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Preventative care could lure state workers into Obamacare

abeam@thestate.comFebruary 15, 2013 

  • State health-plan options State lawmakers must decide whether the state health plan will comply with the federal Affordable Care Act, commonly referred to as Obamacare. A look at some of their options and the costs to taxpayers: If the plan complies with Obamacare, it will cost: $124.3 million if taxpayers pay for everything $102.3 million if state workers pay a 16.8% increase in their premiums $85 million if state workers pay a 20% increase in co-pays $70 million if state workers pay a 20% increase in co-pays and a 10.85% increase in premiums If the plan does not comply with Obamacare, it will cost: $102 million if taxpayers pay for everything $85 million if state workers pay a 13.05% increase in their premiums $53 million if state workers pay a 6.8% increase in their premiums and a 20% increase in co-pays $47.5 million if employees pay a 4.9% increase in their premiums and a 20% increase in co-pays

House lawmakers are considering making the state health plan comply with Obamacare, a move that would cost the state up to $124 million but also would pay for a host of preventative measures — like breast-cancer screenings — for the first time.

Lawmakers have before them nearly a dozen scenarios, each with varying costs to taxpayers and state employees.

“We can’t just, out of hand, dismiss it because it is Obamacare or if (Gov. Nikki Haley) doesn’t like it,” said state Rep. Jim Merrill, R-Berkeley, chairman of the House budget subcommittee that oversees the health-insurance plan that insures state, county and city workers as well as teachers. “We have to have numbers to back it up.”

The state health plan is growing and getting more expensive every year. It covers 530,000 people, or 11 percent of the state’s population. State officials also estimate the plan will owe retirees $10.1 billion for their health care over the next 30 years, but they have set aside only $477 million to pay that cost, less than 5 percent of what is needed.

Even if the state does not comply with Obamacare, taxpayers will have to come up with another $85 million just to keep up with the health plan’s rising premiums.

Complying with Obamacare would be more expensive — costing up to $124 million, depending on how much of that cost state employees pay — because, in part, it would force the state to pay for at least 49 preventative health screenings. But paying for those preventative screenings could help reduce the state’s health-care costs in the long term, which is why state lawmakers are considering the option.

“Anytime you can get on the front end of a disease or illness, you can save a lot of money,” Merrill said. “But it is also hard to quantify that. You can say you have prevented something, but how do you know that person would ever actually develop X illness in the first place? The actual quantification of that would be very difficult.”

One way lawmakers could pay for the screenings is to pass the cost on to state workers. If lawmakers increase employee co-pays by 20 percent and employee premiums by 10.9 percent, it would cost $70 million to comply with Obamacare.

On the other hand, if lawmakers don’t comply with Obamacare and they increase employee co-pays by 20 percent, it would cost the state $54 million to pay the cost of rising premiums alone.

Carlton Washington, executive director of the South Carolina State Employees Association, urged lawmakers to “take the route that provides the most coverage” but is “less punitive to employees.”

“It is very disappointing that (lawmakers) have not had one conversation with the State Employees Association or the Education Association about this issue, particularly since it affects our members,” Washington said.

State Rep. Harry Ott, D-Calhoun, one of the senior Democrats on the House budget committee, said he supports paying for the preventative health screenings. If lawmakers also would pay to give health insurance to more poor people — one of the options under Obamacare — it would keep health-care costs down for everyone, he added.

“If we have all these uninsured people in South Carolina ... then I’m afraid that hospitals are going to start charging even higher rates to those people that have insurance,” he said. “That means all state employees will see another increase in their insurance premiums. I think that is one of the bad consequences of not getting into the Affordable Care Act health care plan.”

Gov. Nikki Haley — who would have to sign off on any changes to the health plan as part of the state budget — said again Thursday she opposes adopting any part of Obamacare.

“We’ve said all we need to say,” she said. “Now, we’ll wait and see what the Legislature does.”

Reach Beam at (803) 386-7038.

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