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Retiree-benefotsLegislative staff pitched a policy solution to lawmakers on Monday that could reduce the state’s $25.5 billion unfunded liability associated with the Retiree Health Benefit Fund by 11.8 percent, producing a larger cost savings than the Senate’s proposal to eliminate retiree health benefits for all teachers and state employees hired after January 1, 2016.

The fix? Shift some of the costs associated with providing fully funded retiree health plans to the federal government. Going that route would require all retirees to enroll in Medicare Advantage plans—and by doing so, retirees shouldn’t be expected to bear more out-of-pocket expenses and the state would save $64 million annually, reducing the total unfunded liability by about $3 billion.

The Senate, on the other hand, wants to address the unfunded liability by eliminating retiree health benefits for new hires beginning in 2016. Some say this option will unfairly shift more costs to the worker and could hurt recruitment efforts, while producing an estimated smaller cost savings of 10 percent as opposed to the 11.8 percent that would come with enrolling retirees into Medicare Advantage plans.

For the full story, head on over to our main site. And you can read the legislative report below.

News

A few short lines in the 2015-17 Senate budget would eliminate state-paid health retirement benefits for teachers and state employees hired after January 1, 2016.

“This will negatively impact the state’s ability to recruit good, qualified folks,” said Richard Rogers, executive director of the North Carolina Retired Governmental Employees’ Association. “In the future, I don’t see folks sticking with state government for the long term or for a career.

Current law provides teachers and state employees with a paid health insurance plan for the duration of retirement. It’s a graduated system, said Rogers, so employees must work a certain number of years in order to receive the maximum benefit of a fully-paid health insurance plan.

The Senate budget provision, located deep in the biennial proposal that was released and passed by Senators this week, would affect teachers and state employees who join the workforce after January 1, 2016 by eliminating the health insurance benefit altogether.

senatebudget

The provision also affects those who stop out of the workforce and withdraw their retirement benefits from the state system, then re-join the workforce after January 1, 2016. Those state employees would also forfeit their retiree health insurance benefits.

The retiree state health plan provides health care coverage to more than 685,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, state hospital staff and their dependents, according to the plan’s website.

The General Assembly is expected to spend the rest of the summer hammering out a final 2015-17 budget for the state. Stay tuned to see if the Senate’s proposal to axe retirement health benefits for teachers and state employees makes it past the cutting room floor.

Commentary

We have written before about King v. Burwell, the case that will be heard before the US Supreme Court to determine whether or not health insurance subsidies can flow to states that refused to establish state-based marketplaces under the Affordable Care Act. As John Stewart has noted, justices would have to be more literal than Amelia Bedelia to find for the plaintiffs, but we live in strange times where anything seems possible.

The next question then is if the Supreme Court strikes down subsidies how many people would it impact? Now Kaiser Family Foundation has a helpful interactive map to estimate an answer. KFF researchers think more than 13 million people nationally, and about 1 million people in North Carolina, would lose tax credits if the Supreme Court denies subsidies to federal marketplace states. For most of these folks insurance would immediately become unaffordable. This is especially true because prices would most likely spiral upward as younger, healthier enrollees lose coverage.

That is a stunning figure. It would be like the Supreme Court cutting the number of North Carolinians receiving Medicare in half.

The cruel truth is that Congress could easily fix this problem by adding a few words to the Affordable Care Act, but they are so obsessed with repealing the legislation that they are unlikely to repair it. The state legislature could also provide a patch by at least establishing a governance structure for a state-based marketplace, but they are also unlikely to move. After all, the federal government stands ready to pay the state to expand insurance to 500,000 more state residents and that hasn’t gained any legislative traction.

So, we wait, while medical care for 1 million North Carolinians hangs in the balance.

Commentary

healthcare.govIf you don’t have affordable health insurance through an employer then now is your chance to shop for a plan on the individual market. New options are now available and many people can get help paying premiums. In fact, in 2014 more than 90 percent of people who enrolled in an insurance plan through healthcare.gov in North Carolina received financial assistance, and of this group the average premium was $80 per month. This is for a comprehensive policy.

The current open enrollment period  stretches until February 15, 2015, but if you want your benefits to start on January 1 then today is the day to purchase a plan. This is true no matter when you bought insurance in 2014.

The website is working smoothly these days but you don’t have to navigate the process by yourself. Plenty of health insurance agents are ready to assist you. Also, application counselors and navigators based at nonprofits around the state can help. They are all volunteers or grant funded and have no financial incentives to steer you toward any particular company or plan. You can check out this website to find help in your area. You can also call 1-855-733-3711.

It is especially important to shop around even if you bought a policy. If you don’t actively switch plans then you will be automatically reenrolled. But with new options and more companies competing in the state reenrollment is unlikely to get you the best deal. As with most products, you need to shop around.

Another reason to buy a policy today is that you aren’t stuck with the plan you choose. To prevent a gap in coverage you can purchase a policy now and continue investigating your options during open enrollment. As long as you act before February 15 then you can opt for a different plan. Last year once you chose a policy you were stuck. This year you can change plans during the entire open enrollment period.

Unfortunately, many people trying to obtain coverage will discover that they fall into the Medicaid gap in North Carolina. Because the state legislature has refused to expand Medicaid working families earning less than 100 percent of federal poverty level may still find coverage unaffordable, and they won’t get help paying premiums. If our lawmakers choose to act in the next legislative session then most struggling citizens will be able to obtain comprehensive insurance.

 

 

Commentary

childrenAs enrollment begins again, on Saturday, for Affordable Care Act health insurance, it is crucial to note that an important population—children—are still often uninsured. More than five million children in the United States lack any form of health insurance.

In North Carolina, this is particularly a problem within the Hispanic population. The state ranks among the top ten states with the highest number of uninsured Hispanic children, according to a joint report put out by Georgetown University’s Center for Children and Families and by the National Council of La Raza. The report found that 12.5% of Hispanic children in North Carolina are uninsured, which is higher than the national average of uninsured Hispanic children. Nationwide, Hispanic children tend to be twice as likely to be uninsured than their white non-Hispanic counterparts.

Contrary to popular belief, immigration status is not the main reason that these children don’t have health care coverage. The majority of Hispanic children in North Carolina are U.S. citizens and are eligible for a program such as ACA, Medicaid, or the Children’s Health Insurance Program which would provide them with health insurance at an affordable cost to their families.

The real barrier to enrollment in health insurance for Hispanic children, according to the report, can often be their parents’ limited English proficiency. A study found that more than one in eight Hispanic children, between the ages of 5 and 17, live in a household where English is spoken “less than well.” A parent with limited English proficiency may not be able to make it through a health care application in English which then results in an eligible child not getting health insurance.

Along with making Spanish language applications available for all health care programs in North Carolina, there needs to be an emphasis placed on educating Hispanic families about health care options for their children and assisting them with the enrollment process. The health care insurance options are available, we just need to do our part in getting these kids signed up.