Posted: 12:36 pm Sunday, January 26th, 2014

The messaging battle over changes to state health care plan 

By Greg Bluestein

State health officials are readying big changes to the state’s new health care plan in response to the outcry from some of the 650,000 teachers, public employees and others covered by the policies. But behind the scenes, a debate is raging over how to explain them.

The argument from Gov. Nathan Deal and other conservatives is that President Barack Obama’s health care overhaul is partly to blame for the rising costs and fewer options under the new state plan. Deal said as much last week, and some Republican lawmakers are using the tumult to push legislation that seeks to exempt the state health plan from changes under the Affordable Care Act.

Another example is the newsletter state Rep. Jason Spencer, R-Woodbine, sent to constituents this week, which warned of a $63 tax per insurance policy under the federal health care changes:

“This is ONE of MANY reasons why your state health benefits plan insurance premiums, deductibles and co-pays are increasing. This increase is a result of the federal government trying to COMANDEER the assets of the state of Georgia and infringe on our sovereignty.”

Democrats and their supporters reject that notion. The left-leaning Georgia Budget and Policy Institute released an analysis Friday that said the governor “scapegoated” Obamacare to mask the state’s unpopular switch to a single healthcare provider.

The analysis, by Tim Sweeney, argued that the changes required, such as more preventive services and the ability to allow parents to keep their children on their health insurance plan until they’re 26, “can hardly be thought of as harmful to plan members.” Said Sweeney:

“The ACA is a politically charged issue here in Georgia, so it is not surprising when employers try to hide behind the law to deflect responsibility for the health care decisions they make. Georgia’s decisions to offer plans from just one insurance carrier and to offer only high-deductible plans at that, were not forced upon it by decisions in Washington.”

As we noted on Friday, both parties tend to listen when teachers get angry. Especially when it happens to be an election year. And regardless of whether the changes likely to be approved on Monday satisfies them, expect to be hearing about the fallout until November.

138 comments
SouthernHope5
SouthernHope5


I work at a small/medium company that's 4 years old. 3 years ago, we renewed our Humana plan..the rep came in to explain why monthly rates would be going up....the reason was something like yada yada....2 years ago, rates went up...the reason was whatever. The rep returned last week. Rates are going up. Why? Obamacare....lots of words...not our fault. 

All this insurance bellyaching is totally bogus....Obamacare is just convenient excuse for this year.  

Joeleejohnson
Joeleejohnson

I suspect your last paragraph "listen when teachers get mad" was copied from Roy Barnes' memoir.

Dismuke
Dismuke

Before blaming ACA , maybe we should look back  to pre-ACA times (last year), when Deal and co. shifted a larger percentage of insurance costs onto the individual.  ACA didn't cause this cost increase, Georgia Republicans did.  And ACA did not make Ga. choose this lousy health care plan.  



Hera
Hera

I am so tired of government workers pissing and crying over their perks not being good enough.  Live in the real world where there are no pension and if you do a less than great job ten people are waiting to take over your position.  If you don't like government work come on out of your palace paid for by ME and the rest of the private sector employees and get another job.  Stop taking my hard earned wages in the form of MORE TAXES and pay for your own insurance. 

cletis
cletis

has the comment section been changed to a boxing ring ,or discussion forum these two creeps need to go to the waffle house parking lot and duke it out and move on if there able ,clearly  they are tech grads !

btn
btn

GOP Government decides to remove free market competition from state insurance plan,  blames "socialist" President for healthcare problems.


This seems like a well thought out plan...

td1234
td1234

Well teachers and state employees you will win this battle tomorrow but the real question is are you ready to suffer the consequences for your actions and lose the war if/when Deal gets re-elected? 


Deal has proven to have a long memory and has proven he is ready, able and likely yo retaliate against those that do not go along with his plans. He cut half the budget of the State Department of Education for Dr. Barge's opposition to the Charter School Amendment. He took Voc Rehab away from Mark Butler at the DOL for his refusal to place Deal people in key positions. These people were Republicans what do you think the retaliation will be against Teachers and state employees when he will never again have to face the voter? 


