After meeting stiff resistance from more than 100 of the state’s hospitals, state Treasurer Dale Folwell recently dropped his plan to change how the state reimburses hospitals for medical coverage of state employees.
The drama between the Republican official, state legislators and hospitals had put schoolteachers in middle. For several tense months, they were at the center of a larger political battle playing out in state government. It was a sadly familiar position for the women and men we trust with our most valuable resource, children. They were potentially facing, at the top of next year, steeply higher prices for medical coverage under the State Health Plan.
Folwell had proposed price changes under his Clear Pricing Plan that would empower the state to set rates based on Medicare. Currently the Health Plan reimburses Blue Cross Blue Shield, which administers the plan, for the employees’ medical expenses.
Folwell contended the current model contains lots of hidden prices for consumers and taxpayers, and that ultimately, the current Health Plan is not sustainable in the long run.
Hospitals resisted his Clear Pricing Plan, which they said would leave them short and having to cut services for patients. Only five of the state’s 120-some hospitals signed on, and no major hospitals, though several said they were willing to continue to talk with Folwell.
They did more than talk, however. The situation came to a head when the hospitals missed a second deadline last Monday to sign up to provide in-network coverage for employees in the Health Plan.
If the standoff had continued, it would have meant that as many as 97 percent of teachers would be forced to pay out-of-network health care medical expenses. For anyone on an insurance plan, the mere words “out-of-network” conjures up images of big bucks fleeing family wallets.
After a few days, Folwell blinked. He announced State Health Plan coverage would carry on like it has been, and employees would have in-network coverage. Employees with coverage from the hospitals that signed up for Clear Pricing would also have a choice of benefits under that plan. Folwell called the hospitals that backed him “courageous.”
Teachers were spared a new worry. … It was not just them concerned, either. Among the 727,000 covered by the Health Plan are retirees, current and former lawmakers and university and community college employees.
Although Folwell was foiled this time, he does raise legitimate issues of transparency and excessive health care plan costs, which are borne by taxpayers. A year or so from now, we hope all parties are ready to sit down and chart a course toward a sustainable plan for the future.
We would also like to see this happen without the go-for-broke tactics that too often define negotiations in our state’s politics. Specifically, we weary of seeing schoolteachers continue to be used as a handy political football in the General Assembly’s Republicans vs. Democrats grudge match. You’ll recall they are also part of the current budget impasse between Democratic Gov. Roy Cooper and the Republican-controlled legislature, where the two sides disagree over teacher pay raises.
Our teachers got a break this time. Let’s make that the rule, not the exception.
— The Fayetteville Observer