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Employees: State Insurance Change A "Life and Death Issue"

Changes in the State Health Benefit Plan have employees wondering how they will afford the rising cost of visiting their doctors.

Credit: morgueFile
Credit: morgueFile
In December, retired teacher and Canton resident Sue McDonald had surgery on her hip and soon started physical therapy to regain full usage of the joint. 
McDonald, who recently retired from the Forsyth County School District, was making the $25 copay per visit under her old insurance plan to take part in the therapy. 

However, when January rolled around, the Canton resident learned how the changes to the State Health Benefit Plan would make it virtually impossible to afford the therapy: she now had to pay $100 per visit to her physical therapist until she hit her $1,500 deductible. 

The Georgia Department of Community Health administers the SHBP, and its board last year voted to implement a single vendor to provide medical care to its customers: Blue Cross Blue Shield. 

SHBP participants in 2013 could choose coverage from either Cigna or United Healthcare. During open enrollment in October, participants had to choose either a Bronze, Silver or Gold plan offered by Blue Cross Blue Shield. 

The change, which eliminated the tradition of state employees of having the ability to choose various plans from multiple companies, has left many plan participants wondering how they could afford the co-payments — often exceeding $100 — just to visit the doctor or specialist. 

McDonald said the changes have been "reprehensible" to the nearly 700,000 state employees, including teachers, school district employees, corrections officers and those working with state agencies. 

"That's why we are all upset," she said of employees now being forced to choose plans under one company. "You could always find a plan that would fit you and your family."

The change propelled a Canton resident to organize on social media to speak out against the changes. Ashley Cline, whose husband Nate Cline is a teacher at Creekview High School, created the Facebook group Teachers Rally Against Georgia Insurance Changes, or known as TRAGIC.

The group serves as a resource for those to share their experiences with the changes, how its impacted their household and budget and for employees to ask questions about various aspects of the SHBP. 

Cline's situation is similar to McDonald's. Her daughter was in occupational therapy and the family was paying $25 per week each visit. Now with the changes, the family's cost skyrocketed to $135 per week for each visit. Cline said she and her husband tried to make sense of the changes, but the details were "convoluted." 

"If this is the new norm for teachers, then I don’t know what we are going to do," she added. 

Members of the TRAGIC group and others affected by the changes have been flooding the phone lines at Gov. Nathan Deal's office to inform the governor how they feel about the changes. As of Wednesday, about 600 calls had been logged at the governor's office, according to the Cherokee Tribune

Both Cline and McDonald said they haven't heard anything official from the governor's office.

The lack of response from the governor's office is frustrating to McDonald. 

For nearly seven years, teachers and other school employees have put up with furlough days and salaries "going in reverse for those who are working." Gov. Deal, whose wife Sandra Deal is a former teacher, should be "more compassionate" to how these changes could impact those who rely on the SHBP, McDonald added.

Both McDonald and Cline said they hope the state will listen to the stories of those having to now navigate the unfamiliar waters due to the change in the plan. 

"People are in crisis," Cline added. "This is truly a life and death issue for a lot of people. It would be nice to be acknowledged and heard."

For Sequoyah High School teacher Jamie Wills, the changes have meant scrambling to find a new pediatrician. Wills has come to rely on Dr. Jennifer Wagner at Cherokee Pediatrics, who said she's treated her children and cared for their injuries since birth. Under the new plan, Wills said Dr. Wagner is no longer in Blue Cross Blue Shield's network. 

"I broke down crying on the phone with the representative," she said when she learned the news from Cherokee Pediatrics' billing office. Wills said she eventually found a new pediatrician in the network, but the new doctor will be one "who doesn’t know my children, their history and everything they’ve been through." 

Wills, who lives in Canton, said instead of having a copay to cough up at each doctor's visit, she noted there's now a contracted amount in place. However, no one has been able to give her what the exact amount is going to be. 

