Politics & Government
6:00 am
Mon March 28, 2011

Bill in Legislature Would Change State Health Plan

State employees may have to pay more for their health care next year. A bill in the legislature seeks to plug a budget hole of more than 500 million dollars in the state health plan by requiring all state workers to pay monthly premiums. The measure would also move oversight of the system from the General Assembly to the state treasurer’s office.

Mary O’Neill and Jonathan Stevenson are old hands at lobbying legislators. Last week at the General Assembly, they were ruffling through a directory of legislators’ offices, figuring out where to go next:

"I’m going to go see Senator Atwater and drop in and say hello- mine is to stop and see Representatives Dollar and Senator Stevens."


O’Neill and Stevenson have taken the day off from their state jobs to tell legislators they support Senate Bill 265. Besides moving oversight of the health plan to the treasurer’s office, the bill would also create a panel of experts to help guide the plan. O’Neal thinks that’s a good idea:


"Rather than having one or two people or simply the state treasurer having complete control over the plan, it removes the political influence that insurance companies might have on a politician, a legislator or a treasurer."


Blue Cross Blue Shield administers the current state health plan. Its contract has been controversial because much of it is confidential- the company can charge many costs to the plan without explanation. The bill would make future contracts open to public review. A spokesman for Blue Cross says much of the information about the contract is already public. Republican Senator Tom Apodaca of Hendersonville is the bill’s sponsor. He says legislators shouldn’t be the ones who set the terms of the health plan:

"An argument can be made that we really do not need to be the ones dictating benefits and so on. That should not be our role. We should fund and then let other people with expertise handle the actual plan benefits."


Many other groups agree, including the state’s main lobbying group for teachers, the North Carolina Association of Educators. But the group doesn’t like the bill’s provision that would create premiums for the first time for healthy workers and raise them for others:

"Our primary concern when we look at Senate Bill 265 is that we see a huge cost shift to our educators and our teachers."


Brian Lewis is the government relations manager for the North Carolina Association of Educators.

 "They are asking nothing from the special interest groups that have their hand out on this state health plan," he says, "they’re asking them to give up nothing, they’re asking employees to front the entire bill."


Lewis argues the bill should include more provisions that require more competition among vendors to provide services at the lowest cost. He says the plan’s current pharmaceutical vendor, Medco, provides drugs at a higher cost than is necessary. The bill would also raise co-pays for medical and pharmacy benefits. Democrats including Senator Doug Berger of Franklinton weren’t happy about that when the bill came up on the Senate floor last week:

"We are now going on year three and perhaps even into next year- four years- without our teachers or our state workers receiving any cost of living increases, so the effect of this premium is essentially to force a pay cut on teachers and state employees and for those reasons I cannot support this bill."


The bill would also eliminate the current plan’s wellness provision that imposed financial penalties on smokers and overweight workers and retirees. Democrats say removing the wellness portion will cost the state more money because enrollees who are more expensive to care for will pay less for their health costs. But the bill’s Republican sponsor, Tom Apodaca, says removing the wellness portion makes the bill more palatable to state employees. And he says the economy requires most people to pay bigger premiums and co-pays these days:

"The argument’s made that our state employees haven’t received a raise in three years. You know, this sounds kind of crass, but a lot of people don’t have jobs, ten percent of our population doesn’t have jobs, so not receiving a raise, I think we’re all blessed to still have employment."


Apodaca disputes the notion that employees will shoulder most of the cost of the plan. He says the state will continue to pay about 1.6 billion dollars every year to keep it running.

A bill in the state legislature would raise premiums and change oversight of the state health care plan.

Tags: