Cost of health care going up Friday for a half million Georgians
Associated Press
ATLANTA (AP) — The cost of health care for more than a half million Georgians will surge sharply upward Friday when new rules for the state health benefit plan take effect, among them a surcharge for smokers and a whopping $100 copayment for certain types of drugs.
State officials argue the aggressive cost-cutting rules for the State Health Benefit Plan are necessary to offset a projected $446 million deficit. The plan covers some 650,000 state employees, teachers, their dependents and retirees.
State employees, many drawn to low-paying government jobs at a time health benefits were good, say it's another in a series of pocketbook blows that weakens their morale and exposes them to new health risks by forcing them to choose cheaper drugs that may not be as effective.
Members of the plan are being hit with a triple whammy of premium increases, surcharges and hikes in their required copayments.
For the state's most popular health care plan, the preferred provider option, premiums are rising an average 9.5 percent. For an individual, the cost will increase from $64.96 per month to $71.14. Family coverage will increase from $198.32 monthly to $217.16.
Smokers will be hit with a $40 per month surcharge, and there will be an extra $30 per month fee for any member of the plan whose working spouse could qualify for benefits under his or her private employer's plan but chooses to enroll in the state plan.
And then there are the new copayments for drugs, designed to steer employees to the less expensive generic equivalents.
For generic drugs, the copayment remains $10. For the state's preferred list of brand drugs, the copayment is increasing from $25 last year to $30 effective Friday. For nonpreferred brand drugs — among them widely advertised products such as Zoloft and Zyrtec — the copayment will be $100.
Last year, nonpreferred brand drugs cost $40 for basic plan members while those in another level of membership benefits paid 20 percent of the cost, up to $100, for nonpreferred brand drugs.
Raymond Wozniak, 57, a Department of Corrections employee in Atlanta, said he won't be affected by the smoking or spouse surcharges but fears the increased cost of copayments.
``As a former nurse, I can say that generic drugs could vary as much as 10 percent in strength from brand name drugs. That's one reason they're cheaper. When we're being forced to take generic drugs because of our increasing personal budget pinch, we're playing roulette with our health,'' he said.
Pat Pickett, 54, a school librarian in Berrien County undergoing treatment for cancer, said her brand name medicine costs $235 a month and fears there may not be a generic substitute for it.
The new $100 copay ``could really hurt a lot of people,'' she said.
Too, Pickett said she fears teachers will find their 2 percent raises this year more than eaten up by increased health care costs, and that paraprofessionals will simply leave the classroom.
``They make such a small salary now. One reason we can get such qualified people is for the health care. Now they may start looking other places,'' she said.
State Rep. Mickey Channell, D-Greensboro, who also will feel the pinch because he is a member of the state health plan, says it's a hard issue.
``I certainly wish some of the things we're quite so onerous. It's going to work a hardship on certain state employees. But where we find ourselves as a state is that the cost of medical inflation goes up faster than the normal rate of inflation. Financially, we've just got to deal with it. We don't have a choice,'' he said.
Channell's already gotten his doctor to give him a new prescription for cholesterol. One he previously was taking, heavily advertised on television, would have cost him a $100 copayment.
The Department of Community Health oversees the state plan. Commissioner Tim Burgess said that with double-digit inflation rates in the cost of health care, ``these benefit changes as well as increases in premiums and copays are necessary to maintain the financial viability of the plan for future years.''


