Georgia’s community health department embraced a sharp change of course on abortion policy Thursday. It moved to end insurance coverage of the procedure in most cases for hundreds of thousands of public employees and their families.
Wading into a controversial subject typically left to elected politicians, health board members voted 5-3 to approve a benefit plan that will no longer cover abortions unless the life of the mother is in danger. The change begins next year.
Commissioner Clyde Reese, who recently took over the reins of the state agency, told the Atlanta Journal-Constitution after the vote that the provider of the coverage also will change. Reese said he plans to select Blue Cross and Blue Shield of Georgia to administer the $3 billion state health plan. The move replaces the plan’s current insurers — UnitedHealthcare and Cigna — which are fighting in court to halt the process. They claim the state unfairly spurned their bids.
Gov. Nathan Deal, who pushed his appointees to make the abortion change after lawmakers didn’t, said in a statement that Thursday’s vote “shows our state’s commitment to reducing the number of abortions in our state by ensuring that state taxpayers aren’t paying for a procedure that many find morally objectionable.”
Critics argue the change creates more obstacles for women in a state whose abortion laws already are some of the most restrictive in the nation.
“I’m furious. And I think every woman and enlightened gentleman in Georgia should be infuriated,” said state Rep. Pat Gardner, D-Atlanta. This is a decision for a family and their doctor, not for a governor to make.”
Currently, the state benefit program — which covers 650,000 state employees, retirees and their families — pays for abortions as it would for any other covered surgery. It has covered abortions since at least 2001.
The new restrictions are likely to please social conservatives who were upset after legislation to press the changes earlier this year did not pass. The Republican-controlled Senate voted along party lines to impose the abortion limits through a late amendment to an unrelated bill, but House lawmakers said they didn't have enough time to review the idea as thoroughly as legislation adopted last year banning elective abortions after 20 weeks of pregnancy.
House Speaker David Ralston said Thursday the “hastily crafted” legislation would have also banned necessary procedures, such as those a mother would undergo after a miscarriage. He said he’d support another legislative attempt next year to bar state insurance plans from covering elective abortions except if they are deemed medically necessary.
“The majority of Georgians do not support their tax dollars for abortion on demand and this direction reflects their will,” said Suzanne Ward, the spokeswoman for Georgia Right to Life. “Why would Georgians want to pay for what is truly not health care, but the destruction of human life?”
Reese, the community health department’s leader, said he was confident the new abortion rules were “legally sound.” But Page Pate, a defense attorney and legal analyst, said it appears to be an “end run” by Deal that encroaches on duties traditionally left up to the Legislature. That could set up a constitutional challenge that may not be resolved before lawmakers weigh in.
State data show that the number of abortions among state workers has fallen in recent years. Some 545 patients under the state plan sought abortions in fiscal year 2009, a figure that dropped to 366 in 2011. Net insurance payments for the procedure fell from about $343,000 to $213,000 in that span.
Georgia is among a number of states that have moved to restrict abortion coverage for public employees in recent years. Eighteen states limit coverage to some extent, according the Guttmacher Institute, a reproductive health and rights group.
Georgia’s move to eliminate coverage for all abortions except those that endanger the life of the mother puts it at the end of the spectrum, said Sharon Levin, director of federal reproductive health policy for the National Women’s Law Center, a reproductive rights group. Other states allow coverage for abortion in the case of rape and incest.
Levin said she sees Georgia’s decision as part of a nationwide attempt to restrict access to abortion by limiting how women can pay for it. “It really comes down to the state as women’s bosses making their health decisions for them, instead of letting women make decisions for themselves,” she said.
The state’s plan to hire Blue Cross and Blue Shield to administer the health plan also marks a monumental change for its employees. The company declined to comment, but Reese said the proposal will help relieve state workers of the “double whammy” of the recession and higher health care costs. He plans to formally announce the award on Friday.
“The plan affords us the opportunity to regain solid fiscal footing,” he said. “We also feel that it will allow our members the opportunity to have reduced premiums at the same time.”
That will likely inflame an ongoing legal feud. UnitedHealthcare, whose contract to help manage the plan expires this year, claims in legal filings that the health department staged a secret bid to cut the company out of competition for the business. It said in a statement that more competition “drives innovation, quality and value.”
State health officials say the switch will save the state an estimated $200 million a year, giving lawmakers more fiscal leeway to consider, for example, teacher pay raises.
Tim Callahan of the Professional Association of Georgia Educators said he hopes the extra money would help teachers who have faced double-digit health insurance premium hikes in recent years, while salaries remained stagnant.
“I would like to see some of those savings result in reduced premiums and reduced out-of-pocket costs,” he said.
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