Despite costs, state and school districts favor current insurance plans over exchange

The state and school districts are sticking with their insurance even though moving to the marketplace could save taxpayers.

adutton@idahostatesman.comJanuary 26, 2014 

  • THE COST OF COVERAGE

    Monthly health insurance breakdown for a 42-year-old, single full-time worker who lives in the Treasure Valley, doesn’t use tobacco and doesn’t qualify for premium subsidies:

    Insurance provided by • Employee pays • Total monthly premium

    Boise School District • $40 • $535 • $575

    Meridian School District • $25 • $523.97 • $548.97

    Nampa School District* • $0 • $467.94 • $467.94

    State of Idaho* • $35 • $744.24 • $779.24

    A plan on Idaho’s health insurance exchange • $183.38 • $0 to $399 • $183.38 to $399

    * Offers two or three plans with different premiums and benefits. Price shown is for the plan most employees choose.

    ** Many plans would cost employees more out-of-pocket than those offered by school districts and the state.

  • THE COST OF INSURING A FAMILY, AND INSURING A FAMILY AS A PART-TIMER

    Your marital and parental status, as well as your weekly schedule, can make a world of difference in what you pay for insurance if you work for local or state public employers.

    For state employees, Idaho subsidizes the cost of health insurance for spouses and children. If you’re single and have no kids, your monthly premium for the state’s most popular plan is $35, while your co-worker with a family of eight pays $127. But it actually costs about $500 a month to insure you, and about $1,500 to insure your co-worker’s family.

    For most school district employees, there is less of a subsidy — a single Boise schools employee pays $40 a month, compared with $875 a month for a large family. The school district pays $535 a month for both of them. (There are times when districts chip in a larger share. For example, the Boise School District pays twice as much of the family premium when both parents work for the district.)

    Part-time workers have it rough. They pay a significantly higher premium across the board.

    For the most popular state plan, part-time workers pay five times more to insure themselves and more than twice as much to insure themselves, a spouse and children. The same is true at the local level. For example, Nampa school employees who work full time pay nothing for the most popular plan, while their part-time counterparts pay $233.56; for families, a part-time worker pays twice as much as a full-timer.

  • ABOUT AUDREY DUTTON

    Audrey covers health care for the Statesman. According to Box 12a on her latest W-2, Audrey and her employer paid a total of $4,478.16 for her health insurance coverage last year.

Pretend that you’re an Ada County man, 34 years old, with a wife and a toddler at home. You work for the state.

One evening after work, you’re chatting with your neighbor, who also happens to be 34 and married, with a toddler. The conversation turns to health insurance costs.

He works for the Boise School District, so he pays $725 a month for a plan that covers his family. Your mid-range family plan costs you $111 a month. The disparity is confounding. You’re feeling pretty good about your situation. He’s angry.

Then you get a dose of reality when you learn the actual cost of your family’s plan: more than $1,100 a month. State appropriations cover most of your costs. (Most state legislators are insured by the state-funded plans, too.)

Your neighbor’s plan through Boise schools? It costs about $1,260.

The monthly costs and the employees’ share vary widely among school districts and the state. The Treasure Valley’s largest districts require workers to pay more for a family plan — though, in some cases, they require less for a plan covering just the employee — than the state requires its workers to pay.

Nampa’s most popular family plan costs more than $1,100, and employees pay $405. Meridian’s family plan costs more than $1,300, and employees pay $792.

Nampa’s amount is not too far off last year’s national average for an employer-sponsored family plan. The total cost was $1,389 a month, and the average employee paid about $382, according to the Kaiser Family Foundation.

THE NEW OPTION: YOUR HEALTH IDAHO

The combined employer-and-employee costs for all three districts and the state are higher than what private insurers are charging on Idaho’s new insurance exchange. The most expensive plan, the “gold” plan, for a 34-year-old nonsmoking couple and a child costs $661 from SelectHealth, $670 from Blue Cross of Idaho, $792 from BridgeSpan and $888 from PacificSource.

So why don’t Idaho’s government employers move their workforces to the exchange, where cheaper plans would mean less cost to taxpayers?

That is something other places have toyed with. Cities such as Chicago are moving their retirees off government health plans and into exchanges. The legislature in Washington state last year considered moving part-time K-12 employees to exchange plans, with savings to the state estimated at more than $120 million — some of which would be picked up by federal taxpayers instead.

Other states are making pre-emptive strikes. Republican lawmakers in the Tennessee legislature introduced a bill this month to bar state and local governments, and possibly government contractors, from buying health insurance plans offered through the federal exchange, HealthCare.gov.

But Treasure Valley school districts and the state’s Department of Administration said they have no plans to move employees to the exchange.

Teresa Luna, director of the Department of Administration, said no one has even raised it to her as a possibility.

Meridian School District spokesman Eric Exline explained that the district’s insurance plans from Blue Cross of Idaho are still considered affordable under the Affordable Care Act. They have a $500 deductible and a $9,000 cap on out-of-pocket expenses for families.

“Insurance is expensive,” Exline said. “When I started with the district in 1998, the deductible was $100.”

ESCALATING COSTS

Health insurance is a growing burden for government employers and their workers, just as it is for private companies.

The Department of Administration expects medical and vision plans for state employees to cost more than $245 million in fiscal year 2014. Employee health insurance for Meridian’s school district will cost more than $16 million this year. Nampa’s will cost $9.7 million.

The premium for Boise schools’ Regence BlueShield of Idaho plan hasn’t gone up from last year, said spokesman Dan Hollar. It increased just once in the past four years, he said, attributing that in part to a “wellness” cost reduction that an employee earns by completing certain tasks.

The Boise School District “did have discussions about the state exchange” as an option, Hollar said. “We determined our employees are better served under our current insurance plan,” he said.

Employees could still opt to buy insurance on the exchanges. But anyone working full time for the state or the districts probably won’t. That’s because their employers’ plans meet federal rules for coverage: They don’t eat up more than 9.5 of an employee’s household income, and they’re designed to keep employees from going bankrupt over medical bills.

Because those workers are eligible for employer-provided insurance that complies with requirements, they don’t qualify for the law’s premium subsidies for low- and middle-income buyers. They would have to pay full price for plans on the exchange.

BUYER, BE AWARE

Not all health insurance plans are created equal.

Some plans historically have cost more because the people in their insurance pools are older and sicker. The health care law’s mandate for all Americans to have insurance was meant in part to make insurers’ pools larger and include more healthy young people, thus spreading around the impact of one person getting cancer, for example.

The average state employee, at 47, is about 12 years older than Idaho’s median.

Premiums are just part of the cost to taxpayers and employees. State and local school districts’ plans might charge workers less — or more — for a doctor’s office visit than does one of the Your Health Idaho plans. The deductible for most state employees is $250 for a single person. Most of the exchange plans have higher deductibles.

There is a type of plan sold on the exchange that has a high deductible but charges a lower monthly premium and allows the member to put untaxed income into a health savings account. None of the large Treasure Valley school districts offers such a plan. The state does — but despite its $17 monthly discount, hardly anyone wants it, officials said.

Audrey Dutton: 377-6448, Twitter: @IDS_Audrey

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