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Hall government still trying to control health care costs
County looking at stop-loss threshold
Bill Moats
Hall County Human Resources Director Bill Moats

The Affordable Care Act has reduced the number of uninsured Americans, but controlling health care costs continues to be an issue for local government.

In Hall County, 17.6 percent of residents remained uninsured in 2014, or about 33,281 people, according to the latest U.S. Census figures. But that’s down from 20.7 percent, or 35,548 people, in 2013.

Still, the county is fighting to lower its health care costs.

In the last year alone, officials have opened a clinic and pharmacy for government workers, which has reduced costly emergency room visits and lowered prescription drug costs.

The county, which is self-insured, has also made repeated adjustments to employee premiums to steer personnel away from costly, unnecessary treatments when alternatives are available.

“It’s an ongoing effort and isn’t any different for us as government than other employers,” said Hall County Human Resources Director Bill Moats. “The ACA certainly added to the problem on top of what was already an issue with health care costs.”

Now, Hall officials are carefully considering where to set the stop-loss insurance amount for those workers with the highest health care expenses.

Employers like Hall County purchase stop-loss coverage from private insurers to protect them against catastrophic losses on employee health plans.

Moats has recommended setting the stop-loss threshold at $175,000. He said one claim currently breaks that mark at $288,000 in health care costs for the year, while another handful of worker claims could surpass the threshold before the year is out.

Commission Chairman Richard Mecum said he wants to know how many times workers have exceeded the stop-loss threshold over the last decade to get an estimate of total costs to the county.

And Commissioner Jeff Stowe asked to review a cost-benefit scenario to determine whether it makes more sense to reduce the stop-loss threshold.

“If we lower the threshold, then the premium will increase because that would be greater exposure to the insurer,” Moats said.

The health care industry has been growing at a heavy clip in recent years as more and more Americans sign up for medical coverage.

According to the Georgia Department of Labor, health care employment in Georgia is projected to grow 2.8 percent annually and add 140,000 jobs by 2022.

With more than 300 providers, including physicians groups, specialty medical services, dental services, elder care facilities and independent clinics, the health care industry employs 14.6 percent of Hall County’s workforce, or about 11,500 individuals.

That’s up from about 8,045 workers in 2006, or about 11.4 percent of the workforce.

Across the nation, about 55 percent of insured individuals receive health coverage through their employer.