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Health Insurance

Agreement smooths way for autism bill

The impasse over Georgia’s autism coverage bill has ended.

A compromise between House and Senate leaders, announced Thursday, would clear the way for a vote on the measure before the General Assembly session ends next week.

And the first legislative step came Friday morning, with approval of a newly reworked bill by the Senate Insurance and Labor Committee.

Rep. Richard Smith

Rep. Richard Smith

The compromise occurred only days after the autism legislation appeared stuck and probably doomed in the House Insurance Committee.

Senate Bill 1 would require many health insurance plans to cover applied behavior analysis (ABA), a treatment designed to help young children with autism reach their full potential in learning ability. The legislation would apply only to children 6 and under, and would not require coverage by large companies that self-insure their benefits.

A similar bill was unable to win approval last year, blocked in a standoff between the Senate and the House.

At the beginning of the week, it looked as though this year’s autism bill would also fail. full story

Autism bill appears stalled in Georgia House

The fight over autism treatment coverage continued in a House committee hearing Monday, pitting organizations concerned about costs against those advocating for the most effective services for children.

Sen. Charlie Bethel

Sen. Charlie Bethel

Senate Bill 1 would require many health insurance plans to cover applied behavior analysis (ABA), a treatment designed to help young children with autism reach their full potential in learning ability.

The issue is contentious. A similar bill was unable to win approval last year, stymied in a standoff between the Senate and the House. And the House Insurance Committee hearing concluded Monday with no vote taken on the bill.

The General Assembly session is expected to end next week.

One in 68 children has been diagnosed with autism nationally, with a Georgia rate of 1 in 64.

Sen. Charlie Bethel (R-Dalton), the legislation’s main sponsor, told the House panel that autism “is a public health crisis in all of our communities.”  full story

Kaiser repeats as region’s top health plan

A study by J.D. Power again ranks Kaiser Permanente  No. 1 in customer satisfaction among health plans in the three-state region that includes Georgia.


It’s the sixth straight year Kaiser has topped the rankings in the South Atlantic region, which also covers North Carolina and South Carolina.

The 2015 J.D. Power study measures satisfaction among more than 31,000 members of 134 health plans in 18 regions in the United States. It analyzes six factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service.

Satisfaction is calculated on a 1,000-point scale.

Kaiser’s score of 718 in the South Atlantic region was followed by Aetna (703) and Cigna (690). full story

Devil’s in the budget details for state workers

The budget issue that has most rattled the General Assembly this year involves the proposed elimination of health insurance for 11,500 part-time school employees, mainly bus drivers and cafeteria workers.

Gov. Nathan Deal, defending the insurance cut for these “non-certificate” school workers, argued that it’s a matter of fairness to other state employees who work part time but don’t qualify for benefits.

The Georgia House, feeling the heat from the public over the unpopular proposal, put the benefits for the non-certificate workers back into the budget. But the legislators shifted that cost – more than $100 million – to the local school districts. That sparked a new outcry.

1280px-ICCE_Fist_Student_Wallkill_busAnd as the debate continues about who should pay these costs, a state document circulated by a Georgia blogger has raised eyebrows about what the State Health Benefit Plan (SHBP) is saving under its current insurance setup.

The document was generated in 2013 by the Department of Community Health, which runs the SHBP. According to the document, the projected savings of the switch to a single health insurer was to be $1.8 billion over three years – for 2014, this year and next.

“Some folks seeing [the savings document] for the first time are starting to question it,’’ says John Palmer, a leader of the group Teachers Rally to Advocate for Georgia Insurance Changes. The group, known by the acronym TRAGIC, helped push for changes in the state health plan last year.

“People want some answers,” Palmer says, adding that state leaders “keep saying the sky is falling with the budget.”  full story

A few words could affect millions of people

Benjamin Wills of Atlanta is among the more than 400,000 Georgians receiving a subsidy to afford health insurance in the Affordable Care Act exchange.

With the subsidy, Wills is paying a monthly premium of $370 for family medical and dental coverage through the exchange.


Benjamin Wills

If he loses the subsidy, Wills said Wednesday, he could be forced to drop his family’s dental coverage, and perhaps re-enroll his daughter in the government PeachCare program.

“The way [the ACA] is now is working for our family,’’ said Wills, who recently left a job with benefits to start a private Christian school in Atlanta.

The fate of the insurance subsidies – and the future of the Affordable Care Act in general – were on the line as the U.S. Supreme Court heard arguments Wednesday on the legality of the credits in the exchanges in Georgia and 36 other states.

This case, King v. Burwell, is not officially a challenge to the ACA. Instead, the plaintiffs in the case say the law is not being followed. They argue that the subsidies, which help people afford coverage, are not permitted by the health law in the 37 states that have federally operated insurance exchanges.

After more than an hour of arguments in the case Wednesday, the justices appeared divided over the subsidies issue. full story

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