For you Democrats that actually believe that Carter can win in November, you are kidding yourself. There is no way he can win in this Red state when the election is going to be about Obama and Obamacare. The best Carter will do with huge support of teachers is turn a 10 point defeat into a 5 point defeat. 


If Teachers and State employees unite and lose their party label then they have a chance to get Deal out of office in the primary by voting for Dr Barge. In 2010 Deal won the primary by receiving 291,000 votes out of 550,000 primary voters in a normal low turnout primary. IF 45 to 50% (way more than the normal turnout) of the 650,000 insurance covered teachers and state employees voted on May 20th in the Republican primary then Barge could win and send Deal into retirement. 

Point
Point

Also in the discussions of the DCH last August they were going to make a direct appointment of a company to provide an HMO option in a 7 county metro Atlanta area...so HMO ' S are too pricey for the rest of the state?

Like I said before they better check the fertilizer they already spread or its going to look like they signed up for a lobotomy.

Wascatlady
Wascatlady

To make people more careful with their use of health resources?  Tell me anyone not on Medicare or Medicaid that goes to the doctor or hospital because they are lonely?  That tells more about the person saying it.  And the idea that people get sick on purpose?  Obsurd, and pathetic to say the least.


On other points on this thread:  You cannot get the subsidy if your employer offers compliant plans.


And, EVERYONE pays taxes:  Sales taxes and property taxes, at least, unless you live in a monastery or prison or inside a church or on National Forest land.  Those are the only people who get by without paying property taxes (sometimes for the owner of the property, if not you.)  Oh, and the dead don't pay property taxes.


Here in Georgia you can get out of paying income tax if you contribute to one of those private school scholarships!  Those are not the "moochers"  (poor) doing that!

MaryElizabethSings
MaryElizabethSings

Watch "On the Story" on public television at 7 p.m. Mondays through Thursdays while Georgia's Legislature is in session to know what is going on under the Gold Dome.

MaryElizabethSings
MaryElizabethSings

Teachers, be wary. It seems that everything today that goes wrong, politically, is blamed on the ACA, or Obamacare.  Look after your own interests. It appears that Georgia's Republican dominated state leadership will not look after your interests unless you call their hand, and let them know that you know what is really going on politically.

Bernie31
Bernie31

This Trojans3 Guy is a Piece of Work! clearly sent here to LIE, Confuse and Distort.  The real Person of Blame  is Kasim Reed's Political  Daddy...Dear Leader Nathan "cannot get a Break Ethically" DEAL!

Point
Point

Oh the spin!! These people better remember the lie they already told.  Note to Republicans pushing legislation to exempt SHBP.  The plan was grandfathered and did not have to make changes. Stop before you make yourselves look too ignorant and out of touch.

Children until age 26 could be on parents plan always as long as they were full time students.

The $63 is not instituted this year so does not apply.

DCH presentation states ACA accounts for 2% increase.  We got stuck with much more than that.

This was done intentionally but thought they could fly under the radar and point at Obama.  Why not? It's worked all the other times.

Did ACA cause bid-rigging also?  Remember Deal's first answer was the losing bidder had us all riled up.

Some GOP members have blamed John Barge.  JOHN BARGE?

I would have thought my premiums would have gone way done now that SHBP won't be paying for 350 abortions this year.

Right now Deal is in the crosshairs.  My advice to the rest of the GA GOP is be careful what you say about this.  You could join Deal in the unemployment line. So far the only name I've added to my no Deal list is Senator Ronnie Chance.


Already taken
Already taken

@DannyX 

"The ACA Marketplace has better plans than the state plan.  Without the tax credit and state contribution there are very good plans that don't cost that much more than the awful state plan."

So did you select a plan from the ACA Marketplace instead of the SHBP?

If not, why didn't you?

trojans3
trojans3

The SBHP plans are designed to promote Healthcare Consumerism.  That is, to get the insured’s more pro-active in the cost of care.  The idea is the consumer will take cost of care in account if there are not low co-pays for medical care and drugs.

