states to assist with budget short-falls, pandemic response costs • Medicaid covers costs of testing for uninsured • Emergency waivers allow Georgia to: • Increase # of Medicaid providers • Increase flexibility for telehealth services • Keeping kids, families, new mothers enrolled • Expand hospital capacity • Increase the pay of home health workers • Pay some health/service providers who cannot provide services right now (ex: day programs)
- 25. COVID-19: Legal assistance for your Medicaid coverage • If you: – Lost your Medicaid coverage – Have complication with Medicaid waivers (NOW, COMP, etc) – Attended a day program that is now closed – Rely on aide who is no longer showing up, or coming less • Atlanta Legal Aid serves Fulton, DeKalb, Cobb, Gwinnett, and Clayton counties: Call 404-377- 0707 • Georgia Legal Services Program serves Georgians in all other counties: Call 833-457-
- 26. Georgians becoming uninsured due to job loss • More than 2,342,772 Georgians filed for unemployment between March 1st and May 30, 2020 • Unemployment may lead to loss of health insurance for individuals who get health coverage through their job • Many are eligible for other kinds of coverage Medicaid, 376,000 Coverage gap, 24000 ACA with financial help, 775,000 ACA without financial help, 268,000 Source: Kaiser Family Foundation, Eligibility for ACA Health Coverage Following Job Loss, May 13, 2020.
- 27. COVID-19: Health coverage after job loss If you or a loved one loses a job or has a drop in income, you are likely eligible for new health coverage: • Affordable Care Act • Medicaid • COBRA More information at: healthyfuturega.org/blog, Health Insurance Options for Georgians during COVID-19
- 28. Affordable Care Act: Private Insurance • A special enrollment up to 60 days after losing your job- based insurance • Enroll or find free, local enrollment help at healthcare.gov • Financial help is available! • ACA coverage covers testing. Covers part or all of costs related to COVID-19 treatment You may qualify for financial help if your income falls in these ranges To receive discount on monthly premiums To receive discount on deductible or other cost-sharing Family size (100%-400% FPL) (100%-250% FPL) 1 $12,760 --$51,040.00 $12,760 --$31,900.00 2 $17,240--$68,960.00 $17,240--$43,100.00 3 $21,720 --$86,880.00 $21,720 --$54,300.00 4 $26,200 --$104,800.00 $26,200 --$65,500.00
- 29. Medicaid and PeachCare for Kids • You can enroll yourself, your family, or your children in Medicaid or CHIP at any time! • Children, pregnant women, people with disabilities, & very low-income parents are most likely to qualify • Enroll at gateway.ga.gov • Learn more & find out if you are eligible a: healthyfuturega.org/medicaid- and-peachcare-for-kids/
- 30. If you cannot find health coverage You can receive free or low-cost services at: • Community health centers & charity clinics – CHCs: gpca.org/locations – Charity clinics: CharitableCareNetwork.com/resources/find-a- clinic/ • Telehealth services: givinghealth.org/how-it-works or call 866-662-1923 • Financial assistance programs at your local hospitals
- 31. COVID-19: Keeping People with Disabilities Safe
- 32. Georgia's Health Care Proposals: What's Happening Now
- 33. Happening Now: Changes in Health Care for Georgians • Governor Kemp’s health care proposals • Changes to Medicaid • Changes to private insurance • How you can help!
- 34. SB 106: The Patients First Act • Allows Governor to submit 1+ “1332 State Innovation waivers” to the federal government • 1332 waivers have been used to lower health care costs & expand consumer choice in other states • Trump admin is allowing them to be used to roll back ACA protections • Allows Governor & GA Dept of Community Health (DCH) to submit a “Medicaid 1115 waiver” • May cover adults with incomes up to 100% of the federal poverty level (FPL) • 1115 waivers have been used to expand Medicaid in conservative states Summary: Allows Governor Kemp to make significant changes to Medicaid & private insurance in Georgia Medicaid Private insurance
- 35. Governor Kemp’s Medicaid plan • Covers only 50,000 (out of the 430,000) who are low- income • Expands coverage to only those making up to the poverty line • Creates illegal paperwork requirements* • Requires that enrollees pay premiums or be disenrolled* • Removes transportation for people who need it to get to appointments* • Georgia will pay 3x more per
- 36. Gov. Kemp’s Medicaid plan
- 37. Gov. Kemp’s private insurance proposal • Threatens comprehensive coverage for 417,000 Georgians • Dismantles healthcare.gov • Limits the amount of financial help available for low- & middle-income consumers • Does not require insurance plans to cover all essential health benefits
- 38. Gov. Kemp’s private insurance proposal
- 39. Medicaid expansion would cover more people at lower cost
- 40. Send an email to Governor Kemp and your state legislators in support of Medicaid expansion To find out who your legislators are visit: HealthyFutureGA.org “Get Involved” tab Contact Your Legislator Sign up for email updates at CoverGA.org Share your coverage gap story Advocacy opportunities
- 41. 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?
- 42. Advocacy Resources • Georgians for a Healthy Future— healthyfuturega.org – Georgia Health Action Network – Consumer Health Advocates Guide – FB & Twitter: @healthyfuturega – Events— healthyfuturega.org/events • Georgia Health News— georgiahealthnews.com • Georgia General Assembly— legis.ga.gov • Georgia Council on Developmental Disabilities
- 43. Join the Georgia Health Action Network Invite us to present in your community Vote! Share your health care story with us Advocacy opportunities
- 44. Thank you! 50 Hurt Plaza SE, Suite 806 Atlanta, GA 30303 Phone: 404-567-5016 Fax: 404-935-9885 info@healthyfuturega.org healthyfuturega.org FOLLOW & SHARE Alyssa Green Outreach & Education Manager agreen@healthyfuturega.org