Health plan critics see cause for hope

Print Friendly and PDF By: Andy Miller Published: Jan 24, 2014

A leader of a group of state employees and teachers critical of their health plan choices said Friday that she welcomed Gov. Nathan Deal’s suggestion that their options may increase next year.

Ashley Cline, creator of a Facebook group that has been a forum for complaints about the 2014 changes in the State Health Benefit Plan, told GHN that the governor’s comments represent progress.

A main criticism of the plan is that it offers only one insurer: Blue Cross and Blue Shield of Georgia. “We’re going in the right direction’’ if more options are a future possibility, Cline said.

Gov. Nathan Deal

Gov. Nathan Deal

Deal, in comments to the media Thursday, said it’s too late to add additional insurers this year. But he said the 650,000 state employees, teachers, school personnel, retirees and dependents taking part in the plan could see more providers for 2015.

“It would be nice, and I wish that we did have more than one provider available at this point in time,’’ Deal said. “We will work to make sure that does occur in the future. It is a one-year bidding cycle, and it will be opened up for rebidding for calendar year 2015.”

Also Friday, the Department of Community Health announced that it will hold a special meeting of its board Monday, and that 2014 State Health Benefit Plan will be the sole topic on the agenda.

A day after the new benefit plan took effect Jan. 1, Cline, the wife of a Cherokee County teacher, started the Facebook page to air complaints. That Facebook group now has more than 10,000 members, she said.

The group is called TRAGIC, or “Teachers Rally Against Georgia Insurance Changes.’’

She said Friday that it’s important not just to have more than one insurer, but also to offer different types of plans, such as an HMO, as options.

 

Ashley Cline and her family

Ashley Cline and her family

“I want to know more. It’s going to have to be spelled out,’’ Cline said. “We need our options and affordability as well.’’

Deal partly blamed the federal Affordable Care Act for the uproar over the rising costs of care.

But Cline said Friday that Georgia budget writers in the past have raided the financial reserves of the SHBP in order to balance the budget. She said she would like to see legislation to prevent that from happening again.

Cline has said that under the new plan, her family’s cost for occupational therapy for her 4-year-old daughter has soared to $130 a week. The deductibles and premiums are high as well, she said.

The group has flooded the governor’s office, Department of Community Health and legislators’ offices with complaints.

Controversy over the State Health Benefit Plan first erupted last year, after the agency chose Blue Cross to provide a statewide health plan for members of the SHBP.

The award was quickly appealed by a competitor, UnitedHealthcare, which called the contracting process “state-sponsored bid-rigging.’’ The Department of Community Health, which runs the SHBP, strongly denied the claim of unfairness and dismissed the appeal. (United still has a complaint pending in Fulton County Superior Court.)

And in September, the Community Health board unexpectedly rejected a proposal to offer an HMO option to state employees in seven metro Atlanta counties. The vote reflected opposition to offering a choice of health plans in metro Atlanta if such a choice was not offered in other areas of the state.

In October, Blue Cross emphasized at a hearing that its contract would save the state more than $1.5 billion overall. Community Health told the Marietta Daily Journal that the plan would save an estimated $200 million this year.

Yet medical providers at that time expressed concern that they would get lower payments if there was a single statewide insurer for the SHBP, especially given the level of savings that the state was expecting.

SHBP members have been given given a choice of Bronze, Silver and Gold plans under what’s officially known as a Health Reimbursement Arrangement.

The TRAGIC group is planning a rally at the state Capitol on Feb. 18.

 

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