House Majority Leader Hugh Holliman looking to shaft state workers.

I just read this over at Isaac Hunter's Tavern, the blog of local NPR reporter Laura Leslie, and was simply astounded. The state health care plan is in a major shortfall, as discussed elsewhere. So, what should we do to fix the problem? Adam Searing and Adam Linker think we should look at the administrator of the health care plan, of course we aren't allowed to look at them because the details are CONFIDENTIAL.



So, over at Laura Leslie's place we find out that:

House Majority Leader Hugh Holliman is proposing a 30 percent hike in dependent premiums over the next two years – an increase, he points out, that’s in line with what private business is dealing with. That would drive the cost of monthly coverage above $600, which would almost certainly push even more healthy dependents out of the plan and into the retail market where coverage is cheaper.

Before I get into the numbers, let me give you one more quote. Holliman wants to increase the amount that state employees pay for our health care. Because, well, we have it too good.

Just FYI, even at 100% employee coverage, NC still ranks 40th in health expenditure per employee. If you count dependents, NC falls to 49.

WE'RE FREAKIN' 49TH ALREADY! Who you shooting to take out of last place Rep. Holliman? Alaska? South Carolina? Do you really want to be the absolute WORST at something? Are you driven to make North Carolina ABSOLUTELY THE WORST STATE IN THE COUNTRY FOR STATE EMPLOYEES?

Now, Laura Leslie says that this 30% increase will lead to more healthy dependents leaving the plan. You betcha. Consider my dependents gone. Because that $600 is a fairy tale. I already pay $595.52 a MONTH to BCBS for my family health care coverage. Beyond that, I still have to pay $150 per person and $450 in total in deductibles before they begin covering anything. At that point I have to pay an additional 10% in coinsurance for everything up to $1000 per person or $3000 for the entire family.

So, my $7200 in premiums each year do not include the $450 in deductibles and the $1000-$3000 in copayments. PLUS, BCBS only pays what they THINK they should pay, not what the provider actually charges. So, if you go to an occupational therapist that charges $110 for a session and BCBS THINKS it should only cost $85, then those deductibles and copayments only include money inside that $85 range - everything else is on you buddy.

If Rep. Holliman jacks up the rates another 30% I will be looking at nearly $800 a month just to have coverage for my family. Add to that the $350 that you the taxpayer pay for MY coverage and you get $1250 a month to cover the whole family. That is $1250 x 12 months = $15,000 + $450 in deductibles + ~$2000 in coinsurance = $17,450.

Now, tell me again about that special plan that legislators have? How about letting me access that Rep. Holliman? Better yet, how about every legislator voluntarily agree to pay what I have to pay this year? Make it a donation to the state, and tell us how bad you feel for us right after you take a $17,450 hit to your wallet for Blue Cross Blue Shield health care.

NOT ME.

I want Medicaid for my family. Have you ever consider it ODD that YOU THE TAXPAYER cover every Medicaid patient at a cost of $5,351/patient and BCBS covers State Workers for $4152/patient? I say it is odd because state employees are a fairly health bunch compared to some of the people on Medicaid.

For instance, Mental Hospital patients age 21 to 65 require $19,375 per service through Medicaid, while those in Nursing Facilities require $24,697 per service through Medicaid, and intermediate care facilities for the mentally retarded require $106,408 per treatment!

So, what you have in Medicaid is a mixed population of fairly unhealthy people which costs the federal, state, and county governments $5,351 per person. Meanwhile, BCBS needs $4,152 per state employee.

Nope, give me Medicaid. See, because Medicaid only pays $3,161 for AFDC ADULTS (Aid to Families with Dependent Children). That's it! That's all! But, what about copays?

$3 copays

And, there are deductibles. I can't find a list of what those deductibles actually are, but since BCBS copays are 7 times that of Medicaid, I'm willing to bet the same holds true for deductibles. No, Representative Holliman, if you really want to do what is right for the people of North Carolina you will open the Medicaid rolls to state employees and use the $4,152 in TAXPAYER money to cover each and every state employee. Then, you will allow state employees to buy into a Medicaid plan at a rate that will cover the health care they use, but will not RIP OFF the employees or the plan. After all, this is taxpayer money we are talking about, doesn't the legislature have a requirement to spend it in a fiscally conservative manner?

Comments

Rep. Holliman, striving for last place!

Can't we at least strive for mediocrity in North Carolina? Can't we at least give our state employees a health care system that is ranked maybe 35th in the nation instead of 49th?

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.
-me

Excellent post

But ya know, who cares right now if a bunch of families go broke trying to take care of their kids? And you wonder why I'm not a Democrat any longer.

These guys have their cushy health plans and they flat-out could care less if you don't.

But pay them first

They need to get paid reasonably first. Sure you can be a slacker and only dod the minimum, but if a legislator takes their responsiblity to the fullest, they have a full time job. Pay them like full time professionals and then it's no problem treating them more like regular state employees with their benefits.

