Tens of thousands of Georgia teachers and state employees are getting good news on their health insurance costs for next year.
Members of the State Health Benefit Plan will have the same monthly premiums, co-pays and deductibles in 2022 as they have now, the Department of Community Health (DCH) announced at an agency board meeting Thursday.
The benefits plan covers more than 600,000 state employees, teachers, other school personnel, retirees and dependents. The members’ options for health plans will stay the same as well, DCH officials said.
Separately, the agency’s commissioner, Caylee Noggle, said at the board meeting that DCH is reviewing the state’s extraordinarily low rate of referring poor children to specialty services under Medicaid.
That inquiry was revealed after a board member, Mark Trail, a former state Medicaid director, asked the agency to look into the services gap, citing a recent GHN article about the issue.
Noggle responded that “the department is actively looking into that’’ to figure out whether the problem lies with an actual lack of referrals or with providers failing to report referrals.
The health screenings of Medicaid kids and the subsequent “corrective treatments’’ are required under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program.
The goal of EPSDT is to provide early detection and treatment of health conditions so children and adolescents covered by Medicaid can get appropriate preventive, dental, mental health, developmental and other specialty services.
Georgia in 2019 had 1.4 million children eligible for EPSDT. A recent report’s figures show the state is doing health screenings at recommended levels. But just 30,000 Georgia kids that same year were referred to corrective treatment for a health condition. That compares with Illinois, also with 1.4 million eligible kids, which referred more than 500,000 for services in 2019.
“EPSDT is essential to maintaining and improving the health of Georgia’s children, especially children with disabilities,” Susan Goico, director of the Disability Integration Project at the Atlanta Legal Aid Society, said Thursday. “The state has an obligation under federal law to ensure that kids are connected to medically necessary treatment. Understanding why this is not happening should be a high priority for DCH, and then corrective steps must be taken.”
A touchy issue at times
Premium increases in the State Health Benefit Plan, along with changes in health plan options, have in the past created political turmoil for state lawmakers and the governor’s offices.
In 2014, a wave of complaints arose from members of the plan, and some of them publicly protested, after employees were limited to one insurer, among other changes. That led to a quick fix for that year’s plan and to more revisions in the 2015 plan.
But the news Thursday of flat rates in 2022 pleased organizations representing educators.
Lisa Morgan, president of the Georgia Association of Educators, said in a statement that “our dedicated educators who continue to do a phenomenal job navigating the back and forth of this continuing COVID health crisis, will most surely be appreciative to see no increases in their premiums or out-of-pocket costs for health care. This past year has been especially demanding not only in the classroom, but personally for their families. This is certainly welcome news.’’
And Ramona Mills of the Professional Association of Georgia Educators (PAGE) said that “amid escalating inflation and the ongoing challenges of the COVID-19 pandemic, a strong benefits package for teachers and school staff is essential. PAGE is pleased by the announcement today that there will be no State Health Benefit Plan premium increase, deductible increase, or benefit reduction for Georgia educators next calendar year.”
Open enrollment for State Benefit Health Plan members will run from Oct. 18 to Nov. 5.
Andy Miller is editor and CEO of Georgia Health News and a contributor to Grice Connect.