AMA urges rejection of Georgia Access Model under waiver proposal
Last week, the AMA submitted comments to CMS opposing Georgia’s waiver proposal under Section 1332 of the Affordable Care Act (ACA) and echoing many of the concerns expressed by the Medical Association of Georgia on the proposal.
The “Georgia Access Model,” proposed under the waiver, would end access to HealthCare.gov in Georgia, and rather than replace it with another centralized marketplace, would disperse marketplace functions among individual health insurers and private brokers throughout the state.
In addition to threatening access to marketplace plans, the plan would decrease Medicaid enrollment as nearly 40,000 Medicaid-eligible Georgia residents relied on HealthCare.gov to redirect them to Medicaid coverage this year. The AMA anticipates that the Georgia Access Model will increase enrollment in non-ACA compliant plans, such as short-term limited duration insurance (STLDI), as brokers offer these subpar plans alongside comprehensive plans and may receive higher commissions for enrolling consumers. All this would significantly decrease access to, and enrollment in, comprehensive health insurance resulting in more uninsured and underinsured individuals in Georgia. Stakeholder comments can be viewed here.
New overdose and treatment research highlights need to remove barriers to evidence-based care
As part of the AMA’s advocacy efforts to support evidence-based care for the treatment of substance use disorders (SUD), the AMA has updated its resource on select 2020 research concerning the nation’s overdose epidemic. This includes:
- Findings in Molecular Psychiatry that compared to Caucasian patients, African Americans diagnosed with COVID-19 and a SUD had greater mortality and hospitalization rates.
- A research letter in JAMA that found only 29% of treatment programs offered and would support continuation of opioid agonist treatment (OAT). Nearly 40% “did not offer OAT or were unclear about whether OAT was available,” and more than 20% “actively discouraged callers from using OAT.”
- A study in the Journal of Addiction Medicine that found “inpatient receipt of MOUD was associated with a decreased risk of ‘against medical advice’ discharge.”
- A secret shopper study in JAMA that compared access to buprenorphine-waivered clinicians and Opioid Treatment Programs for women with private insurance or Medicaid and found, among other things, that “with both buprenorphine-waivered prescribers and OTPs, insurance was associated with appointment access.”
The AMA resource also includes links to August research from Health Affairs and the U.S. Government Accountability Office.
