Southern Health Perspectives: First Edition


Welcome to the premiere edition of the Southern Health Perspectives newsletter, a product of Community Catalyst’s Southern Health Partners network. Southern Health Partners comprise a large and growing network of organizations in 12 Southern states working to advance health justice in the region and proactive state, regional, and national health care reforms.

The Southern Health Perspectives newsletter will highlight health care-related issues and trends in the South, provide updated information for health advocacy efforts in the region, and resources from Southern Health Partners and Community Catalyst. 

In This Issue:

How the South Enrolled Millions

By Amanda Ptashkin

As a region, the South made amazing strides in cutting the number of uninsured people. In both years of ACA open enrollment, nearly half of all uninsured people who obtained coverage live in just 12 Southern states. The South does have some highly populated states, but enrollment increased across the region, and we can identify themes and strategies in this upsurge that can help us understand how and why it occurred.

As of the end of February 2015, 11.6 million individuals have enrolled in Marketplace plans across the country. Of those, 5.3 million individuals purchased plans in the 12 Southern Health Partners (SHP) states. These numbers are all the more impressive given the often stark political opposition from administrations in these states and laws passed in several which restrict who can provide in-person assistance to consumers. Kentucky, which has embraced all key tenets of the ACA including Medicaid expansion, has seen a particularly dramatic drop in its uninsured rate from 20.4 percent to 11.9 percent. But even oppositional states experienced impressive drops. For example, 1.2 million Texans enrolled in Marketplace plans. In Georgia, enrollment was up 71 percent from the previous year and 540,000 Georgians obtained coverage during the second round of open enrollment.

The use of data in increasing the success of second year enrollment efforts in the South was key. Even with serious bumps and hiccups during the first round of open enrollment, the South still enrolled nearly half of all enrolled nationwide. Outreach partners in the region looked at the data from this effort, evaluated their successes and challenges, and then focused intensely on reaching particular communities and populations during the second year. Data helped them identify how consumers were connecting to coverage and where. This paved the way for establishing new and strengthening existing strategic partnerships in round two.  

Outreach organizations discovered that strategic partnerships and working directly with communities were essential in enrollment efforts. During round two, outreach tapped successfully into local networks and messengers like faith leaders already trusted by consumers. Using trusted settings like libraries, VITA sites and churches, advocates and assisters also were able to meet consumers where they lived and congregated, which helped simplify an often complicated enrollment process. 

Other factors contributed to this large increase of enrollees in Southern states. First, the website was vastly superior to the previous year’s. Another factor was word of mouth. Because millions of people already had purchased coverage during the first round of open enrollment, it was possible to share and publicize success stories. This put a face on the Marketplace and made it more accessible to the average person. Although it was expected that perhaps a majority of the second-year enrollees would be repeat customers, data from one recent report shows that in Georgia for instance, 55 percent were in fact new customers. Word spread.

Simply put, it’s now clear that that uninsured people in the South want coverage, and they want affordable access to doctors and hospitals for themselves and their families. While having access to insurance is not yet a guarantee of obtaining great care, the ACA has made it possible to ensure that millions of additional people have affordable health care coverage for the first time. If you build it, they will come, and in the South, they came by the millions.   

Resources and Tools

New resources and tools from Community Catalyst and the Southern Health Partners compiled from various sources. If you have a resource you would like to share in a future edition of Southern Health Perspectives, please email Amanda Ptashkin.


  • Policy Brief: This brief walks through some of the themes we’ve seen in recent 1115 waivers that have been approved by CMS.
  • Coalition Guide: This resource offers tips, tools, and best practices to use in preparing your coalition to respond to policy compromises and to potentially develop coalition principles for how to close the coverage gap.
  • Impact of the Coverage Gap on Hospital Finances: This policy brief illustrates the impact of the coverage gap on hospitals, such as uncompensated care costs, volume of uninsured patients and overall financial health to be able to keep their doors open for their communities.
  • Hospital and Advocates Engagement Strategies: This guide walks through some tips and best practices to prepare your coalition to get hospitals to the table, coordinate close the gap strategy and sustain these partnerships.
  • Medicaid Defense Tool Kit: This kit is a collection of tools and resources designed for advocates who are developing and implementing strategies to defend state Medicaid programs.


  • Check out this new video from Voices for Better Health. “Building Bridges to Better Health” emphasizes the partnership between advocates and geriatric providers. It is a great example of the power of strategic alliances with providers and how that relationship can strengthen the advocacy work of partners on the ground.

State Updates

Noteworthy activities and outcomes from a handful of Southern states.


Florida advocates have geared up for the legislature’s special session in June when legislators will work to pass the state budget and again debate legislation to close the coverage gap. Influencing this debate is the fact that on June 30th Florida’s Low Income Pool (LIP) program that helps hospitals cover costs for uninsured patients will expire. Florida advocates have shared reports on the impact the loss of these funds will have on hospitals serving low-income populations. For additional information on these reports, please visit Florida Legal Services’ website. Additionally, the Center on Budget and Policy Priorities recently released a report analyzing the issues around Florida’s LIP. 


On May 13th, Georgians for a Healthy Future released a new report, Getting Georgia Covered: Best Practices, Lessons Learned and Policy Recommendations from the Second Open Enrollment Period, and held an event to showcase their findings and bring together stakeholders from across the state to debrief the second enrollment period. The event featured: HHS Region IV Director Dr. Pamela Roshell, Lisa Stein of Seedco, Sarah Sessoms of Insure Georgia, Dante’ McKay of Enroll America, and Whitney Griggs of Georgians for a Healthy Future. To read the live tweets from the event, click here.


Efforts to close the coverage gap have not been able to move due to the opposition by Governor Bobby Jindal. Recent news out of the state indicates that lawmakers are warming to the idea of finding ways to close the coverage gap and to help struggling hospitals across the state as they prepare for a new gubernatorial Administration. A proposal backed by the Louisiana Hospital Association would allow for a hospital assessment to help pay for any costs connected to expansion starting in 2017. Advocates are monitoring the situation closely and finding ways to elevate the voice of consumers falling into the coverage gap, as well as the financial woes of struggling hospitals and communities.

North Carolina

Last year Mayor Adam O’Neal of Belhaven, North Carolina, walked from his eastern town all the way to Washington, D.C. to raise awareness for the need to close the state’s coverage gap. He planned this walk after the closure of the only hospital in Belhaven. This June, Mayor O’Neal will walk once again to the Capitol, and this time he hopes to have supporters from all 50 states walking with him for all or part of his journey. Southern Health Partners in Texas have recruited six volunteers to join The Walk at various points on its path from rural North Carolina to Washington. Partners in Tennessee are also working on holding events at hospitals that are in danger or have closed within Tennessee in solidarity with The Walk. To learn more about the walk or to find ways to support it or join in on the activities, visit


After two failed attempts to close the coverage gap through Governor Bill Haslam’s Insure Tennessee proposal, advocates are keeping up the pressure on legislators. The Tennessee Justice Center and the Tennessee Health Care Campaign will hold Town Hall meetings across the state throughout the summer. These meetings will illustrate the need to close the gap for the 280,000 uninsured Tennesseans by highlighting tangible impacts on consumers and their communities from lack of coverage. To learn more about these efforts, please reach out to the Tennessee Justice Center or the Tennessee Health Care Campaign

About Southern Health Partners

Community Catalyst supports Southern advocates’ use of a regional framework to improve health care access, affordability and quality, expand access to Medicaid, strengthen charity care and community benefit, and address substance use disorders and other local and state health policy issues. Partner states include: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas and Virginia.

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