State to give teachers, workers and retirees more health care choices

Sept. 22, 2013: A 60-second "Freedom Means" commercial runs during the Atlanta Falcons game. The ad says that Georgia's state 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. You can view the 60-second "Freedom Means" commercial at www.youtube.com/watch?v=7PT3ntF7fyU. The spot, bought by a group whose backers include UnitedHealthcare, does not mention UnitedHealthcare. It says the spot was "paid for by Taxpayers for Healthcare Choice Inc." and refers viewers to a website called myhealthcarechoice.org.

Nov. 7, 2013: DCH Commissioner Clyde Reese upholds his agency’s decision to award the contract to Blue Cross and Blue Shield. The company has already started enrolling teachers, employees and retirees for the upcoming year. UnitedHealthcare officials have filed suit and will now fight the award in court.

Jan. 1, 2014: Blue Cross and Blue Shield takes over the health plan.

Jan. 12, 2014: Teachers Rally Against Georgia Insurance Changes, or TRAGIC, starts a Facebook page to organize opponents of the change.

Jan. 25, 2014: Gov. Nathan Deal signals that he will support changes to the health plan. The DCH will call on the health board to add HMO-managed care features to the plan and reinstate co-payments many teachers and employees preferred, cutting out some big out-of-pocket costs. Participants in the plan have complained about higher out-of-pocket costs and fewer health care options since Blue Cross and Blue Shield of Georgia took over the plan.

Jan. 27, 2014: Spurred by angry teachers and a governor seeking re-election, the DCH board agrees to spend about $114 million to restore co-pays in its new health care plans for state workers.

April 15, 2014: The state announces another round of major changes to the health care plan, a little more than a month before the May 20 primaries that a group of teachers, state workers and retirees promises to influence. The DCH says it will increase the number of companies managing the $3 billion State Health Benefit Plan and offer more coverage options, including HMOs, starting next year.

July 1, 2014: The state announces that UnitedHealthCare and Kaiser Permanente will also offer health insurance to state employees next year.

Hoping to supress an election-year fire, Gov. Nathan Deal and the Department of Community Health announced Tuesday that 650,000 teachers, state employees, retirees and their dependents will get more health insurance choices next year.

Members of the State Health Benefit Plan will see several new offerings and three providers in 2015. That’s a major change from this year, when the DCH offered limited coverage plans through one company, Blue Cross and Blue Shield of Georgia, in hopes of saving the state big money.

That decision to change the plan substantially for 2014 has caused a major headache for Deal at an inopportune time — when he’s running for re-election.

His opponents called the latest changes announced Tuesday an attempt by the governor to put out a political fire he started. Teacher groups were cautiously optimistic while noting that they still don’t know key elements of the new plans, such as their cost and what would be covered.

“The important takeaway in this instance — and we hope it isn’t just an election-year ploy — is that the governor and the DCH actually listened and responded to the concerns of their employees,” said Tim Callahan of the Professional Association of Georgia Educators, the state’s largest teacher group. “If that two-way communication becomes a trend, health care may cease to become such an annual bone of contention for everyone.”

The $3 billion-a-year insurance plan has been a thorn in Deal's side since last summer, when the contract to manage the program for 2014 was awarded to Blue Cross and Blue Shield of Georgia. That prompted one of the companies that had been managing the plan, UnitedHealthcare, to sue the state, arguing that the DCH had resorted to "state-sponsored bid-rigging" to steer the contract to Blue Cross and Blue Shield.

To save money, the state limited the insurance offerings to three plans, with different deductibles and premiums, along with higher out-of-pocket costs.

Once those higher costs started kicking in, teachers, state employees and retirees revolted, forcing Deal and the DCH to backtrack and add back lower co-payments for services, costing more than $100 million.

The extra money, however, didn't solve all the plan's problems, and teachers and retirees called for more choices and better coverage. A class-action lawsuit was filed in May arguing that thousands of plan members had been overcharged on their premiums.

A Facebook page for TRAGIC — Teachers Rally to Advocate for Georgia Insurance Choices — has become a home for thousands of plan members to vent about their health care coverage, with many pledging to vote against Deal this fall.

Under the changes announced Tuesday, UnitedHealthcare and Blue Cross and Blue Shield will offer statewide HMOs while Kaiser Permanente will offer a plan in metro Atlanta in 2015. UnitedHealthCare and Blue Cross and Blue Shield would offer other types of plans as well.

Morgan Kendrick, the president of Blue Cross and Blue Shield of Georgia, said his company expected competition last year, so the changes now aren’t a big surprise.

“We were expecting others to be involved,” he said, “so it’s kind of business as usual.”

In a statement Tuesday, Deal said, “The Department of Community Health has provided plan members with more new choices to find the health care plan that’s best for their families.”

Bryan Thomas, spokesman for Deal’s Democratic opponent, state Sen. Jason Carter, said the governor is merely trying to fix a costly mistake.

“Yet again, the governor wants credit for cleaning up a mess that he made,” Thomas said. “Teachers won’t be fooled by this election-year pandering.”

John Palmer, a Cobb County middle school band director and member of TRAGIC, called Tuesday’s announcement “a good first step in rebuilding trust between the state of Georgia and its teachers, employees and retirees.

“This addresses one of our many concerns about the (health benefit plan), and we will be watching to see details, such as the amount of deductibles, the size of the provider network and the scope of the pharmacy benefit,” he said.

“Teachers and state employees have trusted the DCH and state officials and legislators to make good decisions involving our health insurance and benefits for decades,” Palmer said. “Now, however, we realize that we must remain vocal and vigilant about our benefits moving forward.”