Insurer uses full-court press to regain state contract

The ad says that Georgia’s workers, teachers and retirees are being stripped of their choice of health care plans and that citizens should rise up and condemn this threat to liberty.

What the ad doesn’t say is that it is less about freedom than hundreds of millions of dollars for one of the biggest insurers in the state. It doesn’t say that UnitedHealthcare, which is behind the campaign, lost a big state contract to its rival Blue Cross and Blue Shield of Georgia, and that United wants it back. It doesn’t say that United has taken the state to court, that it is accusing the Department of Community Health of “state-sponsored bid rigging” or that it’s backing campaign-style commercials to try to enlist your help in winning back the business.

UnitedHealthcare is using the same tactics candidates typically use to win elections, running social media and TV campaigns to persuade the more than 600,000 teachers, employees, retirees and dependents on the State Health Benefit Plan to put pressure on Gov. Nathan Deal, lawmakers and agency board members. One lawmaker said United is leaving the impression that officials are promoting a kind of Obamacare, considered a slur by Republican leaders who run the state.

“I’ve never seen anything like it,” said Robert Highsmith, a statehouse lobbyist and lawyer representing Express Scripts, which won the Department of Community Health’s contract to provide pharmacy benefits to the group.

Bill Jordan, an attorney representing UnitedHealthcare, said, “State policymakers and Georgia taxpayers need to understand the adverse impact DCH’s decision to eliminate choice for Georgia’s teachers and retirees will have on hundreds of thousands of Georgia families.”

The campaign is being run through a newly formed entity called Taxpayers for Healthcare Choice. The paperwork forming the organization was filed by a lawyer in a firm representing UnitedHealthcare. United wouldn’t say who is bankrolling the organization, but it acknowledged it is part of a “coalition” behind Taxpayers for Healthcare Choice. Officials wouldn’t name any other coalition members, and the entity is protected by federal law from having to disclose its funding.

‘Obviously there is a lot of money involved’

The insurance giants are among the state’s most generous campaign donors. UnitedHealthcare donated $50,000 to a political action committee tied to Deal, and Blue Cross contributed $25,000. Combined, the companies, employees and law firms involved in the fight have contributed more than $700,000 to state candidates, party organizations and other state political groups since the start of 2012, according to an Atlanta Journal-Constitution review of campaign reports.

Government health care contracts are a big-money business. DCH, which provides health care to more than 1.8 million Georgians, will spend about $12 billion on public medical programs this year.

“Obviously there is a lot of money involved, which is why they are doing this,” said Steve Anthony, a Georgia State University political scientist. “This (advertising) is a just a business expense.

United and Cigna have been managing the State Health Benefit Plan. Last year, the state paid the companies more than $150 million to run the system, state officials said. In addition, companies running the plan become the sole provider for program retirees buying Medicare supplemental coverage, which can be a highly lucrative business.

DCH announced in July that Blue Cross and Blue Shield would take over the plan starting Jan. 1. The company is preparing to start enrolling people starting next month.

United argued that the bid was rigged to favor Blue Cross and Kaiser Foundation Health Plan of Georgia, which initially won a separate bid to offer HMO services in metro Atlanta. After The Atlanta Journal-Constitution wrote about the awards, Community Health Commissioner Clyde Reese rebid the HMO portion of the program.

However, the Community Health board this month rejected Kaiser’s latest proposal, picking up on UnitedHealthcare’s theme that all Georgia teachers, employees and retirees — not just those in Atlanta — should have greater choice in who will provide their health care.

UnitedHealthcare says that because there are now two big companies managing the plan, and there will be only one Jan. 1, employees and retirees have lost the ability to choose a provider and the business has become a monopoly. Blue Cross has said those in the plan will still have options.

United is awaiting a ruling from the community health agency on its latest protest, but it has also pushed the issue in court, using a team of lawyers that includes Randy Evans, Deal’s campaign lawyer, former Georgia Attorney General Thurbert Baker and Jordan, a former chairman of the state ethics commission. In court, they have been opposed by a team that includes top litigators from Atlanta and Chicago as well as two statehouse lawyer-lobbyists. Among them is Highsmith, a former counsel to Gov. Sonny Perdue.

‘A small group of politicians’

More unusual — and controversial — has been the campaign to take the issue to the public and politicians. The campaign has included routing calls from teachers, employees and retirees directly to the offices of state lawmakers on key committees and in key districts.

A video linked from social media sites asks citizens to contact Deal to “tell him all Georgians deserve the right to choose their own health insurance plans.” TV ads have been run during Atlanta Braves and Falcons games, accusing “a small group of politicians” of giving Blue Cross a “monopoly.”

Blue Cross officials declined comment for this story.

Jordan, the attorney representing United, said, “The state-sponsored bid rigging resulted in a monopoly for one insurer which decreases provider reimbursements, access to quality care and increases overall health care costs.”

That message hit home with some politically important constituents. More than 130,000 public schoolteachers and administrators live in Georgia, and they and their families were given credit for helping to defeat Gov. Roy Barnes in 2002 after he angered them by pushing a school reform package.

“Our members are emailing and calling and lobbying this issue,” said Calvine Rollins, president of the Georgia Association of Educators. “We hope the outcome will be different. Our members are concerned about not having a choice (of providers). Basically, when there are choices and competition involved, prices tend to be lower.”

Donald Palmisano, executive director and CEO of the Medical Association of Georgia, the doctors’ lobby, said much the same thing.

“Our concern is, when you have one insurance company that will provide coverage for the patients, that will drastically impact competition, which will impact access for patients.”

Doctors are also concerned because a memo on Blue Cross’ plans call for big savings, in part, by cutting payments to doctors, hospitals and other providers.

‘I think it is a little less than genuine’

Whether the campaign will have the intended effect remains unclear, but it has irritated another important constituency: state lawmakers.

House Appropriations Chairman Terry England, R-Auburn, said, “When you’ve got a company that is looking at losing a lucrative contract, your first instinct is to come out fighting.”

But he said the company isn’t giving teachers, employees and retirees the whole story. He said the group will get essentially the same insurance coverage, just provided by a different company, and that there will be choices of plans and thousands of doctors and health care providers within what Blue Cross offers.

England said the campaign is “upsetting people.”

“If they were honest and giving the folks all the information, then that would be different,” he said. “I think it’s a little less than genuine the way they are going about it. They are leaving people with the impression they are talking about Obamacare.”