The family is now looking at using an online tracker that calculates how many calories they burn, how many steps the walk per day and how long they exercise to earn a certain amount of dollars that could be applied towards the cost of seeing a doctor, the teacher said. 

To accumulate as many dollars needed to be able to afford going doctor when it's absolutely necessary, Wills said she is now more likely to give her children Tylenol when they develop a fever and hope their sniffles won't morph into a sinus infection. 

Wills said the changes have not been economical for families, and doesn't understand why the state would eliminate the ability to choose for its employees.

"I feel like the state of Georgia is basically making all my health decisions for me," she said. "My hands are tied now."

janh999 January 13, 2014 at 07:53 AM
Thank Obamacare for your wonderful changes. You can also thank the state of Georgia. Because our governor doesn't agree with or want obamacare (neither do I) he is making the people of this state suffer more than we have to just to prove a point.
Kristal Dixon (Editor) January 13, 2014 at 08:27 AM
Hi everyone! These changes have nothing to do with the Affordable Care Act.
Lisa S January 13, 2014 at 08:49 AM
Krystal, these changes have everything to do ACA!
Kristal Dixon (Editor) January 13, 2014 at 09:25 AM
How so, Lisa?
Monica McClain January 13, 2014 at 10:40 AM
Wow , the aca has destroyed everyone's health insurance benefits across the country . It is sad to know there are so many that truly do not understand what this has done to the American people . We must fight back , rally the government . Make a stand for your rights , join together and get rid of this monster that has plagued our nation .
Frank Anastasia January 13, 2014 at 10:55 AM
This is a result of the increase costs of OBAMA care. Yet another reason to keep the damn federal government out of our lives.
Thyme Tugeaux January 13, 2014 at 07:11 PM
This is why people like Deal get elected. Sadly, I voted for him too. I was once uninformed too. This is all DEAL. I agree that ACA changed health insurance, but people that blame this on ObamaCare have no clue. Even Deal is smart enough to know people won't believe that. He blamed it on the DCH!
Frank Jones January 13, 2014 at 10:55 PM
There was a snow storm in the northeast...cause by Obamacare. There was frigid weather down south...must have been Obamacare. I stubbed my toe this morning...must have been Obamacare. Actually, none of the above is a result of Obamacare and neither is the change in state employee health insurance. The state has large purchasing power and can manage their risk pool similarly to other large businesses. In contrast, small businesses are at the whim of the insurance industry. Also, if I remember correctly, the state made an unprecedented move to change the insurance providers. And with any highly funded state program, one must always consider the political ramifications (i.e. campaign contributions) associated with vendor selection. And lastly, Gov Deal has been putting a squeeze to "the people" while giving lavish deals & tax breaks to big business and the well-to-do which would more than offset the costs now put upon state employees.
Frank Anastasia January 14, 2014 at 09:10 AM
Frank Jones, grow up, and try thinking for a change. obama and his mindless minions are screwing everyone by raising premiums, and cancelling policies, all to fund his twisted plan. What fool, other than obama really thought young healthy people, who can't find a job in obama's ruined economy were going to rush to buy health insurance?
Kristal Dixon (Editor) January 14, 2014 at 10:46 AM
Hi everyone! Please stay on topic. The SHBP changes are not related to the Affordable Care Act. The Department of Community Health's board changed vendors and reduced the number of companies state employees had to choose from.
Allah Tabul January 14, 2014 at 02:22 PM
Of course this is related to the Affordable Care Act. Now, thanks to a bunch of freeloaders getting free health care, everyone else's costs have been driven up, including those in the healthcare insurance industry. Result? Those costs get passed to everyone. The state workers absolutely should have had more than this awful package to choose from but other options would have included increased costs as well. Deal's mistake was to limit the options to a single vendor. The blame for the increased costs is 100% the fault of President Obama's failed ACA. To even pretend that this has nothing to do with ACA is the height of naivete. Stop defending this awful president and his stupid, already-failed healthcare package. It has and will continue to be a disaster foisted upon an American public that did not want it. Too bad Obama's ego doesn't care about the American public. Boom shakala Amen!
