by Blake Caldwell, MD, Rosemary W. Mackey, MBA, & Diane Weems, MD
Don’t let Georgia fall behind! Georgia is one of only 12 states that still has not expanded Medicaid. This stalemate has left 560,000 Georgians uninsured and without affordable access to health care in the middle of a pandemic. It’s time for Georgia leaders to make the right choice and expand Medicaid. Medicaid expansion would provide coverage to Georgia’s low-income families, speed up our state’s economic recovery after COVID-19, stabilize rural hospitals, and reduce racial health disparities.
In the GA legislature, currently in session, there are 13 House Bills and 3 Senate Bills that we are following. In addition to advocating for Medicaid expansion, two bills which we believe are of high importance and need our advocacy are HB 72 – New Mother’s Medicaid Expansion Act & HB 49 – Mental Health Parity Act Their importance is as follows:
New Mother’s Medicaid Expansion Act (HB72)
Georgia is ranked as one of the worst states in the US in maternal mortality with recent data from the DPH demonstrating that between 2012-2016, there were 66 pregnancy-associated deaths per 100,00 births. 70% of these were preventable. Georgia can and must do better.
A Maternal Mortality Review Committee formed by the DPH made recommendations that were studied by The House of Representatives in the 2020 session which then sought approval from the federal government to extend Medicaid coverage for new moms from the current 2 months to only 6 months after birth. HB72 would extend the length of that coverage to 12 months which will insure longer post-natal care for the mother and help decrease the alarming number of maternal and infant deaths.
Mental Health Parity Act (HB49)
Although mental health parity is the law of the land, discrimination against people with mental illness continues to be the norm as “parity” receives, at best, the narrowest of interpretations. Some insurance companies pay the same amount for each office visit, regardless of specialty and that is the extent of their application of the federal law. In fact, even that is not always the case. For example
- Insurance covers physical therapy and rehabilitation for non-mental illness but usually balks at rehabilitation for mental illness, which is equally needed and vital to a successful and full recovery.
- Care coordination is routinely covered for diabetes, asthma, cardiac conditions, being recognized as necessary for maximum health and recovery. It is rarely covered for schizophrenia, depression, which are equally biological illness whose organ of involvement is the brain itself and for whom one may argue care coordination is even more vital than that needed for other organ systems or illnesses.
Additionally, most insurance companies require a person with a mental health diagnosis to be a danger to themselves or others before the hospitalization is covered. That means the patient must be maximally ill before a hospitalization will be covered and there is no provision for early intervention to prevent a worsening downward spiral or to stop the brain damage or the road to suicide before reaching desperation. HB49 will require that insurers’ treatment of claims concerning mental and substance use disorders are treated in parity with other health insurance claims and receive the critical care that they need.
ADVOCACY CHARGE TO ALL OUR MEMBERS – CALL OR WRITE
Our own state senator, who is one of the keys to movement on these issue. Tell Senator Ben Watson, who chairs the Health & Human Services Committee, that Georgians have been left behind but a New Year’s resolution to expand Medicaid will help our state catch up! and at the same time tell him how important it is to you that: (1) Georgia’s new moms, who need it get, Medicaid coverage for a full year and (2) that the legislature heads its own committee recommendation to make insurance companies provide the same coverage for a mental health diagnosis as they do for other diagnoses.
Ben Watson (R)
Chair, Senate Health & Human Services Committee
Office: (404) 656-7880
Sharon Cooper (R)
Chair, House Health & Human Services Committee
Office: (404) 656-5069