What the PBA is doing about the State Health Benefits Plan rate increase

Health Benefits Report 

As I write this article to update you on the unnecessary and unwarranted rate increase for members of the State Health Benefits Plan, I grow more and more disappointed and angered with the state’s leadership and the way they are trying to take advantage of our members and their families.

The state continues to act in the interest of its vendors and corrupt medical institutions instead of the plan members. I still encourage you to find a way to collaborate with your local employers, leave the State Health Benefits Plan and find a vendor with a different symbol on your medical card. Pulling out of the State Health Benefits Plan and staying with the same company does nothing to penalize bad behavior.

As PBA members, we must hold our insurers to the same level of accountability and transparency that the legislature is trying to hold us to as police officers. It is time for the legislature and treasury to step up and show they have the integrity they profess to have. They need to remember that they work for the people and not the corporate interests of their vendors and hospitals.

We are continuing to attempt to negotiate with the administration, but their answer is continually to offer nothing but a one-year subsidy in exchange for draconian benefit decreases that will do nothing but shift the costs to our members and guarantee rate increases next year. They continually dismiss the hundreds of millions of dollars in actual savings that we as labor have proposed. Simply put, our government wants us to pay more to make their vendors and the hospital executives richer. There is just no other explanation.

Just to articulate what is on the table, here is the administration’s offer:

• a one-year, $100 million subsidy to mitigate the rate increase.

• a permanent $15 increase in specialist copays

• a permanent $40 increase in urgent care copays

• the elimination of Direct 10

• a permanent decrease of out of network to 175 percent of Medicare

• the treasurer will have the ability to come up with savings of $100 million additionally if the plan design committee doesn’t next year (incentivizes the governor’s appointees to shut down and not negotiate so they can protect their vendors and shift more costs to the employees instead of cutting actual costs).

As you can see, we are better off taking no deal than what the administration wants to shove down our throats. For an administration that professes to hold collective sacred, they seem to be acting more like the Christie administration.

But we are not rolling over. For the past several months, we have been working closely with other labor and now even management organizations to propose real savings. I am talking billions of dollars. And while I cannot disclose all the specifics to be proposed, it is time to take the record profits of the insurers and the hospitals to acceptable levels.

We have also entered a coalition that is going to expose the lack of hospital pricing transparency. The state commissioned a report that it will not release to the Plan Design Committee, although P.L. 2019 c.143 requires it to do so.

The coalition commissioned a white paper that shows that the state is overpaying hospitals by $1.26 billion dollars a year. That alone would be a rate decrease that would be a standard that no other publicly funded plan could claim.

At the League of Municipalities Conference, the principles of this coalition made an announcement. Finally, on Nov. 3, President Colligan sent a memo to the treasurer and demanded that the state’s vendor be held to its contract and make the payments that it is required to with regards to their price guarantees. The vendor missed the guarantees to the tune of more than $20 million in the last cycle with an almost flat rate increase, and the state hasn’t held it to the guarantees for this year. We anxiously await the response of the treasurer to this memo, but don’t hold your breath. The administration will continue to ignore us and all public employees so they can protect their colleagues in the health care sector.

There will be much more to follow, so stay tuned.