Frank Anastasia January 14, 2014 at 03:33 PM
Hey Kristal...Are you kidding me??? The change in the shbp has nothing to do with the obama disaster? You really need to do your homework, and by the way, do not call it the ACA, there is absolutely nothing affordable about this disgrace.
Allah Tabul January 14, 2014 at 06:08 PM
The fact that family coverage now includes "children" up to age 26, thanks to ObamaCare, plus all the new, "required" services insurance companies have to offer, thanks to ObamaCare, are some of the reasons insurance rates are sky-rocketing. Health insurance companies do themselves no favors but to pretend this plan that is disastrous to our teachers exists in a vacuum from the effects of ObamaCare is ridiculously partisan and, frankly, ignorant and irresponsible.
Jennifer Hall January 14, 2014 at 08:36 PM
Let me ask you this question: If the changes to the SHBP that have resulted in much higher costs for far worse coverage have everything to do with ACA, why is it that the University System of Georgia employees have access to a FAR more affordable plan that has many choices? TRAGIC has done its research. Kristal is quite correct when she says that SHBP changes are not related to ACA. If you don't believe that, feel free to call DCH and SHBP and discuss that with them.
Allah Tabul January 15, 2014 at 12:33 AM
I very-clearly pointed out the mistake of using a single, bad vendor like BCBS but it's pointless to argue with ObamaCare fans who blatantly ignore facts in their endless pursuit of removing more money from the taxpayer. I'd ask the obvious question to teachers of "Why did you wait until after-the-fact to complain about this dreadful health insurance?" but I know it'd be met with lame excuses. I'm sorry you guys got screwed over but hopefully you've learned a lesson to pay attention to the fine print next time, rather than complaining after it's too late. All increased healthcare costs have ObamaCare as one of the reasons for their increase. UGA employees indeed have access to a better plan but their costs too have increased due in part to ObamaCare. It's scary that some of you are teaching our children, given how little attention you seem to be paying to the big picture and the fine print.
Jennifer Hall January 15, 2014 at 06:38 AM
One of the reasons that there wasn't a lot of complaint prior to the implementation was that we were not given a lot of information. Many have lost their doctors as their doctors either can't or won't participate in the new plan and didn't know that would be a reality until the doctor lists were available, which was long after the changes were implemented. I also wasn't aware that there was a mandated timeline for those affected to voice their displeasure. Teachers and other state employees are taxpayers as well. This "savings" will save each taxpayer in GA less than $10 each, but will result in thousands of dollars out of pocket from each state employee/taxpayer. It could also cost the state money in the fact that their employees may delay seeking medical care, resulting in increased costs when situations become dire. The "savings" aren't worth the cost. As a member of TRAGIC pointed out, "I've lived through furlough days and years without a 'Step Increase' or any sort of a raise - but gambling with my children's health crosses the line." I won't continue to argue these points with you. I will, however, point out the fallacy in your logic that people who are upset with the SHBP are ACA fans. That makes as much sense as saying, "It's raining outside. Therefore, I need to clean out my refrigerator."
ReasonableCitizen January 15, 2014 at 07:29 AM
I want to offer a few counterpoints to the supposed relationship between ACA and SHBP. 1) If this were a problem from the federal government, it would be affecting more than just the state of GA. 2) The reason SHBP is so suspect is the backroom/no bid process by which blue cross/blue shield was selected as the lone provider of health insurance for state employees. 3) It bears mentioning that blue cross/blue shield was a major contributor to the Deal campaign. 4) The SHBP eligible employees are by definition in eligible for the ACA exchanges. The only parallels between ACA and SHBP are those that Governor is trying to draw. There are political games afoot. But it Governor Deal using the well being of 650,000 GA families to pander to the tax hawks and blame boogeyman Obama.