Actuarially, they are designed within the Obamacare Bronze, Silver and Gold categories.

The problem, IMHO, is that since about 1984 consumers have been spoon fed drug cards and low office visit co-pays.  It may be similar to coming off an addiction to give them up.  :)

CherokeeCounty
CherokeeCounty

There is no way he can win in this Red state when the election is going to be about Obama and Obamacare

td you're clearly more sanguine about that than Governor Deal - he's obviously nervous about Jason's entry into the race.

And by the fall, when the economy continues to improve, and more people hear the good stories about the ACA - you may learn that pinning all your hopes on folks' dislike of Obamacare was a mistake.  (You can already see that in Jack Kingston's struggle to balance the ODS of the tp crowd with the letters he's getting from constituents talking about how they're finally able to get insurance for their kids...)

We'll see...

EdUktr
EdUktr

@Wascatlady Currently 45% of earners pay zero federal income tax—by far the biggest source of revenue for our federal government..

Many of these non-tax payers in fact get cash PAYMENTS from the IRS at tax time.

EdUktr
EdUktr

@Bernie31 What a pathetic loser you are, Bernie. Constantly whining on this and other AJC blogs. Get a job and pay taxes, for crissake!

And then invest in English lessons.

DannyX
DannyX

@Already taken, the state plan has the state contribution which makes the SHBP a better value, barely.


My point was the Marketplace plans even without a tax credit deducted from the premium and maximum out of pocket  are almost as cheap as the state plan with the state contribution.  If the state plan offered the same Humana plan offered on the Marketplace the Humana plan would be cheaper and better.  There is no reason the state should have offered only one plan.

anothercomment
anothercomment

@trojans3 I have compared the plans. The State plan barely meets the ACA bronze plan level with what they are calling a Gold plan. The only difference is the State Gold plan pays 85% after the deductible. The State Silvers pay 80% either way. The plans are garbage and are expensive. As has been revealed by some retires being billed around $1800 for full contributions. Someone is stealing. This minimal Plan in 650,000 member plan of private insurance should cost no more than $1000, both State and employee contribution for a family plan. I ran the numbers on the Obama care website. 


Not a single Plan on the ACA at the Gold level has a HSA, all at least have a Primary care doctor co-pay, and generic drug copay at the Gold Level. At the Gold level The Blue Cross and Blue Shield Plans have only a $750 deductible, with a max. family deductible of $1500.  It would average in the $1250-1400/mo range for a large group. Then the Humana Platinum POS has the best coverage with 90% + of all the hospitals and doctors in it. Plus you can go out of Network. The Humana Platinum POS plans on the exchange are about $200 less. You can buy them for the same direct from Humans. They would probably be around $1200 for a Family on a group this size.


The Federal Employees Exchange which has 17 choices is Atlanta and 7 everywhere in the country at a minimum is based on the costs of the Blue Cross and Blue Shield Basic Plan, It is a PPO you must stay inside the exchange, but it has zero deductible, they just raised the max family out of pocket out of pocket to $7,000. The Employer and Employee portions are $1,236, with a 75% 25% split. The Federal plans which are all Private plans put out to bids every year went either up or down less than $5/per month. Some went down a little, some went up. But I did not see any go up more than $4 dollars or so. Most of the changes where in the $2-3 range.


It sure looks like someone in GA Government has been Stealing a few hundred a month off of 650,000 state employees and teachers every month, with this self insurance plan.  

Bernie31
Bernie31

@trojans3  - How can a SUPPOSEDLY  "low cost" totals on Average of $70.00 out of pocket expense Between the copay to the Physician and Pharmacy at the Time of Service?  Its been that way for years!

It seems to ME, Someone Needs to Pull their Head from a Very Dark Place.

td1234
td1234

@CherokeeCounty Deal is not worried about the fall. He is worried about the primary. This is the reason as soon as he realized he could not blame it on Obamacare or ignore the problem that he has moved to give back co-pays for Dr. visits and medicine. If he was not worried about May then he would have waited longer to take action and try other tactics before rushing and spending $114 million to try to calm down the teachers. 