I agree.

I've said the same thing many times in the past. Pay a real wage so that real people can run, not just retirees and lawyers.

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.
-me

How does Rep Holliman

look his nurses in the eye when he goes in for a checkup using his luxury legislative health care plan? Does he think about his nurses' kids or the sacrifices those very nurses must have to make every day for their families because the Democratic leadership's first answer to any budget problem to to take it out of working families' pockets?

Thanks for this Robert P. That was one of the most persuasive and passionate statements about the state worker health care crisis I've read in a long time.

Rep. Holliman's plan is a disgrace.

Clarification

I want to clarify - Holliman says the rate increase is one of the options on the table. Another would be to raise copays and deductibles, and yet another would be to cut back on benefits. They might go with some combination. Just out of curiosity, what do you think would be the best choice?

Also - to the best of my knowledge, state lawmakers do not have a special insurance plan. (You may be thinking of Congress.)

Thanks for the hat tip!
Laura

Laura Leslie
blogger/reporter for WRAL @NCCapitol
Former Barkeep of Isaac Hunter's Tavern

Laura...I think the confusion over the "state plan"

Was created with Adam Searing's piece. They have the option to buy into the state plan for life....or something similar.

[Edit] - I don't mean for this to look like I'm blaming Adam. I should say the confusion was created when what he said made the rounds and was interpreted incorrectly. Adam L stopped by here to try to clear things up.



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Vote Democratic! The ass you save may be your own.

49th versus 1st

Regarless, every Hugh Holliman wants to do would make the 49th place health care system for state employees WORSE. He wants to make North Carolina worse than every single state. I have a better idea. We are constantly rated in the top 5 best "business environments" or some such nonsense.

How about we raise corporate taxes so that we drop down to maybe 10th. Still in the 10, but not #1. How is it that we can't even talk about shifting some of the budget problems to an area where we rank #1, but we can talk about screwing the people who are getting 49th of 50 service.

BTW, I assume 50 is Alaska with its corporate welfare program.

Edit: Right, so they get the same health care plan as full time workers even though they are part time workers. I have no problem with that, except that they should not be hypocrits and extend that same option to all part-time North Carolina workers.

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.
-me

GA benefits

I guess there is some disagreement over whether or not representatives work full time. I would say that some work full time and some do not.

Some have also argued that it's unfair to publicize the health care benefits that are available to legislators. I strongly disagree with that sentiment. In the short session of the GA I sat in the Health Care committee while influential legislators argued that we should not expand health insurance options to more people in the state b/c we have a shortage of primary care physicians. If we give more people insurance then they will seek medical care and just end up frustrated.

I think it's perfectly legitimate for us to ask why legislators extend health benefits to themselves, without worrying about the frustration it will cause, and not to every North Carolinian.

Also, Betsy is correct: members of the General Assembly have a right available to NO other state workers -- they have a lifetime right to buy health coverage through the State Health Plan no matter how long they serve. Even if you are expelled from office you retain the right to buy coverage through the SHP at full cost. So why not extend that right to all state workers? Once you leave state service you should retain access to SHP coverage at full cost.

Not a bad sentiment

Because the SHP would no longer have to be self-sustaining and per claim administrative costs would be much lower.

But I think the hurdles are too high. NC would have to obtain a Medicaid waiver, which I'm not sure we could get. And the biggest obstacle is that state workers would not want to change the SHP. Even if you raise reimbursements Medicaid would still have a bit of a stigma for some. And those who currently have coverage are loath to change. Retirees, for example, put up a fight when the SHP phased out the indemnity plan.

We could, however, work to expand who can purchase coverage through Medicaid and SCHIP to create an alternative to the SHP for those who are currently uninsured or can't afford coverage.

Good point

You would face a problem with adverse selection if former state workers bought into the SHP. But we face that problem anyway. B/c dependent coverage is expensive the young and healthy tend to buy individual policies through Blue Cross.

That's why we should require Blue Cross to pool the SHP with individual policies to better spread the risk.

Like I've said before, we don't want to strip lawmakers of their health coverage. And we favor a full time legislature that pays a living wage. But I would like members of the GA to consider their own benefits when suggesting that we deny average people health coverage.

For me....this is the crux of it

That's why we should require Blue Cross to pool the SHP with individual policies to better spread the risk.

I don't have time to research this, but which of our electeds gets large sums from BCBS - maybe a PAC? - and upper level employees? Which of these people sit on committees that might influence the pooling decision by BCBS? Is there a connection? Did BCBS gain undue influence by donating large sums to Democrats and/or Republicans on key committees?

I don't believe that receiving contributions from a group automatically means a legislator is on the take. I think it does mean that they should be extremely careful that any decisions they make that might favor these organizations/people will stand a daylight test.



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Vote Democratic! The ass you save may be your own.

You're right

Blue Cross is at the crux of the issue. It helps fund many legislative campaigns and basically has a lock on state government.