0

Critics of state health plan take message to Capitol

Benefit plan covers 650,000 state employees, teachers, other school personnel, retirees and dependents

Jennifer Ludlum displays her out-of-pocket medical costs. (Special photo)

Jennifer Ludlum displays her out-of-pocket medical costs. (Special photo)

ATLANTA: Jennifer Ludlum, a Gwinnett County educator, wore a sign around her neck Tuesday with a number on it: $3,455.09.

That amount, she said, represents her out-of-pocket medical costs so far in 2014, for a visit to her neurologist, an MRI –- she has multiple sclerosis –- and surgery for her daughter.

“That’s more than I make in a month,’’ said Ludlum, who pointed out that she has the Gold option, with the highest premiums, as a member of the state health plan for state employees and educators.

Ludlum was among the roughly 100 people who rallied on the steps of the state Capitol on Tuesday to protest the changes implemented this year to the State Health Benefit Plan. Those changes have sparked a groundswell of criticism from thousands of Georgians about a lack of choice of insurance plans and higher health care costs.

The rally was organized by a Facebook group of teachers, state employees and retirees that has grown to 14,000 members. Ashley Cline, founder of the group, called Teachers Rally to Advocate for Georgia Insurance Choices (TRAGIC), told the crowd that state officials chose budget savings over the welfare of state employees with the health plan changes.

“We are hurting, we are angry, we are not going away, and we deserve to be able to take care of our own families while serving the families of Georgians in a variety of occupations,’’ said Cline, the wife of a Cherokee County teacher. Therapy visits for the couple’s daughter cost much more under the Jan. 1 changes.

Tuesday morning, the group of activists placed apples on the desks of General Assembly members with “TRAGIC” printed on them. The crowd wore green to symbolize both money and illness, Cline told GHN.

TRAGIC members placed apples on legislators’ desks Tuesday. Photo by Holly Sasnett

The State Health Benefit Plan covers 650,000 state employees, teachers, other school personnel, retirees and dependents.

Employees have complained about being given only the choice of a health reimbursement arrangement (HRA) from a single insurer, Blue Cross and Blue Shield of Georgia.

Cindy Deane of Cherokee County, who attended the rally along with her husband, told GHN that the drug she has been taking for her neurological condition has been effective for about a year.

But since Jan. 1, she has had to purchase the medication out of pocket –- for $650 a month — because unlike last year, it has not been approved under the health plan.

“It has been denied repeatedly,’’ Deane said. “I would not be able to work without this medicine.”

The protests since Jan. 1 have made an impact on the leadership of the state.

Last month, Gov. Nathan Deal said the members of the health plan could see more choice of insurance providers for 2015. And the Georgia House on Monday passed a budget for fiscal 2015 that said the board of the Department of Community Health “shall contract with multiple statewide and regional vendors for any SHBP plan offered in Calendar Year 2015.”

Meanwhile, the board of the Department of Community Health, which approved the plan that caused so much controversy, took action last month. It called a special meeting and OK’d a plan to replace the current co-insurance — a patient paying a percentage of the costs of a health service — with a co-pay system for medical services and prescription drugs.

The co-pays are expected to begin by mid-March and will be retroactive to the beginning of the year.

Deal, in a statement last month about the response, said, “We heard our state employees and teachers and we listened.”

A spokesman for Deal, Brian Robinson, said in a statement Tuesday, “The governor recently announced the state would spend an additional $100 million to the State Health Benefit Plan so we can expand options and return to the co-pay system that employees prefer.”

Where does it go from here?

Educators at the rally called the co-pays helpful, but said they were not enough.

“It’s a good Band-Aid but not a solution,’’ said Leon Bowers, a middle school teacher in Floyd County who took a personal day to attend the event.

Bowers told GHN that the combination of teacher furloughs, frozen salaries and benefit changes have created a need for more state funding for public education. He said he has already gone through the money set aside in his HRA this year.

Sarah Lesley, a Henry County school counselor, said she, too, has used up her HRA dollars for the year. They went to prescriptions and X-rays for her daughter’s soccer injury. She noted that the state has in the past used SHBP reserves “to balance the state budget.’’

Cherokee County teacher Jamie Wills addressed the rally and told about having to switch her children from their longtime pediatrician because that doctor was not part of the Blue Cross network. She wondered about how the switch to co-pays will affect members’ costs.

“We’re left with more questions than answers,” Wills said.

This being an election year in Georgia, political experts say the uproar over the plan changes could have an impact on voters.

That sentiment was voiced by Cobb County teacher John Palmer, who made the closing remarks at the rally.

“You have a choice in your vote,’’ Palmer said. “I intend to vote for candidates who stand for us instead of against us.”

Blue Cross said in a statement Tuesday, “We will continue to administer the SHBP in a way that provides cost savings and true value to the state while also helping members get the most out of their coverage. Members are also welcome to nominate a physician for inclusion in the network.”

The Blue Cross statement also addressed the issue of a choice of insurers. “Some think adding more carriers would bring down costs,” it said, “but the opposite effect would actually occur. Doing so would only drive up administrative costs for state government. We’re confident that we’re the right partner to administer the plan because of our expertise executing a variety of plans across the country.”

Andy Miller is editor and founder of Georgia Health News.