Tossing More Than 20,000 Georgians off State Health Plan a Bad Remedy

TimTossing non-certified school district workers who work less than 30 hours per week off the State Health Benefit Plan (SHBP) could unnecessarily push more Georgians into the insurance coverage gap.

Gov. Nathan Deal’s proposal to remove more than 11,500 part time school district employees and 10,300 of their dependents from the plan threatens hardship for thousands of working Georgians, while providing very little financial relief for the health plan itself. According to a new GBPI fact sheet, some of these workers could qualify for federal tax credits to help them purchase private insurance in the federal health insurance marketplace, but others are likely to fall into a coverage gap created by Georgia’s refusal to expand Medicaid.

Nearly 300,000 uninsured Georgians with incomes below the poverty level now fall into Georgia’s coverage gap. Their incomes are too high to qualify for Medicaid, yet too low to receive federal tax credits through the health insurance marketplace. Single workers who earn less than $11,800 annually fall into this coverage gap, as do adults in families of three with annual income up to about $20,000. Federal money is available to close the coverage gap, which would enable these Georgians to get health coverage through Medicaid. So far, state leaders are refusing to extend income eligibility to cover these people.

The potential harm to workers who lose coverage could be significant, but the financial gain for the health plan is very small. The portion of the SHBP that serves non-certified school district employees operated at a $135 million deficit in 2014. State officials estimate the governor’s latest budget proposal reduces this deficit by just $2.6 million, so the plan’s larger financial problems remain.

Efforts to address the larger issues facing the plan are underway. The General Assembly just passed the amended budget for the ongoing 2015 fiscal year. It directs the Department of Community Health study the health plan to:

  • Explain why plan costs are higher than other comparable government employee health plans
  • Describe a variety of options to reduce costs without diminishing the value of benefits received by members
  • Examine options to provide health benefits to non-certified school district workers

This report should provide policymakers with a more complete picture of the issues facing the SHBP, as well as ways they can address these issues without bumping more than 21,000 Georgians off of it.


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