The state announced another round of major changes to the health care plan for 650,000 teachers, state employees, retirees and their dependents Tuesday, a little more than a month before the May 20 primaries that the group promised to influence.
The Department of Community Health said it will increase the number of companies managing the $3 billion State Health Benefits Plan and offer more coverage options, including HMOs, starting next year.
The announcement came in response to months of protests by teachers, state workers and retirees over plan changes made this year that limited their coverage options and dramatically increased out-of-pocket costs.
“We are encouraged that the Department of Community Health has responded positively to the outpouring of complaints regarding our 2014 health care options, and it appears as though our efforts will help bring back choice to the State Health Benefit Plan,” said Ashley Cline, the wife of a Cherokee County science teacher and founder of the 15,000-member Teachers Rally Against Georgia Insurance Changes, or TRAGIC.
“Offering teachers, retirees, state employees and their families more coverage and provider options in 2015 is a step in the right direction,” Cline said. “However, it is imperative that this is a trend that continues in 2015 and beyond — not just during an election year.”
Some members of TRAGIC said better coverage, not more companies providing the coverage, is what's needed.
The state increased out-of-pocket costs and reduced the number of providers this year in hopes of saving $200 million annually.
Those changes occurred in January, just before the General Assembly opened its 2014 session, and TRAGIC and other irate plan members immediately began contacting lawmakers and the governor, holding rallies and using social media to protest the changes. Plan members said they couldn’t afford to see the doctor, couldn’t afford or were refused the prescriptions they’d long been taking, and had to change physicians to get treatment covered.
Robby Richardson, a high school special education teacher in Savannah, said he stayed away from the doctor when he got sick because of the cost. He wound up nearly passing out in class and having to be hospitalized. Lula Hayes, a Cherokee County schools retiree on the plan said her oxygen tank deliveries were cut.
Gov. Nathan Deal, who faces re-election this year, responded by putting more than $100 million into the state budget in January to help reduce some of the high out-of-pocket expenses.
State lawmakers included language in the state budget for the upcoming year directing DCH to give members of the benefits plan more options.
The agency was sued last year when it limited the number of companies managing the main health care program to one, Blue Cross and Blue Shield of Georgia. UnitedHealthcare, which previously helped manage the program, accused DCH of "state-sponsored bid-rigging."
DCH Commissioner Clyde Reese said Tuesday that the agency will have an evaluation team review proposals for 2015, with a final decision coming over the summer. Deal announced two weeks ago that a teacher will be included in the evaluation team.
“The State Health Benefit Plan is looking to enhance member choice in the 2015 plan year,” Reese said.
Deal’s office put out a release later Tuesday saying the governor signed an executive order ensuring that a teacher be included in the evaluation group.
“It is critical that educators have a voice in the development process for shaping the health insurance plans available to them,” Deal’s order states.
Members of TRAGIC and teacher groups planned to be active this campaign season, with all statewide offices and 236 legislative seats up for grabs. The changes announced Tuesday could temper some of their anger over plan changes.
“We are pleased to see that the Department of Community Health has heard the concerns of teachers and other state employees and has decided to allow more company and plan options,” said Tracey Nelson, a lobbyist for the Georgia Association of Educators. “We now eagerly await the recommendations, and more importantly, the actual implementation of those recommendations for 2015. The SHBP is a key component of state employees’ quality of life, and we have to get it right as they all work on behalf of the citizens of Georgia.”
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