Barge is an Educator and liked by the teachers and the only way they can hurt Deal is in the primary by Democrat teachers and state employees crossing over and voting for Barge because they do not have to hold their nose to do so. 

Wascatlady
Wascatlady

@EdUktr @Wascatlady And yes, there are people who don't pay much income tax, after they file to get it back.  Until then, the US government is getting the float on that money.  I am also thinking of those on Social Security, many of whom NEVER WORKED OUTSIDE THE HOME A DAY IN THEIR LIVES, but are allowed to draw off someone else's work record!  So, let's talk about moochers!


Then there are those who have enough shelters and deductions that, although they make a good deal of money, have "nothing to show for it" when Uncle Sam's piper needs to be paid!


Yes, income tax is a tax, but so are property taxes, and so are sales taxes.  (Have you ever seen a special line in Walmart for all those "little people" and "illegals" so they can go through without paying tax on their purchases?)  

Wascatlady
Wascatlady

@EdUktr @Wascatlady Gee, and I thought it was the huge tax burden on business that supplies most of the revenue--so much so that the "job creators" just cannot continue to function on their low incomes!

Bernie31
Bernie31

@EdUktr I Love it when the Personal Attacks start. Its an Obvious indicator that a NERVE has been Touched and someone is Angered.

GOOD!

uh...huh

trojans3
trojans3

@DannyX @Already taken If you are eligible for the SHBP or employer insurance individually or through a spouse you are not eligible for a federal marketplace subsidy.

td1234
td1234

@CherokeeCounty The intensity is way higher on the right than on the left right now and if the polls show it nationally then just think what they look like in GA. 


If you want to have any effect on the election then convince a lot more of you Dem friends to cross over in the primary.

CherokeeCounty
CherokeeCounty

Oh and I trust that you will let me use your tagline with my Dem friends -"'this is not the year Republicans will ALLOW a dem to win"

That should fire them up a little bit :)

CherokeeCounty
CherokeeCounty

I think you're making a few incorrect assumptions, td.

First, you assume that the large turnout in 2012 is because of the black vote for Obama.  You're assuming they only voted because they had the chance to vote for a black guy.  I am not sure that's correct - I think they'll vote against the Republicans because of the continued attacks of voting rights, and the failure to extend Medicaid.

And as you know the demographics are not in your favor - every year the minority population increases as a percentage of the total - plus the electorate is younger.

Like I say, it could be that 2014 is too soon to flip the state - but if the Republicans continue to flirt with the crazy, say, by nominating Paul Broun, there might be enough moderate suburban women in Atlanta to flip the state.

And I will also likely vote for Barge in the Republican primary...

td1234
td1234

@CherokeeCounty BTW: I will not vote for Deal in the primary and will work against him with everything I have but there is a 90% chance I would vote for him in the general election against Carter because of national concerns and I am not alone in this feeling. This is not the year Republicans will allow a Democrat to win and boost Obama. 

td1234
td1234

@CherokeeCounty How can Carter win when Obama could only carry 46% and that is with the largest voter turnout ever seen for Dems in this state? Carter does not have the resources and he is not black so there is no way to increase that turnout. 


The only chance Dems have to effect the governors race is to crossover in the primary and vote for Barge.

CherokeeCounty
CherokeeCounty

Like I say we'll see won't we.

But my guess is that he's looking around and seeing the changes in GA - and he's more concerned about Jason than you think....

(Honestly I think Carter would have a better chance in 2018 - but I think anyone would be naive to write him off this year... let's hope that Republicans all think like you do!)

Bernie31
Bernie31

@EdUktr - Taking care of YOUR LITTLE Lady is My Job!

She said "Things did not MEASURE up with you."

By the way How is every Little THING?



EdUktr
EdUktr

Years of deserved personal attacks from your own wife and kids make you immune, I gather? And getting a job is out of the question?

trojans3
trojans3

@DannyX @trojans3 Sorry, I was just pointing out why the subsidy can't be used by those with other employer coverage options.

