State Health Plan Changes Get Cool Reception in Cherokee

In the wake of collective pushback from employees on changes to the State Health Benefit Plan that left many struggling to pay for doctor visits, the Georgia Department of Community Health hasunanimously approved a slew of revisions designed to give employees some financial breathing room.

The DCH's board on Monday approved changes that would reinstate a co-pay system for the roughly 650,000 employees participating in the plan. 

Employees will now be able to make co-pays for emergency room, specialists, urgent care and rehabilitation visits. The changes will go into effect on March 14, and will be retroactive to Jan. 1, the agency said on its website. Premiums, deductibles, out-of-pocket expenses and HRA contributions won't be affected, however.

Blue Cross Blue Shield will continue to administer the SHBP.

“While the original plan design approved in August...2013 focused on quality and affordable care, we could not ignore the financial distress created by the institution of cost sharing with our members,” Commissioner Clyde L. Reese III, Esq. said in a statement. 

With the vote now recorded in the history books, a Cherokee County-based organization created to take action after the initial changes sparked collective outrage is giving the revisions a cool reception.

TRAGIC, or Teachers Rally Against Georgia Insurance Changes, noted it will "reserve judgement" on the DCH board's vote, according to a press release posted in its Facebook group. 

“It is encouraging to see the governor (Nathan Deal) and the Department of Community Health address some of the shortcomings of the 2014 State Health Benefit Plan,” said Ashley Cline of Canton, founder of the group. “It does not address all of the shortcomings in the current plan, and we will have to examine the plan closely to see how it affects our members. However, we feel it is a step in the right direction. Hopefully, by shifting to co-pays for office and ER visits, state employees will not have to worry about going bankrupt if they become seriously ill or have an accident.”

Cline, whose husband is a teacher at Creekview High School, added she and the organization will be watching to see what happens in the near future. The lack of communication from DCH has been "problematic," and what she referred to as the resulting "finger pointing" has been "unacceptable."

That lack of communication, added Becky Stodola, a Mill Creek Middle School teacher and mother of a child who has to take medication on a daily basis, has been "very frustrating." 

Stodola said no one seems to have the answers on how much she has to pay for her child's medication, and "everyone who needs this medicine is reporting different amounts and problems."

For his part, Gov. Deal applauded the changes at the state level. 

"We heard our state employees and teachers and we listened," he added in a statement. "I appreciate the board and the commissioner’s willingness to work with me on a timely solution. I shared the concerns of state employees and teachers about the high costs they were having to pay out of pocket. I believe this new direction addresses the core concerns of our employees."

He noted in a news release the cost of the changes will be absorbed by SHBP revenues, and won't be passed onto employees. 

Deal added the DCH board "faced very tough decisions" last year as it grappled with "large new costs" brought on by the federal Affordable Care Act. He noted these changes are the same ones affecting companies in the private sector, "many of whom are tightening eligibility or dropping coverage altogether."

"In the next budget year for the state, the mandates in the ACA (Affordable Care Act) will cost the State Health Benefit Plan an additional $225 million." he wrote. "These costs will force many tough decisions in the years to come. I’ll continue to work to keep our best public servants with competitive salaries and the health." coverage their families need.”

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