Allah Tabul January 15, 2014 at 09:07 AM
Reasonable, I don't argue the backroom scumbaggery that foisted this plan upon the state employees. My point is that...to pretend that the ridiculous cost increases associated with this healthcare plan have nothing to do with ACA is disingenous, ignorant, and laughably partisan. Deal's a snake and Obama's an idiot. In other news, the sun rose this morning and it's cold in the winter time. Ms Hall, I don't disagree with you that your new plan, frankly, sucks. Good luck getting it changed after-the-fact though. I'd like to see a grassroots effort actually succeed for once but believe your impact will be that of the TEA Party's: A group of loud voices that ultimately accomplish nothing. This will be interesting to watch.
Common Sense January 15, 2014 at 10:19 AM
This is why scumbags like Nathan Deal continually get re-elected to office. Step 1: Screw almost 700,000 folks out of their healthcare options via the DCH Board, who were appointed by none other than Governor Nathan Deal. Step 2: Ensure that the plan design (again, created and voted on by the DCH Board, NOT the Federal Gov't) mirrors the ACA tier levels to fool the masses (they could have been called "Don't have an accident," "Wear a bubble suit" and "Never Leave Home" - completely up to DCH... and guess what, tiers weren't a requirement!). Step 3: Sit back and watch fooled Georgians blame it on Obamacare while rolling around in the "$200 million savings" that this will supposedly create. Reality check - if this was the fault of Obamacare, THERE WOULD BE NO SAVINGS FOR THE STATE TO TOUT!
Frank Anastasia January 16, 2014 at 09:55 AM
Hey Common Sense, while you are quick to call Nathan Deal a scumbag, don't forget to mention the BIGGEST scumbags of all. obama, pelosi, sleazy harry reid, hillary clinton, each and every one a pathological liar and piece of human trash.
janh999 January 17, 2014 at 08:24 AM
I'll dumb it down in simple terms... All changes to any health insurance policy is due to regulations set forth in the ACA. Insurance companies are forced to have specific "free" services in every policy They aren't going to absorb the costs and neither will your employer, THAT'S WHERE THE SAVINGS COMES FROM. So unless you are willing to pay triple what you were paying, they are cutting services & charging higher copays. Employer Mandate kicks in January 2015, They are getting you ready for what's to come. When the end of this year rolls around (Oct-Dec) anyone with insurance through their employer will start receiving letters from their insurance companies. If you aren't canceled, you will see a huge spike in premiums, copays and deductibles as well as a loss of services. The majority of American get their insurance through their employer. The worst is yet to come. And while I love and admire what teachers do & their dedication to the children, I DO NOT THINK ANY STATE OR FEDERAL EMPLOYEE, ELECTED OR OTHERWISE DESERVES HEALTHCARE ON THE TAXPAYERS FOR LIFE. Once you retire you should be on your own.
Frank Anastasia January 20, 2014 at 09:14 AM
Well said janh999
Renee Gable January 22, 2014 at 12:27 PM
I 100% AGREE WITH janh999. OUR STATE OR FEDERAL EMPLOYEES OR ELECTED OFFICIALS DO NOT DESERVE HEALTHCARE FOR LIFE OR THE CONTINUED PAYMENT OF THEIR SALARY (OR A SUBSTANTIAL PORTION OF THEIR SALARY WHILE IN OFFICE) AFTER THEY RETIRE. THIS IS LUDICROUS. WAKE UP CHEROKEE COUNTY! WE ARE CURRENTLY PAYING THIS FOR ELECTED OFFICIALS.
Jennifer Hall January 23, 2014 at 09:23 PM
Here's some more food for thought: Teachers and other state workers contribute to SHBP and TRS from their paychecks! No free ride there, folks. Point two: today, proof emerged that this has EVERYTHING to do with Deal and robbing teachers and state workers and zero to do with ACA. State employees were STOLEN from and are now being BLAMED for the problem. Read page two, paragraph 1. http://gbpi.org/wp-content/uploads/2011/10/20110622_DepartmentofCommumityHealthFacesFundingShortfallsinFY2012.pdf

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