DannyX
DannyX

@trojans3 , also, Humana offers the same plans on the Marketplace as they do in general.

DannyX
DannyX

@trojans3, and when did I say you would?  I was using the Marketplace as a comparison.  Obviously.

AWA1
AWA1

@Bernie31 and could someone explain why a cosmetic procedure would be the best example? Frankly, removal of skin tags, unless interfering with vision, is cosmetic. And the state employee should pay for that, just as I have to pay for the amount beyond an office visit co-pay with my private insurance plan.


Bernie31
Bernie31

@trojans3@Bernie31- No need to convince Me anymore of YOUR LYING..You have BEEN BUSTED OUT!

trojans3
trojans3

@Bernie31 Again, I have personal experience that they have been.  As I am sure you are aware, plans differ on what is covered and however with different carriers and even within the list of plans of an individual carrier.

Bernie31
Bernie31

@trojans3@Bernie31- A Hit DOG will HOLLER every TIME

You KICK him in the BUTT!

OWWWWWWW! I hear Ya!

trojans3
trojans3

@Bernie31 since you worked on the provider side maybe you lied to your patients which sounds like a personal issue.

Bernie31
Bernie31

@trojans3@Bernie31- ALL TAG removals are considered an IN OFFICE PROCEDURE! Co-pays do not apply on procedures.

Bernie31
Bernie31

@trojans3@Bernie31- You need to complain to UHC..YOU are getting ripped off! review my comments as stated when talking with them...something is very wrong with what you are FEEDING US here. It smells like BS!

trojans3
trojans3

@Bernie31 @trojans3 Not on all plans, as you well know.  Under the SHBP with UHC, for example the "tag" charges were covered by the OV co-pay.  Since we went on the HRA with UHC last year I pay the full cost of the exam after network reductions.

Bernie31
Bernie31

@trojans3@Bernie31 - It does not sound like it! maybe you are confused with The VET you went to see?

Bernie31
Bernie31

@trojans3@Bernie31 - The Co-pay applies ONLY to the  the OFFICE VISIT Charge which averages ($65-$175) if it is an IN-OFFICE procedure with a removal of TAGS this is considered an OFFICE Procedure. Co-pays do not apply!

If you paid One during a Vist a complaint should be lodged with Insurance carrier against the Physician.

OFFICE visits and procedures are Not payable during the same visit. The Insurance carrier will only Pay ONe and Deny the Other...typically the Cheapest which is the Office Visit is usually paid under those circumstances. The procedure part of the bill is denied and the patient cannot be held responsible.

Your Dermatologist Just maybe RIPPING YOU OFF!

They LIE too!

trojans3
trojans3

@Bernie31 @trojans3 Well I have been in the health care insurance side of the business for over 30 years so I don't hold your inexperience against you. :)

Bernie31
Bernie31

@trojans3@Bernie31 - Your entire comment Makes No sense! come on and stop LYING. Lay it ALL out Truthfully to readers "IF" you can. 

You are communicating with Healthcare Financial person with 25 years experience of watching BS from both sides of The Physicians DESK!

trojans3
trojans3

@Bernie31 @trojans3

Try and Dermatologist visit for example.  Cost is $280-300 to get tags etc removed.  These charges would fall under a co-pay.  Under a HRA plan the insured pays the full cost of the exam.

trojans3
trojans3

@Bernie31 @trojans3 It was all in the office and under doctor visit co-pay rules "if billed through the doctor's office" lab etc is covered. 

Bernie31
Bernie31

@trojans3@Bernie31- Then You LIED in your initial comment of it being an Office Visit. More BS!

"No put youself in a barrel when match box can hol you" 

- Jamican Proverb

trojans3
trojans3

@Bernie31

I wish that were true.  I wish I had a co-pay.  Blood work, urine sample, resting ekg = excess of $400.

Bernie31
Bernie31

@trojans3@Bernie31 -  Please explain the $400 office visit charges? are those multiple Visits?

Hold ON...... Putting Hip BOOTS ON! This is about to Get DEEP!

uh..huh

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