Georgia's Universal Coverage Solution

Georgia SecureCare would cover all Georgians under a single uniform, fair health financing plan administered and funded by the State. SecureCare would replace all current public-sector insurance systems including: Medicare, Medicaid, PeachCare, CHAMPUS and the Federal Employees Health Benefits Plan (FEHBP). It would also replace private health insurance plans in the state. The program would be financed with current government health care funding for discontinued programs, a payroll tax to replace employer benefits plans and other dedicated revenues (i.e., taxes) on households.

The SecureCare benefits package covers a broader range of services than are now covered under many private health plans. The program would cover hospital inpatient and outpatient care, emergency room visits, physician services (including preventive care), medically necessary prescription drugs, lab tests, mental health and addictive disease treatment, eyeglasses and other services. The program would also cover long-term care services including nursing home (except room and board) and home and community based services (HCBS), with an emphasis on services that enable patients to remain in the community. Dental care would be covered along with vision exams. It would not cover cosmetic surgery, cosmetic orthodontia and private hospital rooms.

There would be no deductible or co-payments for services under the program. The program would use a primary care provider referral model where all patients are encouraged to select a primary care provider. Only in instances where a patient chose a non-referred specialist would a co-payment of $25 be incurred. No co-pay would apply for specialist referrals made by the primary care provider. Benefits that are currently provided to Medicaid eligible people that would not be covered under the SecureCare program would be continued for low-income people who qualify for the existing Medicaid program such as nursing home room and board for low-income people (including spend-down) and therapeutic services provided by schools for income eligible children.

SecureCare Benefits

The plan would cover the following services:

• Inpatient/outpatient hospital care;
• Emergency room services;
• Physician office visits;
• Primary care and chronic disease case management;
• Patient education;
• Specialist services;
• Regular physical exams;
• Nurse practitioner services;
• Physician Assistants;
  
• Well child care;
  
• Immunizations;
• Emergency transportation;
• Prescription drugs;
• Durable Medical Equipment;
  
• Mental Health including inpatient /outpatient hospital; psychiatrists; and
  psychologists;
• Addictive disease treatment;
• Rehabilitative therapy services including: Physical therapy; Occupational therapy; and Speech therapy.
• Dental care except orthodontia;
• Vision Care including: Optometry; and Eyeglasses (1 pair per year; basic).
• Podiatry;
• Chiropractic;
  
• Midwives;
  
• Long-term care services including: Nursing Home care except room and board; and Home and community based services (HCBS).
• Skilled nursing facilities (as alternative to continued hospitalizations);
• Hospice services.

SecureCare Financing

SecureCare will be financed with current government funding for discontinued programs ($12.8 billion), a payroll tax to replace employer benefits plans, other revenues, premiums, deductibles, co-payments and other cost sharing.

Specific new revenues include:

• An increase in tobacco taxes of $0.50 per pack with proportionate increases in taxes for other tobacco taxes ($215 million);
• An increase in taxes on alcoholic beverages ($52 million);
• An increase in the state sales tax on non-grocery items of one percentage point (i.e., one penny tax per dollar of taxable purchases). This would raise about $1.25 billion;
• An income tax payment for all Georgians computed to be equal to about 22.2 percent of each Georgia taxpayer's federal income tax ($6.0 billion);
• An employer payroll tax equal to 9.1 percent of wages and salaries for all employees ($14.2 billion).

Publications: Executive Summary

GA SecureCare Analysis by The Lewin Group

GA SecureCare One-Page Brochure